Premier shouldn’t blink on reform to health care

When former U.K. prime minister Margaret Thatcher left office, she wrote in her autobiography that she regretted not fixing the National Health Service. When Alberta premier Ralph Klein retired, he gave an interview that suggested the same. “I tried twice — the Third Way and the Mazankowski report — and I failed,” he said in a 2010 interview. Premier Jason Kenney is going to try too, but it will be up to us if he succeeds.

This week Health Minister Tyler Shandro announced changes to the Health Care Protection Amendment Act to make it easier to set up privately owned surgical centres. This will not create a parallel private health system, despite what critics are already saying to try to discredit the proposal.

The bureaucracy has had years to prove that a centralized, top-heavy, union-dominated monopoly could deliver efficient care. According to the Fraser Institute, in 1993, median wait times were 10.5 weeks; in 2019 the wait was 28 weeks. In 1993, health care consumed 25 per cent of the budget; today it consumes 43 per cent. They blew it. Now it’s time to try something else.

I was always surprised that Klein didn’t see the solution to health care was lying right under his nose with his model for public education, in particular charter schools.

Charter schools are fully funded by government grants. They are not permitted to charge tuition. They are permitted to hire non-union staff and in doing so they are not penned in by terms of a collective bargaining agreement. They are able to be innovative and deliver education in different ways without having to answer to a massive school board bureaucracy. What does this do? It gives necessary competition to the publicly owned and run education systems and it gives choice to teachers and students alike. If a teacher doesn’t want to work in a unionized environment, the charter school offers an alternative. In the case of Foundations for the Future charter school, it became so popular it developed multiple campuses. But more importantly, it encouraged the Calgary Board of Education to adopt its own traditional learning centres to cater to students in a higher number of community schools.

This is the model the government is moving to regarding health care. In the government’s news release they talk about streamlining the rules to allow “current and new chartered surgical facilities” to “provide services within the publicly funded health system.” That means, by definition, that this is not a parallel private system. It will work exactly like it works when you go to the doctor now. You get treatment and they bill the province directly.

Ask yourself: What do I value the most about the publicly funded system? Is it sitting waiting for hours to be triaged in a hospital emergency room? Or is it the fact that you never have to worry about paying out of pocket for necessary care? I bet it’s the latter and you don’t give a whit if you get your knee or hip replacement from your surgeon in a public hospital or a surgical centre they operate themselves.

NDP health critic David Shepherd has come out swinging in predictable fashion saying public health care will be weakened by moving more surgeries out of the public health-care system and into “private, for-profit clinics.”

We have to stop treating profit like it is a dirty word. Every successful enterprise — whether public, private or charitable — has to operate so that its revenues are greater than its expenses. Otherwise the entity won’t be viable. Every enterprise — public, private or charitable — has to generate a surplus. The debate is not whether there ought to be a surplus, but who gets it.

In a public monopoly, we’ve seen that surpluses get used up by a massive administration and unaffordable union wage settlements.

Do you really think small chartered surgical centres are going to have five layers of managers? Do you really think they will hire a nurse to work two days a week and then pay her double time when she works a third day? Or do you think surgeons might use the surplus to expand their practice so they can treat more patients?

The last time health reform was attempted in the province, public sector unions staged massive rallies and the government backed down. I don’t want Kenney to have the same regrets as Thatcher and Klein.

The message to him is this: Don’t blink.