The two most striking features of the health-care omnibus bill introduced yesterday by the United Conservative Party are that it opens the door to a higher degree of privatization and two-tier health care, and escalates Health Minister Tyler Shandro’s feud with the Alberta Medical Association.
Neither is a positive development if you want an effective, efficient and equally accessible health-care system in Alberta. It’s likely bad news outside Alberta too, where all the usual suspects on the right are waiting to use developments like Bill 30, the Health Statutes Amendment Act, to wedge the door open to U.S.-style health care.
Still, Bill 30 could have been worse, and a lot of Albertans thought it would be.
According to the government’s press release, the act will improve public health care, reduce surgical wait times and modernize the system. It is unlikely to do any of those things.
Shandro came a little closer to the mark in his description of the bill, saying it will “enable future innovation.” This is true, although not necessarily the kind of innovation a thoughtful observer would want to see in the middle of a global pandemic or the uncertain health care future that follows.
Thanks to the comfortable majority in the legislature Albertans gave the UCP last year and the iron grip Premier Jason Kenney maintains on his caucus, Bill 30 will be the law of the land in a few weeks.
More privatization and the creation of a two-tier gap will be facilitated, in the cheerful words of the press release, by “enabling government to contract with a range of organizations to operate medical clinics so physicians can focus on providing patient care, rather than administration.”
What this means, presumably, is a proliferation of private, extra-fee clinics that offer both medical services listed for coverage under public health insurance and a variety of non-medical wellness services ranging from unneeded medical tests, to dietary advice, to new age remedies. The clinics, which will not need to be owned by a physician, can charge whatever they wish for non-medical services, justifying up-front fees that are really for access to medical services.
In addition, the press release says, the changes will result in “streamlining the approval process for chartered surgical facilities to operate so they can provide more high-quality, publicly funded surgeries to help reduce surgical wait times without compromising patient safety or quality of care.”
This is obviously the not-so-thin edge of the wedge of privatization and two-tier health care in Alberta. As everyone who seriously studies health policy understands, it is unlikely to either save money or reduce surgical lineups.
Indeed, it will have the opposite effect as doctors flee the public system to provide more profitable services and problem cases requiring higher-cost treatments are dumped back into the public system.
Arguably, the transfer of public health care to privately owned clinics is also part of the UCP’s long expected union-busting agenda. After all, the only unions Kenney likes are the ones whose members build pipelines in Montana. He’ll return their calls, at least, if they’re likely to help him lobby a president Joe Biden should that become necessary to keep Keystone XL in play.
Then there’s the UCP’s war on the AMA, the venerable physicians’ association that collectively bargains doctors’ compensation.
Clearly, the Kenney government with Shandro as its point man has targeted the AMA for irrelevance if not destruction. Bill 30, the news release says, will make it “easier for physicians to enter into alternative relationship plans for compensation.”
What that really means is it will make it easier for the government of Alberta to undermine and ease the AMA toward irrelevance.
It’s been clear since the Kenney government arbitrarily terminated its master agreement with the AMA in February that it’s been out to crush the association. Legislation passed last fall gave the government the right “to cancel any physician services agreement, without recourse,” said AMA president Christine Molnar at the time. “What is the value of an agreement when it can be revoked at any time with no public discussion?”
The UCP’s war on doctors has been waged by the government through the COVID-19 pandemic and will now proceed with new legal teeth.
The government is obviously hoping there will always be someone who will break solidarity, fracturing and weakening the AMA a step at a time. But you have to wonder, given Shandro’s history with the association, why any doctor would sign an individual contract with this government.
The AMA, for its part, can be expected to push back vigourously. It sued the province in April, arguing the government violated its charter rights and seeking $255 million in damages. Many doctors, particularly younger ones in rural practices, continue to pack their bags to leave the province.
The UCP doesn’t seem to care. Maybe they just plan to hook Albertans up with Babylon by Telus, the Canadian version of the controversial British virtual medicine smartphone app they were plugging in official news releases last March.
Other aspects of the bill seem like housekeeping, such as clarifying quarantine requirements for travellers, and some could even deliver minor improvements — raising the number of public representatives on professional colleges’ boards might help in the unlikely event the UCP didn’t try to pack them with their ideological allies.
Of course, if this doesn’t seem quite as bad as it might have been, you may only have to wait another day for the other shoe to drop.
Later today, the government is expected to introduce its package of labour law changes — which are likely to be designed to hamstring public sector health care unions, make collective bargaining and organizing more difficult for public and private sector workers, and make it harder for elected union leaders to speak up on behalf of their members.
Justice minister off the hook after ethics complaint
Alberta’s ethics commissioner says no rules were broken when Justice Minister Doug Schweitzer asked Steve Allan to run the province’s dubious inquiry into the UCP’s nutty conspiracy theory that foreigners are funding “anti-Alberta” opposition to oil sands development for nefarious purposes.
In her report yesterday, Marguerite Trussler wrote that “just because Mr. Allan made political donations to Minister Schweitzer in the past does not make the subsequent appointment of Mr. Allan as inquiry commissioner a private interest for the minister.”
As for Allan’s award of a $905,000 sole-source contract to a law firm where his son and a good friend worked, Trussler said she had no jurisdiction to look into that.
She also suggested media reports of the situation were not factual.
“This is a first,” responded CBC investigative reporter Charles Rusnell, who broke the original story. “Alberta’s ethics commissioner Marguerite Trussler slags media as not being concerned about facts — after her report verifies all our reporting.”
“The biggest glaring error is that the ethics commissioner sets out all the different things that Steve Allan did for Doug Schweitzer to help him get elected and then she ignores almost all of those things when concluding that he did not cross the line and it was not enough to create a conflict of interest for Schweitzer,” said Duff Conacher of Democracy Watch, the organization that made the original complaint last year.
“You can’t just ignore facts in your own report when making your ruling,” he said in a statement.
But this is Alberta, so I guess you can. Nothing to see here folks. Please move along.
David Climenhaga, author of the Alberta Diary blog, is a journalist, author, journalism teacher, poet and trade union communicator who has worked in senior writing and editing positions at The Globe and Mail and the Calgary Herald. This post also appears on his blog, AlbertaPolitics.ca.
Image: Alberta Newsroom/Flickr
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