With the health care policy it released last week, the market fundamentalist Wildrose Alliance Party has signalled it is now prepared to play a bold game to defeat Alberta’s ruling Conservatives.
Wildrose Alliance Leader Danielle Smith has over the past few months indicated she is a fairly cautious politician, so rolling the dice on health care probably reflects the go-for-the-throat instincts of the federal Conservative insiders now in key positions plotting her party’s course.
Seen from their perspective, an aggressive health strategy makes sense. Realistically, the party probably has only one election, certainly no more than two, to prove it is a player in Alberta. Without significant gains in the next general election, media, voters and corporate donors will rapidly lose interest.
The party’s only chance not to be a flash in the pan may be to play to its far-right base, a group that includes many right-wing activists who still find an uneasy home in the Progressive Conservative Party of Premier Ed Stelmach. To do that, it needs to call for a private role in great swaths of the health care system, which it clearly did in its Nov. 2 policy statement on health.
As Smith said of her policy, “right now, we are far too consumed with upholding the public delivery model at any cost.”
At the same time, the Alliance needs to persuade nervous voters for whom preserving accessible health care is the No. 1 issue, but who are sick of the way Stelmach’s Tories manage the file, that they can safely vote Wildrose. So, Smith professed that “choice and competition” among private and public health providers won’t add up to full-blown privatization.
“A Wildrose government will uphold the principles of the Canada Health Act,” she shrewdly promised. “We will ensure health insurance is publicly administered, comprehensive, universal, portable and accessible. That means you won’t have to use your credit card to get medically necessary treatment.”
There’s plenty here to quibble with if you’re paying attention: Publicly administered but not publicly delivered means two-tiered, right? If we have a physician shortage, and specialists work for private clinics that give superior service to those who can afford to make “choices,” who guarantees the promised universal access to the rest of us? Who gets to determine which treatments are “medically necessary”?
Who pays the inevitable costs of “competition”? Did competition help us when the Alberta government deregulated utilities?
And where does Smith get off comparing Alberta’s health care system to North Korea’s when in fact it’s much more like the European model she offers as an example? Just like France and Germany, we have a system now that mixes public and private care. And note that Smith had nothing to say about Australia, where an increased private role raised costs and had little impact on waiting times.
According to media, Smith “flatly denied” the Wildrose Alliance intends to privatize health care. “The Wildrose party believes Albertans should have the right to use their public insurance to obtain needed medical treatment from either a public, private or non-profit medical provider,” one report said.
But if we all want the same treatment from the same specialists at the same facility — public, private or not-for-profit — how is a Wildrose government going to decide who goes to the front of the line? Here’s a hint: get your wallet out.
There’s a widespread understanding of this issue among Alberta’s public, which is ambivalent about privatization. Opinion research indicates most Albertans view the idea of privatizing health care with deep distrust. But they also see themselves as pragmatic and not too concerned how a public service is provided, as long as it delivers the goods.
Wildrose strategists clearly think they can get the public to stop worrying about privatization if they call it anything but the P-word and say it will deliver the same level of service.
This strategy may work — but only if Alberta voters don’t do the math.