Reforming health care

January 9, 2002

Garbage In, Garbage Out - Public Policy in Alberta

Asking which pocket pays misses the point Premier Klein's Advisory Council on Health reported:

"If we restrict ourselves to a system where all the funding comes from provincial and federal taxes we have little choice but to ration services - and Albertans deserve better. We can't sustain a system where people are told: these services or treatments are available, they will diagnose health problems, cure illnesses, and make your life better, but they cost too much so you can't have them."

From that premise (garbage in) they concluded that universality of Medicare needed to be redefined (benefits had to be excluded) and more private payments had to be allowed (garbage out).

If necessary health care costs too much, how is it made any cheaper by shifting the costs onto sick people? The Alberta health report is a political treatise on the role of the public sector from people who appear to prefer lower taxes to healthier populations.

The Alberta report said:

"Currently, the health sector is viewed primarily as a cost centre consuming vital tax dollars. In reality, the health sector is a driving force in Alberta's economy. With new sources of revenue and expanded opportunities for organizing and delivering health services, the health sector has the potential to add considerably to Alberta's economy and help expand the province's reputation as a world-wide centre of research, expertise and leadership."

Think for a moment about that world view. Health is a cost centre if it is publicly insured but it is a driving economic force if it can collect private payments - what nonsense!

Those who read the Alberta report will recognize similarities with some recent statements out of the Campbell government. On regional health authorities, the Alberta report called for "Establishing multi-year contracts between the province and health authorities setting out performance targets to be achieved and budgets to be provided." That looks very similar to the rhetoric from BC's Health Ministers when they appointed new regional health authorities.

Provincial governments that deny responsibility and shift costs do not help to improve the health system. We are in this together. Any problems have to be solved not only for the provincial governments but also for the millions of users of the health system. An aging population, technological change and increasing chronic illness all drive up health care costs. Earlier death is cheaper but no one is blunt enough to say that their alternatives lead to that end. Wouldn't we all be better off by paying more while we focus on health outcomes? Even if it is done in the public sector, aren't better health outcomes a "driving force in the economy"?

Let us hope that the political virus that got lose with Alberta's report doesn't spread to BC.