Two pernicious and slightly dissonant myths that cloud discussion of public health care are the idea that to get the best public-sector managers we must pay excessive private-sector style salaries and perks and the plainly preposterous notion the private sector always does everything better.
So it was interesting how Stephen Lockwood, the apparently cold-eyed and pragmatic trucking company executive from Okotoks picked by the Progressive Conservative government of Premier Alison Redford to lead the Alberta Health Services Board, tossed both ideas over the side the instant he was told to get serious about appearing to save money.
In other words, whatever Board Chair Lockwood's other flaws may be, he can apparently add and subtract.
The AHS news release yesterday outlining Lockwood's cost-cutting plans in the face of a smaller-than-anticipated provincial increase to the AHS budget -- 3 per cent, versus the expected 4.5 per cent -- was one of a phenomenal six press releases issued by the massive province-wide health agency today. (Hint to AHS cost cutters: if your PR department is trying to get in the Guinness Book of Records for the most news releases in a single day, perhaps some of them should be reassigned to front-line health-care duties!)
Actually, the release implied the plans were jointly cooked up by Lockwood and CEO Dr. Chris Eagle, but one has the unshakeable feeling that on this one that it was Lockwood calling the shots. It’s also a bit of a stretch to call the contents of this release news, since the key points were all released once before in a meeting with the Calgary Herald editorial board at the end of February.
Regardless, the statement lists eight "initial administrative cost savings," and the stuff that made the lead of the newscasts were promises to freeze management pay for three years, reduce administrative expenses by 10 per cent over all, and deeply chill the hiring of new administrative employees not deemed to be "mission critical," whatever that means.
Of course, mission criticality may turn out to be a pretty elastic concept, although not likely in the first year -- which when you think about the budgeting process is really the only year of this packet of promises that has any meaning.
Still, here's a little wager, despite the constant repetition of the mantra that we have to pay top dollar to get top managers, not many of these top managers will immediately decamp for other top jobs.
If I am right, perhaps we should bear this in mind when we set the management salaries of a whole range of senior public jobs in future, including university presidents, health system vice-presidents and government deputy ministers.
Oddly enough, from the market fundamentalist perspective not usually advocated in this space, the iron law of supply and demand would suggest demand is high worldwide for physicians, nurses, practical nurses and other front-line medical professionals and that therefore their pay is probably too low.
The same cannot be said of managers, who are a dime a dozen even if we pay them more than that.
Meanwhile, buried in Point 8 of the release was a notation that, to immediately save money, AHS would now be "cutting expenses incurred for the use of consultants and external facilitators."
One could argue it's about time.
It's well established that with its massive purchasing power and many economies of scale -- and without the need to pad corporate bottom lines with profit -- single-payer public health care is far less expensive and much more efficient than for-profit health. Health care marketizers and highly ideological right-wing governments just hate this well-established fact, and are endlessly creative but not terribly successful in their efforts to wiggle past it.
Public health care agencies like AHS that instead of using their own skilled public sector workforce go outside to the private sector to “save money” rarely achieve that goal, and often end up costing themselves and taxpayers far more.
That Lockwood immediately spotted that bad habit as exactly what it is was should be a useful yardstick of the truth behind the risible claim private operators do key jobs better than public employees.
After all, he’ll have the before and after cost and quality comparisons right in front of him for future reference when the cash starts flowing again.
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After much puffing and blowing, teachers and government reach deal
After all their wary circling and a tentative jabs, it appears Alberta’s schoolteachers' union and the Redford Government reached a tentative collective agreement yesterday that everyone can live with -- well, maybe everyone except some school boards, whose association was predictably screeching about the costs of the deal last night.
Details must await our commentary until the 35,000 eligible Alberta Teachers Association members have voted on the pact, which the union’s provincial executive has endorsed.
Expect the relative amity that have long characterized the relationship between the government and the ATA to quickly return once the agreement is signed.
This post also appears on David Climenhaga's blog, Alberta Diary.