Alberta Politics
Health Minister Tyler Shandro saying we’ll have answers in due course (Photo: Screenshot of CBC Video posted to Twitter).

Here’s a bet: Alberta Health Services review announced yesterday will cost more than any savings it finds

Posted on May 31, 2019, 1:35 am
11 mins

Tyler Shandro was pretty bold yesterday when he put out a Government of Alberta news release announcing the United Conservative Party Government’s promised review of Alberta Health Services.

Mr. Shandro is the baby-faced MLA for Calgary-Acadia who was made minister of health by Premier Jason Kenney. He is a lawyer and former member of several important boards, including the Calgary Police Commission and the National Parole Board, so you wouldn’t think that he’s a dope.

Another view of Mr. Shandro (Photo: Screenshot of CBC Video).

Just the same, so far he’s attracted attention from coast to coast for his unintentionally hilarious performance sticking too close to what was apparently his single authorized talking point – that, “in due course” something would happen.

“AHS review to find savings, improve performance,” read the headline on Mr. Shandro’s announcement, which was doubtless written by a professional. A subhead continued: “A performance review of Alberta Health Services will identify ways to deliver better results for Albertans and find efficiencies across the health system.”

I guess we’ll confirm this in due course, but anyone who’s been paying attention knows this little bit of UCP election rhetoric is highly unlikely find any real savings or meaningful efficiencies in the system, let alone across it.

So while the inevitably overpriced review, doubtless by a multinational consulting company with a bias in favour of privatization, may look for new efficiencies, it’s extremely unlikely it will find many.

In fact, I’ll make a little wager: a review of the operations of a $15.2-billion public health care agency with well over 100,000 employees that has to be done by the end of a year that’s already nearly half gone will cost far more than any efficiencies it uncovers.

Yet another view of Mr. Shandro (Photo: Screenshot of CBC Video).

We can be reasonably confident of this because the respected Canadian Institute of Health Information has already done a comparative study of health administration costs across Canada and AHS came out smelling like a rose. AHS has the lowest administrative costs in health care in Canada – 3.3 per cent of total spending, compared with a national average of 4.5 per cent.

So during the campaign when Premier Jason Kenney first raised the idea of the review of AHS, he was talking through his “Cattleman” cosplay hat when he said stuff like “we believe there are too many managers managing managers.”

Alert readers will recall that Mr. Shandro’s boss – who was presumably the one who dictated the health minister’s risibly restrictive talking point – also said during the campaign that “other jurisdictions have done thorough administrative performance reviews like this and have found savings of between one and two per cent of expenditures.” Therefore, Mr. Kenney told credulous Alberta voters, “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.”

Alberta Health Services President and Chief Executive Verna Yiu (Photo: David J. Climenhaga).

Well, good luck with that, because as CIHI’s analysis showed, AHS has already saved what Mr. Kenney promised he could save based on actions by less efficient health systems. In other words, Mr. Kenney’s wildly optimistic prediction is founded on a phoney diagnosis that won’t work because there’s not much fat left to cut at AHS.

AHS President and CEO Verna Yiu has every reason to be distressed and irritated by this distracting and time-consuming snipe hunt, and indeed she sounded as if she was during the election campaign.

“Health-care leaders from more than 40 countries named AHS one of the top five most integrated health systems in the world last May at the 18th International Congress on Integrated Care,” she said in a letter to the Medicine Hat News back in March. “Delegates also ranked AHS second in the world – behind the Netherlands – as the health system from which the most could be learned.”

Of course, given the change in government, Dr. Yiu had little choice but to be a good sport about this disruptive foolishness. “We look forward to working with government on this review,” she said diplomatically. That said, I expect we’ll discover in due course what she really thought of the whole thing.

The reality is that the only targets for meaningful cuts to health costs remaining in Alberta are physicians’ salaries and rural hospitals.

But don’t bet that Mr. Shandro’s news release on this topic, the one that will be published in due course after the “review” has been completed, will even take note of this fact.

Foolish promise made. Foolish promise kept.

Justice Minister caves on independent prosecutor demand

After getting flack from all quarters of the political spectrum, Justice Minister Doug Schweitzer caved yesterday and announced the government will appoint an out-of-province independent prosecutor to oversee the RCMP investigation of allegations of vote tampering in the 2017 “Kamikaze Campaign.”

A government official said the decision was “based on new information,” although it’s said here the new information was most likely the astonishing fact that the government was even being criticized by a Postmedia political columnist.

Election Commissioner now investigating newly elected UCP MLA

In a similar vein, Albertans learned yesterday that the province’s Election Commissioner is now formally investigating allegations of “fraud, forgery, improper inducement and bribery” made against newly elected UCP MLA Peter Singh.

Immediately before the April 16 general election, RCMP officers searched a Calgary auto repair business run by Mr. Singh, although what they were looking for and whether it is connected with the Election Commissioner’s investigation is not known.

The UCP, I am sure, would dearly love to get rid of Election Commissioner Lorne Gibson. This development, one would think, may make that harder to do.

Postmedia columnist urges Kenney to can Calgary Council

Does anyone remember the brouhaha that erupted back in 2017 when the NDP dared to dismiss three elected councillors in rural Thorhild County, 100 kilometres north of Edmonton?

It was a textbook example of the perils of such actions, whether or not they’re justified. Last I heard, the dismissals had been overturned by a court and one of the councillors was threatening to sue the inspector who wrote the report responsible for the government’s decision.

Now a Postmedia columnist is calling on the Kenney Government to dismiss Calgary City Council because … I’m not making this up … “my friend Ervin Nelson, who owns Mr. Volvo Plus, was almost in tears Wednesday as he described the crushing tax burden on his business.”

Mr. Nelson’s tears may very well be justified. His taxes do seem to have gone up a lot. But needless to say, Mr. Kenney is not getting sound advice on this file from Postmedia, no matter how much Calgary taxes have soared.

Here’s the thing: We have a boom and bust economy in Alberta tied to the prices fetched by fossil fuels. In case you missed it, we’re in the bust phase right now. There’s lots of empty space not generating tax revenue in Calgary’s office towers as a result.

No provincial government has been willing to do anything meaningful about it, though, and now we have one that is determined to slash provincial taxes and hack public services, inevitably downloading costs onto municipalities.

The result is completely predictable. Firing city councillors won’t help, even if that’s what Postmedia and the Calgary Sprawl Cabal demand.

Alberta’s carbon tax ends; celebration cancelled because of fires

Alberta’s carbon tax is dead. However, a self-congratulatory news conference by Premier Kenney planned yesterday for an Edmonton gas station had to be cancelled because the wildfires in northern Alberta continue to rage out of control. Indeed, at noon yesterday it was twilight in Alberta’s capital city, not the ideal conditions for great B-roll. You could’t make this stuff up!

15 Comments to: Here’s a bet: Alberta Health Services review announced yesterday will cost more than any savings it finds

  1. Sam Gunsch

    May 31st, 2019

    Kenney and crew doing ‘all hat’ but ‘no cattle’ as ‘cosplay’ in their messaging… cool, cool. LOL

    excerpt: So during the campaign when Premier Jason Kenney first raised the idea of the review of AHS, he was talking through his “Cattleman” cosplay hat when he said stuff like “we believe there are too many managers managing managers.”

    Reply
  2. rommac

    May 31st, 2019

    Well Jason Kenney did promise he would get Albertans back to work even if they are trimming fat off tenderloin. A promise kept.

    Reply
  3. Doug Brown

    May 31st, 2019

    If AHS is so efficient, why is Alberta’s health spending so much higher than that of other large provinces, despite having a younger population?

    Reply
    • Rocky

      May 31st, 2019

      You’re comparing apples and oranges, although you’d have to really be paying attention to understand this. Alberta’s health care spending is the highest per capita (though in line as a percentage of GDP) but AHS is more efficient. How can this be? As our host has pointed out, part of the story is the large number of redundant rural hospitals that are inefficient and expensive to run and that were put there by the Lougheed and Getty governments for political reasons not because they were needed. Large numbers need to be closed, as Janice MacKinnon courageously closed 52 of them in Saskatchewan. Another part of the story is physician payments direct from Alberta Health, not laundered through AHS, now approaching $6 billion a year. These docs need a haircut, obviously. Why won’t Kenney consider these sensible measures?

      Reply
    • stayinganonymous

      May 31st, 2019

      Maybe because Alberta pays for more health care services than other provinces do. It would be a worthwhile thing to look into. It’s not all about overpaid managers.

      Reply
    • tom in ontario

      May 31st, 2019

      Could it be higher quality of care?

      Reply
    • Athabascan

      June 1st, 2019

      Alberta’s health care spending is NOT higher than that of other large provinces. Get your facts straight instead of spewing out UCP propaganda.

      Oh, and just in case you missed it: Global warming is real, and it is caused by human activity.

      Reply
  4. Murphy

    May 31st, 2019

    I don’t know that Shandro’s role with the Calgary Police Commission indicates any quality other than “dopey”.
    https://calgarysun.com/news/crime/systematic-issues-created-dark-struggle-in-calgary-police-service-former-chief
    https://calgarysun.com/news/local-news/calgary-police-commission-dysfunctional-in-dealing-with-contentious-cops-inquiry-hears

    As the Alberta Petro-state’s decay picks up speed and we head from neoliberal-tinted “friendly fascism” to the more pure laine kind where people disappear off the streets and get thrown out of aircraft, CPS is looking like a real late canary at the mine face.

    Reply
  5. Hana Razga

    May 31st, 2019

    …..and more of such nonsense for next four years.

    Reply
  6. Lulymay

    June 1st, 2019

    If you think about it, perhaps your primary industry, oil extraction, is not that healthy and therefore creates health problems for all those young folks working in this “industry”. Even agriculture, with all the chemicals used here, cannot be the most healthy environment to work in.

    Chemicals and their use, are extremely harmful, not matter what industry they are used in.

    Reply
  7. Jerrymacgp

    June 1st, 2019

    Health care is not only one of a provincial government’s biggest budget line items, and a programme that affects virtually each & every resident of the province; it’s also one of the most complex files in government. This oft-repeated right-wing trope that the system is top-heavy with unproductive management is nothing but male bovine excrement.

    Two of the main cost drivers are physician compensation and pharmaceutical costs, since drugs administered in hospitals and nursing homes—but not in seniors’ lodges and “supportive living facilities”—are paid for by the taxpayer. But, more fundamentally than that, the real cost driver is the incessant and virtually exclusive focus, not only at the system management level but at the political, public pressure and media level, on the most expensive sector of health care: acute care and hospital services. We keep pouring more & more dollars, either public or private, into pulling drowning people out of the rapids, but invest very little on keeping them from falling into the river in the first place. https://www.policyalternatives.ca/publications/commentary/upstream-thinking-healthy-society-and-reviving-canadian-democracy

    It’s a bit like flipping the arguments for or against increasing oil pipeline capacity on their heads. In oil & gas, there’s this economically dubious argument that increasing supply, by diversifying export routes and increasing pipeline capacity, will increase demand and lead to better prices. Conversely, in health care funding, conservatives have this bizarre idea that if we cut supply, demand and costs will also go down. Of course, as we saw in the latter half of the 1990s, as the full impact of the Klein-era cutbacks began to be felt by the populace, this is absurd. Costs escalated dramatically as wait lists exploded, people struggled with access to care, and market-driven labour costs for physicians, nurses, and other health care professionals skyrocketed, both through ramping up salaries and massive use of overtime to manage under-capacity.

    The only way we will ever slow the growth of health care budgets is by reducing per-capita demand for services, by working hard to keep people well. This requires a whole-of-government, intersectoral approach to address the social determinants of health, seriously address injury prevention, and to better manage chronic non-communicable diseases. I could write a whole treatise on this, but our host might object :-), so I won’t, but anyone knowledgeable about this policy area knows what I’m talking about.

    Reply
  8. Connie

    June 1st, 2019

    Trimming the executive fat
    Let’s look into their contracts in less than 10 years there were 8 CEO.
    Regardless if they fulfill their term their contracts were paid out..
    AHS pays their moving expenses to Calgary and departing expenses.
    E.g.
    2009 Dr. Stephen Duckett we moved him out from Australia, his wife didn’t like living in Calgary, so we housed them in Canmore.
    After he was used as an escape goat for the cookie mess 2010 We paid out his contract.
    April 2011 Dr.Chris Eagle , after another
    2012 Health Quality Council CEO John Cowell released 428 pg report on dangerous emergency wait times.
    AHS appoints Stephen Lockwood as new board chair, after another government mess, in 2013 he is fired. Bring in Janet Davidson AHS administrator.
    2013 Fred Horne shakes everything up again, Dr. John Cowell takes on role AHS official administrator.
    2014 Davidson returns as in-term official from Cowell.
    2014 we move Vickie Kaminski out from NFL May 2014 we paid her out.
    When she was with us less than 2 years, she moved to Australia.
    Goes on and on changes to executives.
    No wonder AHS has no money were to busy hiring and firing executives and paying out severance packages.
    Wages they receive are criminal.
    Plus all their benefits and perks that come with positions.
    Trimming the wages and payouts of the executives, would leave more money to run the hospitals.
    The higher up you are in the wage scale greater the benefits and perks. Talk to your personal care attendants would you do the work they do?
    For crumbs they receive.
    Lowest benefits paid our are to the AUPE workers. Front line works do not revive a payout if we decide we have had enough, and quit.
    There are 20 other people standing in line for our position.

    Reply
  9. Keith McClary

    June 1st, 2019

    “one of the councillors was threatening to sue the inspector who wrote the report responsible for the government’s decision.”

    I’d be interested to know how far that got. When Russell Farmer presented their 2013 Crowsnest Pass report they were at pains to say that it (including recommendations) was from the Minister and may have been modified from what they wrote. There was a hint that the recommendation to consider dissolution (Fort McMurray style) was stuck in by the ministry.

    Reply
  10. Dave

    June 2nd, 2019

    Welcome to four years of politics as theatre, something Mr. Kenney is well versed in. Often in politics the impression of doing something is as important or more important than doing something. Therefore, here we go with a cost review at AHS. It immediately appeases or comforts the base that supports the UCP or is likely to support it. If it comes up with conclusions that Mr. Kenney does not like or does not want to implement, like say closing rural hospitals, then it will be soon be forgotten about and Mr. Kenney will go off in whatever direction he prefers, or more likely the review will just provide the conclusions Mr. Kenney wants, like vague statements about the efficiency of the private sector providing cover for more privatization.

    Sorry, Mr. Shandro’s opinions probably do not matter much here, the UCP is mostly a one man show and I think Mr. Kenney plans to mostly keep it that way for now, unless he decides to eventually pack his bags and go back to Ottawa Although if some of his inexperienced cabinet ministers do a good job, perhaps they will win best supporting actor and eventually move up in the pecking order to a better supporting position in anticipation of that moment. However, that might not be quite as simple as it seems, sometimes sticking to closely to the talking points or positions dictated by Kenney’s staff will just make them sound silly. You might expect loyalty to be rewarded, but incompetence may not be.

    Reply

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