Jason Kenney’s health care policy announcement yesterday was a typical conservative political speech – a mish-mash of anodyne sentiment, misleading spin, market-fundamentalist nostrums, scraps of red meat for the base, cheap shots at the federal government, terrible ideas he’ll implement if he gets the chance, and even a couple of good ones he’d probably ignore.
However, it was almost entirely delivered in a reasonable, even soothing tone of voice. So you had to listen carefully and make frequent use of your political decoder ring to understand the bad stuff.
But there was a bit of a bombshell at the end – a barely disguised pitch for full-on, two-tier, cash-for-care medicine in the final two minutes.
Mr. Kenney employs competent political advisors. So how did that slip past the spinmeisters? I don’t know about you, but when Mr. Kenney started rambling on about the so-called Chaoulli Decision it sounded to me as if his mouth got jammed in motor mode and no one on his staff had the presence of mind to pull the plug on his microphone.
Well, Mr. Kenney may get elected anyway for a variety of reasons, but nobody now has any excuse that they had no idea he intends to seriously undermine public health care by opening the door to wide-open cash-fuelled line jumping.
The Chaoulli (pronounced Show-wally) Decision is the highly controversial 2005 case in which the Supreme Court ruled that Quebec laws prohibiting private medical insurance when there are long wait times for treatment violated the Quebec Charter of Human Rights and Freedoms. (Three of seven judges argued it also violated the Canadian Charter of Rights and Freedom’s security of the person provisions.)
So when Mr. Kenney said “a United Conservative Government will comply with the spirit of the Supreme Court Chaoulli Decision,” he was saying a UCP government will encourage two-tier medicine. As is well understood, this will mean longer wait times for the rest of us, since physicians and surgeons can’t be in two places at the same time, even in an Ayn Rand novel.
“Unfortunately,” Mr. Kenney rambled on – to the horror, I am sure, of his advisors – “that only applies legally to Quebec, but we will apply that principle to Alberta with our surgical wait times reduction strategy.” (Emphasis added.)
Premier Rachel Notley’s swift response was that “this election, the future of our public health care system is on the ballot.”
“Mr. Kenney wants to privatize our health care system meaning less care for more cost,” she said, vowing, “I won’t let this happen.”
When I speak of misleading spin, a good example would be Mr. Kenney’s effusive praise of Saskatchewan’s effort to cut surgical wait times by contracting private day-surgery clinics, claiming dramatic reductions in waits and significantly lower costs than public hospitals. Mr. Kenney even praised a former NDP finance minister, Janice MacKinnon, for her role in cutting health care costs in Saskatchewan.
He forgot, however, to mention Alberta’s experience with the same thing, and what happened when a private surgical clinic allowed to do business in a former private hospital when Ralph Klein was premier went bankrupt under Ed Stelmach. Taxpayers ended up holding the bag to ensure the essential hip and knee surgeries it had been contracted to perform continued to be available.
He forgot to mention that all the surgeries done by that private clinic in Alberta cost about $500 more per knee or hip than the same ones in a public facility in Calgary. So the jury remains out on such cost claims.
He forgot to mention that since 2015, surgical wait lists have been growing at about the same speed in Saskatchewan as in Alberta. That province’s wait-reduction strategy ended in 2014 and its three-month wait target is now ancient history.
And he forgot to mention that Ms. MacKinnon is best known in Saskatchewan for her signature policy in 1993: Closing 52 small rural hospitals throughout the province.
Mr. Kenney mixed spin with bad policy ideas too: Touting his plan to commission a comprehensive performance review of Alberta Health Services and claiming that “we believe there are too many managers managing managers.”
“Other jurisdictions have done thorough administrative performance reviews like this and have found savings of between one and two per cent of expenditures,” he said. “So we believe that is something in the range of $200 million that we could find in administrative savings to be pushed out to nurses, doctors and patients on the front lines.”
But he forgot to mention that according to the respected Canadian Institute of Health Information, Alberta’s health care system has the lowest administrative costs in Canada – 3.3 per cent of total spending, compared with a national average of 4.5 per cent.
So AHS has already saved what Mr. Kenney promises based on cuts elsewhere. In other words, Mr. Kenney’s drastic cure is based on a phoney diagnosis that won’t work because there’s no fat left to cut.
Sad to say, the only targets for meaningful cuts to health costs remaining in Alberta are physicians’ salaries and rural hospitals. If you live in a rural area and you’re determined to vote UCP, as the polls suggest you are, think about that.
Red meat and cheap shots at the federal Liberals? Mr. Kenney said he would help solve the opioid crisis by bringing back the Harper Government’s mandatory sentences for drug traffickers.
Market fundamentalist ideological nostrums that will actually end up costing more and delivering less? Mr. Kenney vowed to kill “the unnecessary superlab in Edmonton, and the NDP’s ideological drive to nationalize lab services” and “the NDP’s purchase of laundry machines ’cause they think civil servants know better how to clean laundry than private sector contractors.”
Occasional good ideas? Letting Nurse Practitioners work to their full scope of practice, might qualify, although don’t expect Alberta’s physicians to agree.
Yes, public health care is on the chopping block if Kenney wins. But for most of the rural UCP supporters I know this election is about the economy. This past fall our local hamlet got an addition of a very nice couple whose kids are now on their own. They both worked in the oil and gas drilling/ pipeline sector. Decent, community minded people who are pitching in volunteering in their new home. They downsized from owning a three car garage/house to a house-trailer on a rental pad in our little rural hamlet.
They blame the NDP for chasing off the foreign capital that kept them wealthy for most of their lives rather than accept that the fall in world oil prices is caused by US fracking flooding the North American market with cheap high quality oil and natural gas.
If they do not blame Premier Notley for their misfortune, then they have to accept the fact that a Premier Kenney will be powerless to restore their income. And that would mean they have to abandon hope.
All of us may well lose public health care. If so, it will because of a small group of fundamentalist creeps and people like our new neighbours who are innocent of history and context, and blinded by false hope.
So, this idea that rural Alberta—which to most residents of Calgary and Edmonton encompasses the entire rest of the province outside those two big cities, and includes the smaller cities—is in dire economic straits, and that the NDP is “scaring off investment”, is not borne out by the evidence. Case in point: the largest single-level Canadian Tire store in the entire country—105,000 square feet in floor area: https://everythinggp.com/2019/03/18/new-canadian-tire-opens-in-grande-prairie-this-week/—just opened, in … wait for it … Grande Prairie, 4½ hours northwest of Edmonton. There have also been a number of recent announcements of major new industrial developments in the Grande Prairie area:
https://www.dailyheraldtribune.com/news/local-news/peace-pipeline-system-receiving-500-million-expansion
https://www.dailyheraldtribune.com/news/local-news/wapiti-gas-plant-finished-ahead-of-schedule
https://www.dailyheraldtribune.com/news/local-news/its-a-good-day-for-grande-prairie-province-supports-2-billion-methanol-plant
So, there’s that.
Gerry: yes you have your facts nicely lined up. But the appeal of the UCP is emotional and irrational. It works with people like the couple I mentioned because they have few skills that an economy more sophisticated than “ripping and shipping” need. They know this and are experiencing downward mobility.
Irrational as it may sound, in my observation and experience they are not open to rational persuasion based on evidence.
I don’t know if Mr. Kenney has perfected the art of making right wing extreme ideas sound reasonable, but he is pretty good at it. He has learned well from his former boss Stephen Harper. Now Mr. Kenney hasn’t taken up sweater vests yet, like Mr. Harper did in one campaign in an effort to appear like a non threatening political version of Mr. Rogers, but perhaps that works better for a family man like Harper, for Kenney it might come across as a bit creepy. In any event, I’ve noticed that art is comprised of three things – speak with a calm and confident voice, gloss over or ignore anything negative or controversial related to your ideas or proposals and if that is not possible just deny any potential problems. However, there are two serious problems Kenney faces that Harper did not.
First, I got the sense Harper did not care that much about social conservatives. Yes, he would occasionally try to appease them to keep their support, but not at the expense of losing too many mainstream voters. Kenney who apparently got his calling into politics as a social conservative activist seems much more invested in social conservative issues, hence his proposal to scale back GSA’s which I think will hurt him politically considerably.
Second while Kenney is supposedly politically strong on economic issues, he is trying to peddle an an ambiguous austerity that leads to a number of unsettling concerns and unanswered troubling questions. One concern is that Kenney’s cuts will end up being bigger and more painful that he is letting on. While he has refrained from making too many spending promises, his proposed corporate tax cuts and carbon tax elimination will leave a huge whole in the budget. Of course, Alberta did have a somewhat lower corporate tax rate back in 2014 when the PC’s were in power and that didn’t seem to be much help to the economy at the time, so I doubt it will magically produce any extra revenue this time either. Other parties in this election are free to promise modest targeted spending and because they are not eroding the revenue side of the budget they will probably end up in about the same place budget wise as Kenney without the cuts. Its one thing to promise blood, sweat and tears – people will support that if they feel it is necessary, but it is another thing to promise a devious, stealthy austerity to do what – pay for corporate tax cuts that may have little or no benefit for most people?
I think it is fairly clear that Kenney will make a mess of health care, if elected. The puzzling thing to me is why other parties do not challenge him more strongly on economic issues. It may be perceived to be a UCP strength by many, but behind an impressive facade I think is a lot of weakness. I think if the NDP hopes to win this election, they will have speak more to the economic issues that concern many people and to do that they will need to cast more doubt about the UCP’s economic ideas, as well as the UCP’s ideas on health care and social issues.
“Too many managers managing managers” … yeah, right, so if I have a request my boss can’t approve, she can just call up Verna Yiu for a go-ahead? AHS is Alberta’s largest, and one of Canada’s largest, employers, with over 100,000 staff. Every front-line manager, middle manager and senior executive has a broader “span of control” than is considered optimal under accepted management theory. Is it perfect? No, of course not, and in fact I think the very size of the entire organization inherently lends itself to glacial decision-making and bureaucratic inertia. But fixing that could, paradoxically, mean hiring more management, not less.
“…physicians and surgeons can’t be in two places at the same time, even in an Ayn Rand novel”
I think I just found my new favourite phrase!