Edmonton Journal

UCP’S plan to address health-care spending remains shrouded in mystery

- KEITH GEREIN Commentary

As we head into the so-called dog days of summer, here’s a little provincial history lesson sure to make you sit up and pay attention. (Or roll over and play dead, depending on how much you like history.)

A century ago, in the summer of 1919, Alberta became the second province in Canada behind New Brunswick to create its own stand-alone health ministry.

According to the Canadian Journal of Public Health, the move was precipitat­ed by the crisis of the Spanish flu, which killed an estimated 4,000 Albertans and sickened more than 30,000.

Among the victims was the province’s first health minister, Alexander Grant Mackay, who died after less than a year in the job. (For a province that now struggles to get 30-per-cent take-up on the seasonal flu shot, you can imagine the demand from Albertans in 1919 had a flu vaccine had been available.)

One hundred years after the health ministry was establishe­d, Alberta’s health system is today arguably one of the best in the country in terms of quality and breadth of services, if not in wait times. Yet the system is nearing another crisis point, this time not from an epidemic of infectious disease but of rising costs. Like a virus, it has been spreading.

A ministry that was once among the smallest in government is now by far the largest, with an annual budget of $22 billion that represents 40 per cent of all operationa­l spending.

Costs are set to jump much higher over the next decade or two, when the baby boomers reach their advanced senior years and start requiring more surgeries, drugs and hospital stays.

As it stands, Alberta’s current tax regime isn’t nearly sufficient to pay for it. The job of handling this conundrum now falls to new Health Minister Tyler Shandro and his UCP government, though their actions to date remain as difficult to decipher as a doctor’s handwritin­g.

You may remember that prior to the election, Premier Jason Kenney guaranteed that a UCP government would do no worse than freeze health spending, and even made a big show of it by signing a large poster board.

Wherever that signed “guarantee” wound up, the UCP is probably best served by burning it because it appears increasing­ly likely that Kenney has no plans to honour it.

Given his repeated (unverified) comments that the NDP misreprese­nted the state of the provincial treasury, it now seems a good bet that the UCP’S first budget this fall will deliver the first real cut to the health ministry in more than two decades. And it’s probable the government will seek pay rollbacks from unionized workers to accomplish it.

There is a case to be made for that since many Alberta health workers are well paid compared with counterpar­ts in other provinces.

However, if that’s indeed where he’s going, Kenney should be upfront about his intentions, and would be better served by selling it as a move toward the longterm stabilizat­ion of the system, not as a reaction to some phantom book-cooking by the NDP.

Regardless, the trick with managing the cost issue is to do it in a way that doesn’t compromise the quality, breadth and other features of the health system Albertans are fortunate to have.

Remember that Kenney also promised during the campaign to reduce wait times for surgeries to no more than four months by the end of the UCP’S first term.

That would have been difficult enough with a spending freeze, but it becomes much harder to imagine how he can pull it off with a spending cut.

At the time, the UCP said it could accomplish the goal, in part, by outsourcin­g more day procedures to private surgery clinics. But when asked about it these days, Shandro has been vague or has suggested it is a project for down the road.

And that’s not the only aspect of the UCP’S health plan still wrapped in mystery.

While the government has vowed to keep its promise to increase spending for mental health and addictions, which is needed, there’s no word yet on vows to remove the cap on midwife services, further empower nurse practition­ers or resume a grant program for continuing care beds, all of which hold the potential to reduce costs.

More importantl­y, the government has been largely silent about its approach to the much bigger cost drivers of pharmaceut­icals and doctors’ compensati­on, not to mention the province’s inordinate number of rural hospitals.

If the UCP really wants to rein in spending, those factors can’t be ignored.

Perhaps the blue-ribbon panel looking into Alberta’s finances can provide answers, or else the Alberta Health Services review. Failing that, the budget tabled this fall will hopefully provide insight into the government’s direction, not just for the current election cycle, but for the long term.

After all, as tales of history are told a century from now, I can only imagine what the Albertans of 2119 will say about us if we fail to address a crisis when we had the chance.

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