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Why is Alberta studying seniors' care at the same time as it's privatizing it?

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Fred Horne

On Monday, Alberta Health Minister Fred Horne announced a year-long project to study seniors' residential centres and figure out the best way to fund and run them.

Sounds good, lots of Albertans must have concluded, before getting on with their business confident the administration of seniors' care under Premier Alison Redford is in good hands.

But if Horne and the provincial Health Department are really serious about assessing the financial sustainability of the 400 or so seniors' facilities, weighing various funding models and exploring what type of services and programs they ought to offer, why is Alberta Health Services plunging ahead and closing publicly run seniors' centres right and left, pushing the residents into private facilities?

If this were a serious public policy study, wouldn't decisions that logically flow from the study's conclusions need to wait until after it has been completed?

Yet since last summer, AHS has announced (as quietly as it can get away with) that it's closing well-run public seniors' centres in the communities of Carmangay, Bashaw, Grande Prairie and Stettler. Count on it there will be more to come in the weeks and months ahead.

In each case, elderly and vulnerable residents and their families have been told they have no choice but to move to a private-sector facility being built with government subsidies in the same community, or, in some cases, to be scattered to the four winds in locations right out of the community.

It is very difficult to avoid the conclusion Horne and the Redford Government have already made up their minds about what to do with the province's publicly run seniors' centres. Likewise, it is impossible to avoid the thought Alberta Health Services has already received its marching orders from the government and is getting out of the business of running seniors' centres altogether.

If so, just for starters, what is the government doing spending even the insignificant sum of $70,800 of our tax money to get the University of Alberta and a couple of seniors' organizations to "study" what to do next when they've already decided on a course of action? Is this the distraction before the sleight-of-hand illusion?

In fact, if you've been paying attention, it's been perfectly clear since the Broda and Mazankowski reports in 2000 and 2002, led respectively by dependable Conservatives Dave Broda and Don Mazankowski, where Alberta's Progressive Conservative government intends to go with seniors' care.

And that place is not the excellent public care that Alberta seniors have enjoyed in the past, but mainly into private, for-profit facilities that are intended to move the costs of care from the public to individuals and their families.

In other words, they plan to "unbundle" health care and housing from one another to pass the costs of caring for the province’s most vulnerable citizens to their estates and their families -- or, if you wanted to take a particularly cynical view of it, to redirect their modest estates from their families' bank accounts to the wealthy operators of private, for-profit seniors' residences.

To the market fundamentalist worldview, this makes sense -- although the costs of running a private for-profit health care system for a vulnerable sector of the population are inevitably much higher and the quality of service delivered to residents will surely be worse.

Each of the four closings announced since last summer will result in an immediate decline in the quality of care when the re-designated facilities are no longer required to have a Registered Nurse on the premises at all times.

But at the heart of the Broda-Mazankowski approach is a long list of items and services that in publicly run facilities were covered by the operator but which now will have to be paid by residents and their families: call bells, laundry, furniture, medical supplies and equipment, diabetic supplies and equipment, dressings, personal care supplies, dental care, vision care, glasses, medically required transportation, snacks, and of course, pharmaceuticals. The costs can run to thousands of dollars a year.

In additions, under the new model, many services that were provided on site -- physiotherapy, rehabilitation, Registered Nurses, physician visits and recreational activities -- are all likely to move to more expensive and inconvenient locations off site.

The costs to taxpayers, it is said here, will not decline as much as the government claims or imagines -- but instead of helping citizens, the cash will go into the pockets of wealthy businesspeople.

It's enough to make one pine for the days when Stephen Duckett, the Australian PhD health economist with a professionally fatal addiction to cookies, ran Alberta Health Services. For all his sins, at least he understood that from both cost and social perspectives, it made better sense to keep seniors' care in the public health care system.

Undoubtedly, he was told to drop that idea poste haste by his boss, the health minister of the day.

There were also some rather mysterious references in Horne's remarks Monday to what "the untapped capacity of senior centres might be across the province" might be.

What do you want to bet that what he has in mind might be as places to locate the Redford Government's much ballyhooed but likewise vaguely defined "family care centres"?

If this speculation is true, it would provide a plausible excuse to further subsidize the operations of the for-profit landlords, and perhaps also offer a justification for banning strikes by their unionized employees -- who, as things stand, can't legally strike at publicly run seniors' centres but can walk off the job at the privatized facilities this government is hell-bent on encouraging.

The bottom line -- an appropriate enough a metaphor given the circumstances -- is that notwithstanding its commitment to public primary health care, this government continues to be dedicated to the wholesale privatization of long-term care for seniors in Alberta.

If that makes you feel uncomfortable, don't look to the Wildrose Party for help, because they stand for exactly the same thing -- plus the privatization of whole swaths of primary care.

If Albertans want to protect the excellent system of seniors' care enjoyed by previous generations, they are going to have to elect political parties that are genuinely committed to the idea caring for the elderly is part of health care. I don't think I have to tell you who that would be!

CORRECTION: I am reliably informed that the seniors' centres referred to by Health Minister Fred Horne thyat this study will be looking at are community centres, not long-term care centres. This is my error and I own it. However, most of the points made in this piece about the seniors' care model in Alberta are valid, so, rather than a tortured rewrite or a craven retreat, I'm just going to leave the piece stand with this correction. Alberta Diary, as the saying goes, regrets the error … and so do I. DJC

This post also appears on David Climenhaga's blog, Alberta Diary.

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