Criticism grows over Wildrose health plan
Wildrose denies plan for two-tiered care
Wildrose Leader Danielle Smith fended off accusations Friday that her party’s push for more competitive health care would create a two-tiered system that would see top doctors move to private facilities and wealthy patients get better care.
Smith said the system already features private operators, including family physicians and clinics that do cataract surgery.
Her party wants to encourage more independent facilities, creating a greater mix of public and private that would create incentives among all providers to reduce costs and bring wait times down, she said.
“If we can have additional choice in our health-care system, it will create best practices that can filter into the public hospital environment so they can become higher performing,” she said at Calgary’s Fountains of Mission seniors home.
“I look at this as saving our public health-care system. Our priority is to have a public system that works. But in the meantime, we can’t afford to have our seniors waiting years for the system to magically get its act together doing the same things it’s always done.”
Rival parties jumped on the Wildrose position, arguing the health-care system should not be forced to survive in a competitive market.
NDP Leader Brian Mason said he’s so concerned by Smith’s approach that his party will make the defence of public health care the focus of its election campaign.
“This is going be the thrust and the theme of our campaign from now on. we need to make sure that this election is about health care,” Mason said in Edmonton. “Danielle Smith has thrown down the gauntlet, and we’ll pick it up.”
Voters can’t trust Conservative Leader Alison Redford to protect public health care, given the track record of previous Tory premiers such as Ralph Klein and Ed Stelmach, Mason said.
“This PC party, to its very marrow, believes in private health care . . . All (Redford) will say is that she wants publicly funded health care,” Mason said. “What does she mean? She means that we will use taxpayers’ money to fund their friends in private business to deliver health care. Publicly funded health care isn’t good enough. It has to be publicly delivered health care as well.”
Liberal Leader Raj Sherman said he’s also worried about the PC and Wildrose platforms.
It’s clear both right-of-centre parties don’t understand how the health system really works, he said.
But Redford denied her party has a hidden agenda for further privatization.
Alberta already has a system where doctors can have their own offices “but that’s about as far as we go,” she said.
“That’s a system that’s working fine for people and certainly isn’t in any way impacting people’s ability to get access to service with family physicians, but we are not talking about any changes to that.”
The Tories are planning more long-term and continuing care with different types of accommodation, yet every senior will receive the same level of health services in those facilities, Redford said.
Earlier this week, she argued the Wildrose approach of encouraging more private delivery and competition goes too far.
“What does competition look like in a system like that? It looks like the people that are providing health care are going to go where they’re best paid for that health care, for those health care services,” she said.
“You’re going to end up with a system where people are going to find opportunities to create a different set of health services for people that can afford to pay, and people that can’t afford to pay are going to end up suffering.” However, Smith said the Wildrose plan would ensure medical treatments are publicly funded, no matter where they are done.
Private operators wouldn’t be allowed any extra billing and would be paid for procedures at the same rate as the cost in a public hospital.
However, some health policy experts have suggested there would be nothing to stop private clinics from offering patients non-medical services that could accompany their surgery.
This would allow the clinics to make extra money, potentially letting them pay doctors and nurses more than the public system offers
They also tend to focus on the easiest, cheapest types of procedures, leaving the more complicated and costlier surgeries to hospitals, some experts say. They also may not pay union wages.
This leads to concerns such advantages will push the top doctors and nurses to work at independent clinics.
“There’s not enough frontline staff as it is. Opening a private, shadow system would only take those limited resources away from the public system,” said Guy Smith, president of the Alberta Union of Provincial Employees.
His union represents between 35,000 and 40,000 health care workers in the public sector.
“I think it’s a very dangerous move for the Wildrose to do this, but at least they’re showing their true colours. The brass ring is within their reach and they’re being quite aggressive about what they’re going to do when they get into power.”
However, Danielle Smith said her expectation is that many health practitioners would wind up working for both public and private operators.
She said a number of doctors want more surgical time than they receive in hospitals, and would welcome the opportunity for more.
As well, part-time nurses could get additional hours at private facilities.
“I expect what we will see is that surgeries performed at independent facilities will always be a small share of the total amount of surgeries performed.”
Political scientist John Church, who studies health care policy at the University of Alberta, questioned whether costs and quality can still be controlled under the Wildrose policy.
He also wants to know if it would actually lead to quicker access to a new range of services.
Even if capacity is added and competition is encouraged through public and private delivery, there’s still a limited supply of health care workers, Church said.
“There’s not some magic tree of doctors and nurses out there somewhere just waiting for someone to harvest it.”
Becoming overly reliant on private operators can be a problem, he added, if the company suddenly goes out of business or other complications ensue.
Church points to Networc Health Inc.’s for-profit Calgary clinic, the Health Resource Centre, that performed orthopedic surgery paid for by provincial taxpayers.
In 2010, the deal between Alberta Health Services and the company collapsed into a messy legal conflict that cost Alberta taxpayers at least $3.5 million for Networc’s rent, debts, receivership fees and other items.
“The government is left scrambling to figure out what to do,” Church said. In some cases, “they then end up propping them up.”
If services are contracted out to a private provider, the government also has to ensure that high standards are maintained, he said.
However, there are advantages to contracting out public services, he said.
For example, the province isn’t on the hook for building all infrastructure, and it potentially takes on fewer liabilities.
“The government is able to manage their costs, but they still tap into the good stuff and the capacity in the private sector,” Church said.
“It’s not like it can’t work. It’s just there are some significant downsides.”