After months of waiting and guessing, the provincial government finally released their “third-way” healthcare reforms on Tue., Feb. 28. The plan calls for some privatization of health services and will encourage the use of secondary insurance to cover certain procedures. Debate began almost immediately on the merits of the proposal, and the province wants Albertans to respond. Many question whether these changes will address the core problems plaguing the health system.
“Capacity is the main problem,” said Dr. Guido Van Rosendaal, a physician and University of Calgary medical professor. “There isn’t enough infrastructure and personnel to address the demand.”
Dr. Van Rosendaal explained that most healthcare workers are currently working at capacity.
“When you start talking about privatizing the human resource sector of healthcare, it’s not something that you can expand,” said Dr. Van Rosendaal. “If there aren’t enough people when you start privatizing your services you’re not increasing capacity, you’re just redistributing care.”
Dr. Van Rosendaal does approve of certain aspects of the plan, however, specifically the province’s proposal to change the scope of healthcare practice.
“You can expand capacity by using what you have more effectively,” he said.
Others have difficulty making sense of the proposal because it provides few specifics.
“For a policy that has been discussed for literally years, it’s awfully thin on details,” said U of C political science professor Dr. Lisa Young. “It’s difficult to debate the substance of this because it is so vague.”
Young believes the response from Albertans will be mixed.
“On the one hand, there is a sense that healthcare is facing some pretty serious challenges and innovation is needed,” said Young. “But my sense is that there is going to be a lot of negative reaction, and not just from the opposition parties. There is a lot of Ralph Klein’s natural constituents, like blue collar workers, people in rural communities and those getting older, who are going to be worried about what this means.”
Many wait to see what the response will be from the newly elected federal government, especially as it pertains to the Canada Health Act.
“It probably doesn’t stay within the boundaries of the Canada Health Act,” said Young. “But the bounds of the Canada Health Act have not really been tested and the federal government has not enforced it consistently over time.”
Young said some Albertans will wonder why systemic reform is needed when the province is in such an enviable financial position.
“Because of the oil revenues, we could afford to spend more on healthcare,” said Young. “But times may not always be so good, and a long term solution needs to be in place. When you look at the projections for healthcare spending in the next 30 to 40 years, provinces entire budgets could be swallowed up by the healthcare cost of keeping our aging baby-boomers healthy. There is an issue of inter-generational disparity here; if we give the money to healthcare it won’t be there for education and infrastructure.”
One of the goals of the province is to share the burden of healthcare with others, either through individual payment or private insurance.
“The cost will shift to industry,” noted Dr. Van Rosendaal. “Private insurance is usually provided by employers as something gained through collective bargaining, and while some businesses pick up the tab for their ill employees, other businesses stand to reap the benefits of ‘for-profit’ healthcare.”
Dr. Van Rosendaal argued the plan will mark a huge shift in healthcare policy, regardless of the outcome.
“If you reduce the input of government, then there is a chunk of the population that is going to have to pick up more of it on their own,” he explained. “The sustainability, and by that I mean the affordability, for people of limited means is going to deteriorate. If we start privatizing essential services, it is a dramatic point of change, it’s a whole new health system. It’s hard to do it just a little bit, once we make the philosophical commitment there is the potential for things to be drastically different.”
“This is a major event in Canadian health,” he said.