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Alberta’s health care system has arrived at a critical crossroad. Despite massive annual increases in health spending, waiting lists are at all time highs, patients are left languishing in emergency rooms for hours and sometimes days, finding a family physician is increasingly difficult, and many seniors find it impossible to secure the care they so desperately need.
The PC Government continues to mismanage health care. They have squandered millions of dollars on executive health salaries and bonuses for chronic underperformance. They have centralized control of health care in a massive Health Superboard bureaucracy that has been unresponsive to local needs. They have broken contracts with our most effective health care providers, subjected our health care professionals to intimidation and censorship, and misallocated billions of dollars on projects that are unable to open due to unavailable operating funds and staff shortages.
To be clear, once patients gain access to the system, our doctors and nurses provide treatment that is second to none. However, being forced to wait weeks, months and sometimes years for access to needed health treatments is not health care, it’s a prison sentence that thousands of Albertans are suffering through each and every day.
Alberta’s health care system can be fixed, but we cannot continue to allow the PC Government to repeat the same flawed strategies and expect different results. Reforming health care will take honest and principled leadership. It will take a new government working cooperatively with Albertans and health care professionals to do what is necessary to build a health care system that puts Albertans first. The Wildrose is ready to be that government.
Universal Public Health Insurance
Albertans want access to the health care they need. Albertans do not want a U.S.-style health care system that leaves millions uninsured. It is critical that any proposed health reforms for our province comply with the five key principles of the Canada Health Act – namely that health insurance coverage is publicly administered, comprehensive in scope, universal, portable among provinces and accessible.
Unfortunately, many special interest groups and political parties have used the obvious flaws inherent in the U.S. health care system to actively scare many Albertans into resisting critically needed health reforms. This has resulted in one of the least accessible, least flexible and most expensive health care systems in the developed world.
The fact is the most effective, sustainable and patient-centred health systems in the world are not found in Canada or the United States; they are found in Western Europe. Countries such as France, Austria, Belgium, Germany and Switzerland all deliver world class universal public health care to their citizens; and they do this while spending less per person on health care than we do. These countries, and others, are able to accomplish this by fostering a culture of patient choice and accountability and providing competition within their publicly funded health system.
We cannot continue to allow the voices of the status quo to keep our province from doing what so badly needs to be done. Failure to change our direction on health care will result in a bankrupt system with ever-growing wait times and increasingly poor health outcomes.
Get it Right
Albertans deserve better. A Wildrose Government will implement the following principles to ensure Albertans have timely access to world class health care:
- Uphold the five key principles of the Canada Health Act, namely that health insurance coverage is publicly administered, comprehensive, universal, portable and accessible.
- Foster a culture of patient choice and competition by giving Albertans the right to use their public insurance to obtain needed treatment at the public, private or non-profit health provider of their choosing.
- Look to model Alberta’s health care system after successful European systems that have substantially shorter waiting lists and higher patient satisfaction while maintaining universal health insurance coverage for all.
Decentralized Health Care
With each passing week, it becomes increasingly clear that the PC Government’s decision to place control of health care delivery in the hands of a massive centralized Superboard has been a mistake.
Under Alberta Health Services (AHS), the health budget has skyrocketed, waiting times for cancer treatments and emergency care have increased dramatically, access to hospital beds has worsened, and local communities and hospitals have been stripped of any and all decision-making related to their unique health care needs. Despite these problems, millions in performance bonuses have been paid to an ever growing number of health executives.
Meaningful health care reform is extremely difficult at the best of times, but it is made infinitely more challenging by the AHS’s neglect of our frontline health care staff. Instead of consulting with local doctors, nurses and other health care professionals who understand exactly what needs to be done to improve local health services, AHS has instead created layers of cumbersome bureaucracy making timely decisions and improvements impossible.
AHS has even imposed restrictions on its employees who want to publicly disclose ways in which the health system can be improved. And despite an official reversal of this policy by AHS, health care staff continue to express fears of retaliation should they dare to speak out. It is hard to understand how we can improve health care when front line health practitioners feel unable to inform Albertans (and their representatives) of needed improvements.
Centralizing the administration and delivery of core social programs does not work – it never has. If we centralized control of all food production and delivery in the hands of bureaucrats at the Legislature, long lines, high prices and shortages would inevitably result. Health care is no different.
Get it Right
Albertans deserve better. A Wildrose Government will work with front line health care workers to return health care decision making back to the local level by implementing the following measures:
- Gradually decentralize the delivery of health care services to locally funded, managed and integrated hospitals, Primary Care Networks, family physicians, specialty centres, long term care facilities, chronic care programs and other health services. This will enhance and incent a proper continuum of care for patients and allow for flexible innovation to address unique local needs while meeting established care standards.
- Overhaul bonus incentives for health care managers and workers to ensure that reasonable bonuses are awarded only to those that have had a direct effect on measurably improving the quality and efficiency of the health care system.
- Immediately remove any clause in the current AHS Code of Conduct that might act as a deterrent to the ability of health care professionals to voice their ideas and concerns regarding health care.
- Work closely and cooperatively with front line health care professionals to ensure needed changes to the health care system are practical and effective. This should include the establishment of an advisory panel of qualified health care professionals that will meet with the Health Minister at least once every 2 months to act as an early warning system for health issues that need to be immediately addressed.
- Establish a fully independent Health Ombudsman to help Albertans anonymously deal with problems and barriers encountered in the health care system. Currently, patients facing such challenges have no effective recourse.
- Redirect funding to health education programs that assist Albertans (especially those for whom English is a second language) to better understand the most appropriate and effective ways to access the health care system.
Patient-Centred Service Delivery
The most fundamental flaw of Alberta’s health system is the lack of choice and competition in the delivery of health services.
The provincial government has created a monolithic public delivery monopoly wherein there is virtually no competition for patients; no incentives for providing effective service or excellent treatment; and no reason to run hospitals or utilize operating rooms more efficiently. Is it any wonder why emergency rooms are in crisis?
Choice and competition between health care providers is the key to solving these problems. In many cases, well run public hospitals will provide patients with the best and most timely treatment.
In other instances, independent non-profit and private facilities will be able to treat patients more effectively and efficiently. As long as the needed service is publicly paid for and done safely, it shouldn’t make a difference whether an operating room is run by a public hospital or private surgical centre.
Get it Right
Albertans deserve better. A Wildrose Government will ensure that Alberta’s health care delivery is patient-centred, and that wait times for specialists, procedures and emergency room care are significantly decreased by implementing the following policies:
- Significantly reduce wait times for specialists and medical procedures by opening delivery of publicly paid for health services to any accredited private and non-profit health service provider. If a private or non-profit provider can deliver the same or better quality of care, more quickly and at a reduced cost to government, that provider should have the opportunity to compete with the public sector for each and every patient.
- Introduce a health care funding model in which public, private and non-profit health service providers and facilities are compensated according to the quality and timeliness of the care they give, and guarantee Albertans the right to select the health provider and facility of their choice. Many Western European health systems have proven that building a culture of patient choice, competition and accountability within a public health insurance system successfully incents hospitals, emergency rooms, surgical centres, specialists, doctors and others to provide world class health treatments in a timely and cost effective manner.
- End the practice of building expensive health facilities until there is clearly enough available staff to open them. With the money saved from this practice, immediately work to open and staff available capacity within the public system to reduce wait times.
- Further reduce surgical and specialist wait times by funding needed services for Alberta patients outside the province should timely access to a medically necessary procedures be unavailable in Alberta. In such cases, the cost to the Government to have that same procedure performed in Alberta would instead be sent to the out-of-Alberta health provider. The patient would be responsible for costs over and above that amount.
Seniors Health Care
As individuals age, health care becomes a primary concern. The PC Government continues to fail our seniors on this issue. Despite continued promises, there remains a dearth of funding for assisted home care and massive waiting lists for rooms in long-term and palliative care facilities.
Instead, seniors are often left to age in uncomfortable and expensive hospital rooms far away from loved ones. This, of course, exacerbates emergency room wait times, jams hospital beds, and because of the high cost of an acute care bed, unnecessarily drains millions from the health care budget which could be put to better use elsewhere in the system.
The PC Government has also mishandled drug coverage for seniors. The Government’s unfairly structured proposed ‘Seniors Drug Plan’ would see a monthly premium charged to seniors on already stretched fixed incomes.
Get it Right
Alberta seniors deserve better. A Wildrose Government would improve health care for seniors by taking the following steps:
- Redirect more of the health budget to expanding home care thereby empowering seniors who are able to continue living in the comfort of their own homes and communities. This will not only save taxpayers millions, it will free up hundreds of badly needed acute care hospital beds.
- Greatly reduce the complexity and regulatory barriers to families, non-profit organizations, charities and businesses who wish to establish safe and affordable facilities providing assisted living, long term care and palliative care. Again, increasing the number of these beds will greatly reduce health costs and hospital overcrowding due to the thousands of Alberta seniors who have been placed unnecessarily in acute care hospital beds.
- Introduce a ‘Kinship Palliative Care’ program where family members who might otherwise be employed in the workforce are moderately compensated for providing end-of-life care for their loved ones. As our province’s nursing shortage becomes more acute, it is imperative that we enlist the help of family members in caring for our aging population.
- Scrap the PC Government’s new Seniors Drug Plan which introduces onerous premiums for tens of thousands of Alberta seniors. The current drug plan for seniors is far more fair and appropriate.
In Alberta, health care now consumes over 40% of provincial spending, and is on pace to grow to more than 50% in coming years. Clearly, this is an unsustainable system, and we must address the issue immediately or we will soon see health expenditures erode other essential public services such as education, policing and environmental protection.
As is the case with any good or service, choice and competition between health providers will certainly moderate increases in health care costs. However, given the nature of our current public system, it is important that Albertans, doctors, the provincial government and other health service providers understand the individualized costs of health care in order to capitalize on efficiencies.
As we have seen with the Alberta Health Superboard’s unwillingness, or perhaps inability to fully publicly disclose its financial statements, it is difficult to understand where efficiencies may be realized if no one knows where the money is actually being spent.
It is also critical that patients have all the information needed to make informed decisions as to which health provider is the best fit for them. Albertans need to be able to monitor waiting lists, know which health facilities provide the best patient outcomes, and have complete access to their personal medical records.
Finally, a critical part of having a sustainable health care system is to ensure there are enough health professionals available to work in the system – especially given the increasing number of seniors requiring additional health services. The current PC Government has moved in the opposite direction by permitting restrictive limits on post-secondary enrolment for health-related degrees and diplomas and doing little to expand the number of available residencies for medical students.
Get it Right
Albertans deserve better. A Wildrose Government will ensure a sustainable health care system by introducing the following policies:
- Ensure Albertans have full access to their medical records and treatment histories and make those records available to each patient’s physician through a vastly improved electronic health record (ensuring patient privacy and confidentiality is respected) in order to minimize duplication of medical services and ensure the right medical information is available to the right person at the right time.
- Make electronically available to each Albertan an annual statement outlining the costs of health services provided to that individual during the previous year.
- Carefully track and publicly disclose waiting lists for all procedures and emergency rooms, the per-person and overall cost of each type of procedure, and the treatment outcomes of all health facilities.
- Work with doctors and their related professional organizations to significantly increase the number of residencies available to medical graduates.
- Establish a student loan forgiveness program that gradually forgives student loans incurred by graduates who remain in Alberta to practice a profession of high need (i.e. doctor, nurse, etc) over an extended period of time. Incentives could be strengthened further to encourage health practitioners to practice in more remote rural areas as well.
- In consultation with Alberta’s post-secondary institutions and professional associations, expand spaces for high-demand degrees and diplomas (i.e. medicine, nursing and other health related fields) by allowing a substantial amount of post-secondary government funding to directly follow the student to the institution of his or her choice. Rather than setting arbitrary limits on courses of study, Alberta universities, colleges and technical schools should be competing for students by offering the programs and courses students most want to enrol in.
An ounce of prevention is worth more than a pound of cure. Unfortunately, this sage advice is being ignored by far too many. Whether it be smoking, drugs, too much alcohol, a lack of exercise or over-eating, billions of dollars are spent each year in our province to treat entirely preventable illnesses and conditions.
A successful health care system should be focused on supporting wellness as much as treating the sick. A continuous and healthy doctor-patient relationship is vital to preventative monitoring and early treatment of disease.
Of course, the taxpayer cannot afford to pay for every kind of health service or treatment. Relying on Albertans to do all they can to maintain their personal health is vital to the sustainability of our public health system. However, government can and should provide incentives where appropriate to empower individuals to do just that. Instead, the current PC Government arbitrarily delists preventive health treatments while providing no incentives for individuals to better manage their own care.
Get it Right
Albertans deserve better. A Wildrose Government will promote wellness by introducing the following reforms:
- Give every Albertan the opportunity to set up and invest in a personal Medical Savings Account (MSA). Pre-tax dollars could be invested in these accounts, grown tax free, and used to purchase health-related services that are not fully or only partially covered by Alberta Health Insurance (i.e. chiropractic care, naturopathic medicine, long term care, etc).
- Promote healthy lifestyle choices by introducing tax incentives for various preventative health measures and activities.
- Guarantee that decisions regarding treatment for individuals that are mentally ill, AISH recipients and persons with developmental disabilities are based on the needs of patients first and foremost. Denying adequate treatment to these individuals greatly increases health and treatment costs in the long run.
- Invest in proven community organizations and programs that work to prevent, assist and treat victims of addictions and abuse, again saving health dollars down the road.