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.