Article Edition August 2020

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Proposed changes to Alberta
Health Act. require reassessment
By Diana Gibson
In the same month as the
Alberta Government launched
consultations on a new
Alberta Health Act, one of its
prodigal private surgery
centres, the Health Resources
Centre in Calgary, declared
bankruptcy. Before
consultations have even
begun, the Alberta Health Act
initiative has been seriously
undermined because the Act
is all about that style of
private for-profit delivery.
The only documents to
emerge on the new Act to
date are “A Foundation for
Alberta’s Health System” and
the online survey. These
documents are drowning in
warm sounding rhetoric about
patients, families, quality and
access. However, hidden
within are chilling terms like
flexibility of delivery and
personal responsibility.
Flexibility of delivery is often
code for increasing for-profit
health care, and individual
responsibility means moving
away from universality and
public responsibility and in
some cases penalizing
individuals for unhealthy
behaviours.
Of greater concern is the
behind-the-scenes agenda for
the Health Act. That agenda
is clear in the submission
from Alberta Health Services
CEO, Steven Duckett, which
states the goal as, ‘Recognize
the role of private and nongovernmental
organizations in
service delivery within the
Canada health framework.’
Even more telling is the
submission from the Calgary
Chamber of Commerce, which
has been advocating for a
long time for this form of
legislative change.
Specifically it asks for the
repeal of the Health Care
Protection Act and stripping
Alberta Health and Wellness
of its role in regulating private
surgeries and clinics.
Their submission also
advocates for increased direct
competition between private
for-profit providers and
public providers while at the
same time allowing private
providers to benefit from any
economies of scale and other
advantages of the public
sector through a “levelling of
the playing field and cooperation
in the distribution
of resources.”
The HRC bankruptcy
reveals the folly of that
approach. Albertans and
Canadians should be alarmed
and should watch the health
act initiative closely.
Certainly there are
serious challenges to be
dealt with on the delivery
side of health care. Hospital
stays are becoming much
shorter, and community or
day-surgery alternatives
have been growing. That
sector is fragmented and
mostly outside of the public
health system and
protections of the Canada
Health Act.
Services such as
rehabilitation services that
were previously offered in
hospitals are being offered in
communities and homes.
Long-term care is being
downgraded to assisted
living, and the sector is
becoming increasingly
dominated by for-profit
providers.
On the flip side, the
province has under-funded
hospitals for many years,
causing shortages of beds,
nurses and physicians and
has not adequately funded
quality public services for
seniors needing long-term
care.
The growth of the forprofit
involvement in those
service areas has come at a
cost, Albertans now have the
highest out-of-pocket
spending on health care in
the country.
Not only has this path
been costly, but it means
lower quality. A number of
academic studies have shown
that care in for-profit
institutions is often lower in
quality than in not-for-profit
institutions.
Findings include higher
death rates in private
hospitals and dialysis clinics,
more quality deficiencies and
less nursing care in nursing
homes and less care for the
dying in for-profit hospices.
The Alberta government
pays a lot of lip service to
best evidence. Best
evidence shows for-profit
providers deliver poorer
results at higher cost. It is
time to learn from our
mistakes and stem the tide.
To this end, the Alberta
Health Act initiative should
not proceed as planned.
Certainly, there are
challenges in health care,
not only the fragmented
delivery system that is
increasingly for-profit but
also the lack of attention to
prevention and the social
determinants of health such
as poverty and inequality.
The act will not address
these problems; the barriers
to reform are political not
legislative. Without the
political will to account for
the health impacts of social
policies, without the political
will to fund adequate public
health services, and without
the political will to limit the
profits of pharmaceutical
companies, pharmacies,
doctors and private insurers,
legislative changes will not
significantly improve health
care outcomes or
sustainability in Alberta.
The public health system
is now paying to bail out the
HRC and surgeries are at risk.
Alberta can afford better
and should invest in making
the HRC back into a nonprofit
hospital and bring it
under the public umbrella.
Beyond that, the health-act
plans should be shelved and
the government should get
down to the business of
delivering health care that is
public, universal and
affordable.
There is room for a new
health act, but it needs to be
one that limits for-profit
involvement in health care
and strengthens the public
system which delivers the
most cost effective, most
accessible and best quality
health care.
Diana Gibson is the
research director at the
Parkland Institute. This
opinion piece is based on a
new series of reports by the
Institute on the proposed
Alberta Health Act.
© Copyright (c) The
Edmonton Journal
(The End)
Sikh Virsa, Calgary 42. August, 2020