UCP should articulate a vision for health care
Minister’s war with physicians won’t heal medicare ills, Ronald Kustra says.
A tenet of medicine is, “First, do no harm,” from the Latin phrase “primum non nocere” or “primum nil nocere.” It is attributed to the 17th century English physician Thomas Sydenham.
Its antecedent was not the Hippocratic oath, but “Of the Epidemics” which was part of the Hippocratic Corpus: “The physician must be able to tell the antecedents, know the present, and foretell the future — must mediate these things, and have two special objects in view with regard to disease, namely, to do good and to do no harm.”
What if Alberta Health Minister Tyler Shandro abided by tenets of the medical profession? How might that change what currently is occurring?
Stephen Covey was named one of the 100 most influential thinkers and writers of the 20th century. His bestseller, The 7 Habits of Highly Effective People, offers insights and advice such as “Begin with the end in mind” and “Seek first to understand, then to be understood.”
What if Shandro offered his vision of a highly effective health-care system? The angst, anguish and disillusionment from physicians suggest that understanding and being understood are not the minister’s forte. What if he explained what end he has in mind from the changes that his department is making or contemplating and how they are doing so?
In the highly acclaimed The Art of War, Sun Tzu cautions: “A problem usually arises when one holds to a view that has become too small and inflexible.” (He also notes, “War is not a thing to be trifled with” because war is “the place where life and death meet.”
What if Shandro had credibly explained why his government has chosen to go war with Alberta’s physicians and their organization, the Alberta Medical Association (AMA)?
Why does Shandro profess allegiance to the Canada Health Act when he ignores its prescription — binding arbitration — to resolve disputes with physicians over compensation? In doing so, he is not alone, but is mimicking the hypocritical behaviour of governments of all political stripes since the act became law April 1, 1984.
In the familiar strategic model SWOT (strengths, weaknesses, opportunities, threats), it would be surprising if the 2019-2020 analysis had identified the COVID-19 pandemic. The upside, however, is that the leadership of the province’s medical officer of health appears to be efficacious. Ah, finally a bright light.
During the election campaign, Premier Jason Kenney referenced options for patient care available from private surgical centres in Vancouver and Montreal. This created hope among those who believe it is long past time to transform our health-care system for the 21st century by ending the unionized public monopoly created half-a-century ago in 1970.
Shandro’s intention to offer more surgeries through outsourcing to the private sector — but still within the ambit of the Canada Health Act — has predictably provoked false cries of “privatization” from unions, the NDP and groups such as the Friends of Medicare. They are shrill, dedicated, organized and very well-funded in their opposition with its anti-american jingoism.
They demonize “private, for-profit” health care, claim it is un-canadian, and demand it be outlawed. It’s a classic example of “don’t confuse me with the facts.” In two pilot projects, one each in Alberta and Saskatchewan, the private sector was more cost-effective than the unionized public sector in delivering certain services. And Shandro thinks physicians are a problem.
Absent is a pivotal innovation equivalent to medicare itself, specifically the introduction of a patient-care guarantee offering patient choice when medicare fails, e.g., lengthy waiting lists for appointments, treatments and surgeries that exceed clinical practice guidelines. As the Supreme Court of Canada observed: access to a waiting list is not access to care.
Governments and politicians are all too ready to hold the private sector to account when there is a problem with a product, a service or behaviour. However, they have refused to impose similar obligations on themselves by introducing a health-care guarantee (access, quality, choice).
“Cry ‘Havoc!’ and let slip the dogs of war,” regrets
Mark Anthony in Shakespeare’s play, Julius Caesar. Shandro’s two key adventures — war with physicians and more private delivery of publicly funded health care — will not heal the ills and woes of medicare.
Albertans deserve a publicly funded health-care system that delivers timely access to quality care, and they deserve choice with a private-sector option. Minister, you have three years and a majority government to make history. Carpe diem (seize the day).