Brace yourselves, people. Alberta Premier Jason Kenney has announced his “Blue Ribbon” panel to do a “deep dive” into the province’s books and figure out how to get them into the black in less than three years, eliminate debt, and do it all without raising taxes or introducing a sales tax.
Never mind the ribbon, the emphasis should be on the blue. Because there’s only one way to do what Mr. Kenney is talking about, and it won’t be pretty.
I suspect an appropriate name for this group would be The Sweeney Todd. You know, Cockney rhyming slang for something along the lines of Oh My Gawd! This is going to turn out to be like eliminating the mortgage so fast you have to sell the house.
Still, give Mr. Kenney credit, it was a clever piece of political marketing, with the chair of the six-member panel a former New Democratic Party finance minister, which is certain to be noted immediately and many times hereafter by the United Conservative Party Government’s media cheering section, and her vice a former Alberta Liberal.
But don’t worry about that if you’re a die-hard Conservative, they’re the kind of New Democrat and Liberal that radical market fundamentalists can love.
Janice MacKinnon, now a University of Saskatchewan history professor, is a former New Democrat alright, but not really one that can be called a Dipper in good standing if you happen to believe in the sorts of things that normally define New Democrats.
She was long-ago Saskatchewan premier Roy Romanow’s finance minister and her signal policy achievement in 1993 was closing 52 small rural hospitals throughout the province. Saskatchewanians, rural ones in particular, have never forgiven the NDP for this betrayal of New Democratic principles, ironically contributing to the rise and long success of the right-wing Saskatchewan Party.
Truth be told, if you’re serious about saving money in health care, there are really only two options: physician salaries, which aren’t going to be cut, and closing rural hospitals. Well, if Prairie history repeats itself, rural Albertans can’t say they weren’t warned!
How a historian is qualified to make economic recommendations is a question for another day. But if you want to know what Dr. MacKinnon is likely to recommend for Alberta, look no further than her own recent history. To wit, what she has already recommended for Alberta in the company of the University of Calgary’s Jack Mintz, pet economist of Canada’s market-fundamentalist media: Harsh austerity, cutting public sector pay, restructuring health care, and a charming faith in the fantasy that tax cuts for corporations will create jobs.
Vice-chair Mike Percy is now a University of Alberta business professor, but back in the day he was the finance critic of Liberal leader Laurence Decore’s opposition in the Alberta Legislature. That was when Alberta Liberals campaigned against Ralph Klein’s Progressive Conservatives by arguing they were wet, squishy and far too left wing.
Mr. Klein proved them wrong, but Dr. Percy nevertheless would fit right in with Drs. MacKinnon and Mintz. He was an Alberta Liberal MLA from 1993 to 1997, the party’s most right-wing period, and he has been a loud and consistent voice for discredited conservative economic nostrums ever since.
The other members of The Sweeney are:
- Dave Mowat, former President and CEO of ATB Financial, the Crown-owned Alberta financial institution that Mr. Kenney badly wants to privatize. Mr. Mowat was hired by former premier Rachel Notley to lead the review of the province’s ludicrously low oil royalties that discovered what the fossil fuel industry wants was exactly the right thing for Alberta after all. Who knew? If nothing else, this proved that Big Oil could capture a social democratic government as effectively as a conservative one, not that it helped the NDP much come election time.
- Kim Henderson, former deputy minister to B.C. premier Christy Clark as well as a former DM of finance in the B.C. Government. She was fired by the NDP in that province when they came to power in 2017.
- Bev Dahlby, a British-trained PhD U of C economist and former International Monetary Fund boffin. In addition to his day job, he is associated with the neoliberal C.D. Howe Institute and the even-more-market-fundamentalist Fraser Institute.
- Jay Ramotar, a senior Alberta civil servant who previously was DM of Alberta Health and a former member of the board of the Canadian Council for Public Private Partnerships. In 2013, at least, he was Alberta’s top-paid civil servant, with a salary of $406,379. Come the worst, he’s unlikely to be the public employee taking a haircut.
If you’re a rural Albertan expecting a little down home, school of hard knocks common sense, you won’t find it in this elite collection of well-heeled right-wing academics, a banker and senior civil servants. The only guy who came faintly close in this stage production was Finance Minister Travis Toews (pronounced Taves), the MLA for Grande Prairie-Wapiti and the sole cabinet minister from Northern Alberta, there mainly for decorative purposes at yesterday’s one-man show.
It’s important to remember that the promise cutting taxes for billionaires and corporations will create jobs is guaranteed to fall flat, just like it always does. Look for plenty of stock buybacks by already rich corporations instead.
My guess is the panel will recommend outrageous spending cuts to public services, Mr. Kenney will shave it back by a percentage point or two, maybe to the 5 per cent he’s rumoured to be telling all his ministers to come up with immediately, and we’ll all be expected to be relieved.
Readers will get the picture, though: We’re in for a shave.
Mr. Klein got elected promising big spending cuts. Mr. Kenney started talking that way, then when he realized it might be harder to sell politically than he thought, changed to no cuts and freezing spending at current levels.
If Kenney decides to go back to big cuts now that he has a safe majority for four years, I think a fair number of voters are going to feel betrayed and lied to. I don’t think he can just slide it by, saying well the blue ribbon panel recommended it.
As for Ms. Mckinnon’s proclivity to close rural hospitals, well that didn’t turn out very well politically for the Saskatchewan NDP, did it? They haven’t been in power for quite a while now and that is in a province that was much more inclined to elect the NDP. Mr. Klein was not so politically stupid to do that sort of thing even though he blew up a big city hospital. I don’t think Mr. Kenney will be closing a lot of rural hospitals eithet unless he has a political death wish.
The UCP may feel they have a big mandate, but they don’t have a mandate to make big cuts, whether their blue ribbon panel full of people from out of the province and from the 90’s (some both) realizes this or not.
Well, look at it this way. Pompeo and Notlob are about to start a war with Iran that may well turn into much worse than a regional bombing campaign of murdering Muslims for talking back against white power. While the evangelicals celebrate the likelihood of Herbert W Armstrong’s prophesy of the final battle between Christians and non-believers duking it out in a Middle East armageddon unafraid of the consequences because Jesus will descend from heaven to save us all, practical persons might be somewhat concerned.
The mad dog Yankees are out to force the entire world into submission to be a place like Kenney wants Alberta to be, a capitalist nirvana, but with the Earth itself falling apart as CO2 levels pass 415 ppm and with zero chance for remedial efforts, we may well find that Russia and China say to hell with all this and escalate the conflict. Well past a nasty conventional war. Then the petty idiocy of local Cons, convinced they are of superior human genetic stock and intent on sticking it to the less well-off and rural residents won’t matter a bit.
Albertans will do well at first. When Iran closes the Straits of Hormuz, and knocks off an American aircraft carrier, world oil prices will skyrocket. Never will a barrel of bitumen be worth more. Conservatives will rejoice for a brief moment before the world economy crashes. Misery will be widespread, and even Albertans might look up from a spot of happy navel-gazing to take note of the chaos. It might well be worse than the temporary inconvenience of wildfire smoke from BC ruining outdoor barbecues of a summer.
Because 99.9% of the populace is about as uninformed on world affairs or even local politics as a gopher or the common loon, this catastrophe will come as a major surprise. Fearmongering you say? Really? The writing has been on the wall since at least 2001, more like 1997 when The Project for a New American Century was promulgated by a group of dopes not entirely different in societal makeup than this group Kenney has convened to remake Alberta according to his fundamentalist dreams. Darn, there goes the neighbourhood.
There was a brief respite in the advanced economies, from the kind of hierarchy espoused by Kenney’s masters, from 1945 until approximately 1972, this being a significant anomaly in the status quo of about 1700 until now. Alberta’s experience lagged by perhaps ten years because the province, unlike any other part of Canada, benefited from the creation of the petro-dollar world. Life in North America is going to look a whole lot more dismal for a vast swathe of the population once the Empire loses the battle to keep the Eurasian hegemonic rival from forming. Belt-road is going to remake the world, barring a nuclear conflagration or, more likely, climate-induced fragmentation of the global economy in the post-jobs era. The NDP were literally powerless to do more than rearrange the proverbial deck chairs.
If I can make a couple of suggestions to the panel:
1. Alberta has 34 Members of Parliament. The City of Calgary is able to govern itself with 15 Councillors, and it has one third the population of Alberta; Edmonton manages with 13, with a slightly smaller population. Therefore it stands to reason that the province could get by with a legislature with 40 – 50 MLAs, not 87.
2. Once every couple of weeks or so, the City of Edmonton runs several pages of ads in the Journal (Sun too?) advising people of proposed zoning changes which, I suspect, they are required to do because of provincial legislation. The cost of this has to be brutal.
Running these ads made sense in pre-internet days, but now it would be much more cost effective, and efficient, to have a website for people to look at, and perhaps have people register for automatic notification of something that impacts their neighbourhood. If the province allowed municipalities to quit buying the ads it would allow them to decrease municipal grants a little bit with no pain at all.
David, You’re absolutely right about rural hospitals being the most obvious potential target. Health is the biggest item in Alberta’s spending, and there are really just 2 ways to cut health expenditures in the short term: reduce the number of physicians, and cut the number of hospitals. It’s hard to imagine that many UCP voters consciously voted for either of those measures: hence the “blue ribbon” panel to take the heat. Flash forward to election 2013: “Don’t blame us – we just did what the blue ribbon panel told us to do!”
This would be a good time to reprise your column of February 22, and if I may I will recycle my comment (edited) of February 21:
“David, excellent point about the rural hospitals. Any comparison of per capita hospital costs between Alberta and other jurisdictions has to be adjusted for the reality that rural hospitals in Alberta, at least since the dawn of the Lougheed era in 1971 were intended for more than health care: they were intended to be anchors to keep people in small towns at a time when rail lines and elevators were closing: they let grandparents in long term care stay close to the family, attracted doctors and nurses to the local economy, and their kids to local schools, provided government-paid construction and maintenance jobs. In short, the hospital building boom in the 70s to the 90s was not for health reasons but rather part of an economic subsidy for rural Alberta. That’s not necessarily a bad thing, by the way, and perhaps a legitimate government expense. But it was not driven by health care needs.”
Apologies: long post coming …
So, here’s the thing about health care: each and every approach taken to date, by governments of every stripe and across Canada—disappointingly, including the recently-dethroned Notley NDP—has attempted, without success, to control costs by throttling services to the people. All that does is lengthen waiting lists and, in some cases, shorten lives.
The only real solutions to the high cost of the health care system involve whole-of-government measures to slow demand for care, by keeping people healthier. For example, seniors with broken hips caused by slips, trips and falls are an enormous cost, from EMS and ER costs, to costly orthopaedic surgery, to often prolonged hospital stays, to the frequent need for continuing care placement in lieu of discharge to their before-injury home. And yet, a modest investment in prevention, through exercise and physiotherapy care, better nutrition, improved management of polypharmacy, and improvements to the built environment—like keeping walking trails and sidewalks clear of snow and ice in wintertime—could dramatically reduce the overall costs of this problem, and free up resources to serve people with less-preventable conditions.
The same applies to the growing epidemic of chronic diseases, like diabetes, heart disease, and obesity, all of which are amenable to community health interventions like addressing social determinants of health. A lot of this requires coordinated work outside of what we traditionally consider the “health” portfolio, like municipal affairs and rules about zoning and development, public infrastructure and road and sidewalk maintenance. Issues around personal safety and injury prevention for all demographics are also a major cost driver, so those physicians being criticized for calling for better gun control are most certainly in their lane.
Addressing flaws in the service delivery design of the health care system is also part and parcel of the path to a solution. One major change that politicians are universally afraid to take on directly is to abolish the dysfunctional fee-for-service model for physician compensation, which incentivizes volume over quality and disincentivizes interprofessional team-based care hubs. Optimal management of complex chronic diseases requires a comprehensive client-centred team, including nurses, dietitians, therapy professionals (like PT & OT), social workers, psychologists, pharmacists, and many others; the era of the “lone wolf” family doctor is gone. And yet, while there are pockets of excellence scattered around the province and across the country, most citizens don’t have anywhere near the kind of access to this kind of service that they truly need, and participation by physicians in these kinds of programmes remains voluntary.
Full universal first-dollar coverage for non-physician allied health services, like regulated mental health professionals and physiotherapy, will also work to keep people well and out of the hospital.
Unfortunately, many conservatives, especially “small-government” and libertarian conservatives, assail such measures as “social engineering”, but if we are truly going to constrain health care costs without cutting services to the public—which often leads to political backtracking once the pain starts being felt by voters—we are going to have to bite the bullet and tackle these difficult issues.
We can’t cut costs by closing hospitals and ERs. But we can cut costs by reducing demand for expensive hospital and ER care.
Cutting costs is not the goal. Creating opportunities for “entrepreneurs” to insinuate themselves into a transaction is the goal. It’s well past time to stop using the euphamism “libertarian” in place of the perfectly adequete “kook”. Healthcare is a luxury. People can hang on in the most wretched states, whether morbidly obese, chronically intoxicated, hooked up to oxygen, etc., for a long time. Preventative interventions are for bilingual transgendred communists, whereas health is for the “hard-working”, to coin the Konservative phrase.
Mr. Kenney has assembled a modern day equivalent of the 1927 New York Yankees Murderers’ Row. The heavy bats of Ruth and Gehrig have been replaced by high priced free agent talent the blogger has described. Secure your batting helmets Albertans, get ready for some high hard ones, you might be hitting the dirt.
If it’s a shave we’re all in for might as well learn to do it the right way. https://youtu.be/NOGGzhR8MCs
This spells a recipe for deep cuts of at least 20% to bring us in line with other provinces. These are the deep cuts that we need, and we need now. The deep cuts that are long overdue and will make union bosses wince. The deep cuts that will ensure our prosperity for a generation!
Good Point Mike.
Let’s start by eliminating your job as a result of the 20% cuts.
When you are unemployed you won’t have to pay union dues at all.
Yes, 20% cuts to the obscene amount of capital looted from the province’s economy by the rich would definitely ensure “our” prosperity.
Do you see any areas of waste, Mike? Since 2001 our population has increased from roughly 3 million to 4, which has brought on the need for significantly increased spending.
I can’t say that I am surprised to see that Mike Percy and Janice McKinnon are a part of this panel. As David C. has stated in his blog, he was the Liberal finance critic and was one of those criticizing the Progressive Conservatives for not cutting hard enough and Janice McKinnon has spent her time as an MLA beating up on New Democrats for being concerned about the state of our public services and not embracing market fundamentalism as professed by the Fraser Institute. She has given lots of talks there as well as go to work for Fraser Institute in disguise-the School for Public Policy at the University of Calgary. I think that a lot of New Democrats view her much the way that Democrats viewed former Senator Joe Lieberman which is with a great deal of suspicion.
Talking about reducing the number of Drs in the province, and closing rural hospitals – because, really, “they’re not needed” is short-sighted and naive. Obviously, those who believe this to be the answer have not had cancer, for example, where they were required to attend radiation and/or chemotherapy treatments every day for 6 weeks, or 3 months. The cost is astronomical (prohibitive) if you don’t live within driving distance of a treatment centre.
I agree that healthcare needs an overhaul – however – before throwing money at – or slicing money from – the healthcare budget, there needs to be some common sense acknowledgement of our societal needs. More and more seniors are in need of care and there simply aren’t resources to do so. This problem is not going away – we are an aging society. We are also not a society in which we have extended families available to take on caregiver roles. Our long-term care facilities are in desperate need of staffing, basic facility maintenance, upgrading and new builds.
Have you tried to access orthaepedic care in our province? It is next to impossible. There are brokers available to help you find private clinics – mostly in Vancouver, BC – who can assist you for $$. Waiting for an orthopaedic consultation in Alberta can take years. Why? And there are those of you who think we need fewer Drs?
I agree that we need more coordination of health care – the PCNs are a good idea – but don’t seem to be easing the wait times much. Those with chronic and complex health concerns – particularly pain management are simply unable to get appropriate care. And that is living in the major cities.
A 20% cut is not what we need. All that does is reduce service levels, increase wait times, and cause injuries and burnouts in the workplace. Do you honestly believe that the ones earning $500,000 a year are going to take a 20% cut? No – it’s the housekeeping staff who make $20,000 a year with no benefits or sick time who take that cut. Again – the rich are protected and the poor get poorer.
And speaking of being poor – it is extremely expensive to be poor – and it’s hard to eat well when you’re poor. Fresh vegetables and fruit, good proteins, milk, and so on is much more expensive than a $5.00 burger meal. When you have money to access services such as physiotherapy, and a nutritionist, and so on – it is much easier to avoid the problems associated with poverty-level existence. Making people poorer is not conducive to reducing healthcare costs.
Bottom line is – if you want a healthy society – one that doesn’t require so much expensive healthcare – then you need to address the societal issues that impact demand.
Please understand that I am not advocating closing rural hospitals. I am stating that there is nothing left to cut but rural hospitals and doctors’ salaries. Everything else has been cut to the bone already. Moreover, Dr. MacKinnon’s most famous policy was … cutting rural hospitals. So there’s at least a high probability she and her “blue ribbon panel” will recommend the same thing here. DJC
Rural hospitals, in rural ridings, to be closed you say?
Oh well, maybe rural Albertans should have voted more intelligently.
Maybe Kenney-boi will make it up to them with a buck a beer scheme like his buddy in Ontario. Enjoy the next four years fellow Albertans.