Leadership is needed to introduce proven public solutions to strengthen our public health care
Today’s health policy announcement from Jason Kenney, leader of the United Conservative Party, made clear that he and his party are not interested in finding public solutions to improve and expand our public health are system. Kenney presented Albertans with the UCP’s “Surgical Wait Time Reduction Plan,” and confirmed that if elected, his party would introduce policy to mirror the Saskatchewan Surgical Initiative. He touted their achievements and successes; however, he did not disclose how much money they would need to invest in contracting out and privatizing public surgeries, nor where this money would be coming from.
He also failed to mention that from 2009 to 2014 the Saskatchewan government spent $176 million to create its private surgical facilities, and another $60.5 million on operating costs in 2015. While these facilities initially saw a decrease in the province’s surgical wait times, once government funding significantly slowed, the wait times have been steadily climbing. Targeted funding has now run out, but these clinics continue to exist without adding a long-term solution to wait times.
A report released today by the Canadian Institute for Health Information, “Benchmarks for treatment and wait time trending across Canada,” indicates that the percentage of Saskatchewan patients who received hip replacements within national wait time benchmarks decreased significantly between 2016 (80%) and 2018 (66%). The report also found that the percentage of knee replacements that met benchmarks decreased from 77% to 66% in the same period. According to this data, Alberta in fact has shorter wait times than Saskatchewan for hip and knee replacements, hip fracture repair, and radiation therapy.
“This is a perfect example that private solutions to a public problem is the wrong direction for governments to take,” said Sandra Azocar, Executive Director of Friends of Medicare. “We need systemic changes that will address issues of wait times, but they must be in line with the vision of improving on the solid foundation that we already have within our public system. True leaders learn from the mistakes of others, and we should be looking at finding solutions that take into consideration Alberta’s resources and system capacity.”
What is not considered in announcements like these is the toll that incremental privatization has had on our health care over the years. Provincial governments, including Alberta’s successive PC governments, have gutted the Canada Health Act a bit at a time through policy and regulation. Deeming diagnostic imaging to be non-insured; deeming people non-insured in other provinces so they can pay cash for preferential access in private clinics; allowing concierge/private clinics to set up in the first place – each decision was a clear violation that was simply imposed, to the detriment of our public system. Much needed essential services, such as medications, mental health care, home care and long term care, have become increasingly less accessible in recent years due to growing costs and privatization. The consequences of this inaccessibility are evident in prolonged hospital stays, overburdened ERs, and surgeries that are not done in a timely manner.
There has always been a considerable political pressure on Alberta governments to find ways to reduce costs in health care. However, in their efforts to find ‘savings’, governments often focus on structural change, rather than clinical care. When speaking about health care, Alberta still has the lowest debt-to-GDP ratio of any province. Many would argue that a provincial government should spend according to its means, and that jurisdictions with greater means should invest more in public spending – under this logic, Alberta has an opportunity to invest considerably more in public services. But this investment needs to be smarter and based on the principles and values that underlie our single-payer health care system.
We don’t need private solutions to public problems like wait times. We need more transparency and accountability as to where our health care dollars and resources are being allocated, and we need to know the impacts of contracting out and privatizing integral parts of our health care as in the case of home care, seniors care, diagnostic imaging and surgeries. “Our health care system has the capacity to provide the best care possible. What we are faced with is the problem of how to properly manage our resources in order to improve and expand our health care, and to ensure quality and timely care for all Albertans,” states Azocar. “Contracting out will only add to the complexity and inequity of the system.”
Collectively, Albertans have the responsibility to understand that election 2019 is a referendum on who you can trust to take care of you and your loved ones. The challenge is to sift through the rhetoric being spread to see that privatization is being presented as an option to solve public issues, despite countless examples to the contrary. “Any time health care announcements are released by political parties, Albertans need to ask themselves if what is being proposed reflects the values of public health care, embraces clear provincial standards to improve access to care and if it establishes ways of assessing quality of care,” states Azocar. “Anything else is just talk and empty promises.”