Once considered among the foremost advocates for two-tier health care in Canada, the Alberta government has released a report that calls for changes that could reshape the province’s health system into a more public model.
Health Minister Gene Zwozdesky said on Thursday, however, that a new Alberta Health Act the province is developing, and other controversial changes to the health-care system already implemented, include no move to privatize.
“Make no mistake about it: [the AHA] will be in the parameters of the Canada Health Act, and it will reflect one of Albertans' central values – for a single-tiered, publicly funded health system.”
The report released on Thursday, based on citizen feedback and produced by the province, urges in abstract terms that Alberta fundamentally reverse its approach to delivering patient care by “putting people first,” rather than a current model that report stakeholders say prioritizes health professionals and institutions in determining levels of care. Effectively, it says Albertans believe funding and treatment should follow a patient, rather than a patient having to seek it out.
If adopted in the new Alberta Health Act, the system envisioned in Thursday’s report would emphasize wellness over treatment – guaranteeing access to primary care, setting up multidisciplinary teams to provide it, developing performance standards, creating a Health Charter and hiring an advocate to enforce it.
Canada is facing a looming funding crisis in health care driven by an aging population and rising costs. The head of the Canadian Medical Association earlier this week urged a total rethink of the country’s health system, and on Thursday praised Alberta’s report.
Mr. Zwozdesky said the province is leading Canada in turning around the health-care model – no province has a Health Act as wide-reaching as that envisioned by Alberta, where health law is currently made up of about 30 individual pieces of legislation.
But critics worry it’s part of an ongoing boondoggle that could lead to more private care.
“The devil’s in the details,” said Liberal Leader David Swann, a physician. “That's one of the challenges I think we'll have to watch closely as [the act] comes to the legislature. Is this another excuse for privatizing?”
While he praised the medical professionals who signed off on the report, Dr. Swann added that “overall, I guess I'd have to say we don't need more laws, we need better management of the health system.”
Some observers say Alberta, which recently invested billions in health-related capital projects and consolidated its health boards, has abandoned its position as a proponent for some privatized care since the departure of former premier Ralph Klein.
The kind of primary care suggested in Thursday’s report could include a broad range of preventive treatment typically not included in public care – funding front-line acupuncture, chiropractors (which Alberta has recently de-insured), and pharmacare-like streamlining of prescription drug access. One stakeholder suggested that even homeopathic care could be considered, though another said he'd oppose that.
No mention was made whether providers would be public or private.
Study author Fred Horne, a backbench MLA who entered politics after a career as a health-care consultant, was left defending his report Thursday amid early coverage suggesting it was too vague. However, he said he was not asked to come up with specifics, but rather report what Albertans want. Access was their top concern, leading to his recommendation of a fundamental shift.
“Pretty much all Albertans I talked to say we have an excellent health-care system. A lot of our issues are just getting in,” Mr. Horne said. “It's up to the minister and the government to really reflect on what Albertans said and come back with a response.”
In his report, which cost just over $1-million to produce, Mr. Horne recommended the AHA augment, and not replace, five existing pieces of provincial health legislation, contrary to what was initially suggested.
Jeff Turnbull, the president of the Canadian Medical Association, praised Thursday’s report, telling The Globe and Mail the report “deals with many of the issues that we feel are important and that physicians across the country feel are important: patient-centredness, putting patients first, a focus on safety and quality.”
