The Seniors Action Liaison Team had the opportunity to present to Alberta Health Minister Iris Evans for half an hour on March 13, 2006.

This is a copy of the presentation they delivered. To provide feedback to SALT please click here and we will forward your comments to them.

Madam Minister,

My name is Noel Somerville. I am a Vice Chair of the Seniors Action and Liaison Team (SALT) and a member of the board of Public Interest Alberta. This presentation is made on behalf of both organizations. There are several points we want to make about the Health Policy Framework.

First, we reject the premise that public health care costs are unsustainable. The dramatic growth rates that have occurred following the radical cutbacks of the mid nineties create a misleading picture. Yes, these costs are growing and will continue to grow, but when growth patterns are viewed over the longer term, we believe they remain a relatively stable percentage of the provincial GDP and in that respect are quite sustainable. In the interest of a meaningful consultation on the proposed health care reforms, we request that your department publish information on Alberta’s annual public health care expenditures as a percentage of Alberta’s GDP for each of the past twenty-five years.

What we do believe to be unsustainable is the ideology that government should get smaller and smaller, tax cuts should get larger and larger, and that privatization is the means to accomplish these ends. In our view, privatization is a major part of the problem, not the solution, to controlling costs in the health care system. The areas in which costs have grown most steeply are those that are almost exclusively in the hands of private and corporate interests – pharmaceuticals and technology. With respect, Madam Minister, we do not believe that your government has a mandate to preside over the dissolution by privatization of our most cherished social services.

Secondly, we reject any reform of our health care system that allows access to necessary medical services on the basis of ability to pay rather than on the basis of need. Our health care system represents a huge investment of public money in the institutions to train doctors, nurses and other healthcare professionals, in the cost of building and maintaining our hospitals and equipping them with the latest technology, and in the cost of government-funded medical research. Having collectively paid for this system, we are all entitled to access on the basis of need. It violates any standard of fairness that preferential access should be granted to the wealthy or those fortunate enough to qualify for individual or group health insurance plans.

Third, we reject the proposal that allows doctors to practice in both the public and private systems. To do so creates a conflict-of-interest in the doctor/patient relationship, makes queue-jumping inevitable and may encourage doctors to perform lucrative but unnecessary procedures. If doctors have two sets of patients, one paying and one not paying, preference will obviously go to the paying patients and the non-paying will face longer wait times and second-class status in the system that we have all funded. People weakened by severe pain or ill health are extremely vulnerable to manipulation; what such people are interested in is not ’choice’ but treatment and a cure.

The Health Policy Framework places great emphasis on choice. Choice is a great thing when shopping for a car or a pair of shoes. But the fact is that a great deal of choice already exists in the health care system. Doctors are free to opt-out of the system and set up whatever type of practice they want. People with money are free to seek treatment wherever and whenever they want. One has to wonder, however, about those who are old, frail, ill, have pre-existing conditions or even genetic pre-disposition to illness. These people don’t have choice, and private insurance will not give them choice because they can’t qualify for coverage nor afford the premiums.

Fourth, we reject reforms that undercut the huge economies of the single-payer national health insurance system by introducing private insurance for medically necessary services. Such a move is counter-productive to the primary objective of improving the efficiency and sustainability of our health care system. It will lead to massive, non-productive expenditures by private insurers in advertising and claims adjudication and will impose huge additional costs on hospitals and clinics that have to employ bean-counters to track every service to know which insurer to bill. A recent statistic from the Harper Index quotes a study by a researcher at the University of California, San Francisco, who estimated that, if the USA adopted a single-payer health care system, the annual saving on paperwork alone would amount to $161 billion.

Again, it would really promote a meaningful consultation if your government were to estimate the costs resulting from the proposed health care reforms on the following:

• the cost to government and corporations of additional health insurance for employees, costs that will be subsidized by consumers, many of whom cannot themselves access such insurance;
• the loss of competitive advantage to manufacturing industries that will have to finance a larger range of health benefits at a time when their competitiveness is already threatened by the rising value of the Canadian dollar;
• the additional costs for self-employed people like farmers and small businesses that can’t qualify for large group insurance rates.

Finally, we oppose any framework for change that sidesteps the democratic process and provides for the health care system to be governed and reformed by regulation rather than by legislation. Substantive changes to regulations can and have been implemented by Orders-in Council, completely circumventing the accepted principles of parliamentary democracy.

We do not, however, oppose genuine reforms in health care delivery:

• initiatives that promote safety and wellness;
• reducing the cost of prescription drugs by bulk-purchasing either on the provincial or national levels;
• primary care centres that give patients access to a team of health care professionals such as nurse practitioners and pharmacists to reduce the pressure on doctors;
• the management initiatives within the public system such as those that have been so successful in reducing waiting lists for hip and knee replacement at the Bone and Joint Institute of Edmonton.

What we want is a continuation of initiatives such as these that will make the public health care system more efficient and cost-effective.

What we want was neatly summarized in the undertakings that Premier Klein made in his television address to the province on November 16, 1999 when he said:

• “For as long as I am Premier, there will not be any so-called two-tiered American–style health care in our province.”
• “There will be no facility fees or queue-jumping or direct billing in the Alberta health care system of the 21st century.”
• “No Albertan will pay for insured medical services and nobody will be able to pay to get faster service.”

With so much written about Ralph Klein's Third Way for providing health care in Alberta, the staff at Ralph's World has combed the media reports to bring you the two articles that we feel best represent the opposing sides of this issue.

In order to appeal to all Albertans, and not just those interested in health care, we have chosen to display the picture at left. It is our hope that those of you attracted by the picture may also read the articles. For those that take offence, we apologize for our crude methods.

Supporting Premier Klein and the Progressive Conservative party is:
Paul Jackson - Calgary Sun Columnist with his well-reasoned article entitled Freedom healthy.

Supporting Kevin Taft and Brian Mason and the Opposition parties are:
Colleen M. Flood, Canada Research Chair in Health Law and Policy, University of Toronto
Terrence Sullivan, President Cancer Care Ontario
Steven Lewis, President, Access Consulting Limited, Saskatoon
Noralou Roos, Canada Research Chair in Population Health Research, University of Manitoba
Dr. Tom Noseworthy, Director, Centre for Health and Policy Studies, Calgary
Their opinion piece is Top ten reasons against two-tier medicine in Canada.

Have a look at both and see what makes the most sense to you. Let us know what you think by dropping us a line.

This classic Catch-22 was sent in by a Ralph's World reader from St. Albert. The following is from a letter that she sent to her MLA looking for advice.

Now that my gas bills are running around $300 per month, this warmest winter ever in the Province of Alberta, I am motivated to quit dithering and try to wrestle a furnace replacement subsidy out of the (unwilling?) hands of the Government of Alberta.

To that end I just called gov-ab seniors' information- to ask if there were any new twists-and-turns in the application procedure. Well, there's a dandy. And I need your advice.

I spoke with an advisor (no sense in asking for a name for they're "not required to provide that information"). My question was: "What is the procedure for applying?". The answer: get a form; fill it in; get quotations, provide copies; and "provide a copy of a letter from the gas company saying that your furnace is unfit"; mail it all in to us. *EEEK!*

As I am sure you know, gas-appliance inspection requires a gas-fitters' ticket. And for some years now, there has been a regulation in Alberta that a gas-fitter who finds that a gas furnace is in any way a possible danger is required to turn the furnace off, and also to lock it down in such a way that the owner cannot restart it.

So, do you see the picture? The poor senior, eaten alive by gas bills who only wanted a letter, is standing in a cooling house. By tomorrow, her house may be frozen solid. Nothing to do but call for (frightfully expensive) emergency action.

So I explained that to the advisor. Then the schpiel changed substantially. Quoting from her "answer-book", she said that..well, we'll need a letter saying your furnace is unfit either from the gas company or from a contractor. I told her thanks and rang off.

So you see, they're fooling with us again (still?). And I have no idea how to proceed.

Will you please suggest how a senior is supposed to navigate this minefield?

Deane Doucette,
St-Albert

Dateline March 3, 2006 - RW NewsWire - Edmonton

Stung by opposition criticism that one month was not enough time for Albertans to provide input to the new Third Way" health initiatives, Premier Klein has ordered Health Minister Iris Evans to implement major enhancements to Alberta Health's Online Public Consultation System.

"The system has to provide instant feedback to those Albertan that take the time to help me build a better and brighter health care system" the Premier said. "We only have a month to get this done so we need to get on with it."

We are pleased to announce that Ralph's World Political Polling Systems, a division of Ralph's World International, has been awarded this important contract.

The picture at left shows Health Minister Evans walking the Premeir through a prototype of the new system.

We are asking all Albertans to try out the new prototype using the following link.

"Third Way" On-line Consultation System

Please provide any feedback you may have to Ralph's World Political Polling Systems, Health Minister Iris Evans, or Premier Ralph Klein.

Premier Klein and his faithful sidekick Iris Evans have together conceived a new 18-page white paper entitled Health Policy Framework along with a spanking new webpage to explain it all to us rubes.

This is the legendary "Third Way" for Alberta health care that the Premier has been teasing us with for the last few years.

For an overview of what it's all about you might want to read "Klein moves to gut medicare" - an article by Thomas Walkom in the Toronto Star.

The Premier's happy face took a distinct downturn in the legislature yesterday as he hurled a copy of the Liberal Health policy booklet back in the face of the 17 year old female page who had just delivered it from the Liberal benches. The Premier had asked for their input. When it was provided it he had his tantrum and called it crap. Don't believe that the Premier of our Province could be that childish; that out of control? Read all about it here.

You have to hope that the Tory faithful will do the right thing at their upcoming leadership review.

John Clark, the most prolific contributor to Ralph's World of late, has decided to create his own weblog. He has asked that we remove his postings which we are in the process of doing. He plans to re-post a number of these on his new site.

John's new weblog is called "Alberta -- The Details" and is located at http://www.albertathedetails.blogspot.com/.

The management and staff at Ralph’s World wish John the best of luck with his new site and thank him for his many contributions.

Keep on blogging John!