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.”