Alberta
Alberta’s bureaucratic shuffle bears little resemblance to necessary health-care reforms
From the Fraser Institute
Sometime soon, the Smith government will begin a major shift in the administrative structure of the province’s health-care system, switching from a single overarching health authority (Alberta Health Services) to multiple authorities each tasked with overseeing one area of the health-care system. Unsurprisingly, the usual defenders of the status quo were quick to decry the reform as unnecessary or problematic. To other critics, this seems a lot like a distraction tactic from the old playbook where the deck chairs on the Titanic are shuffled to make it appear as if the government is finally doing something about the province’s failing health-care system while nothing will really change.
Then again, it’s also possible that the provincial government is building the structure for some very positive reforms that will meaningfully benefit Alberta’s patients in the future. Alberta’s health-care system is not known for being efficient, effective or timely—and reforms are badly needed.
Among the provinces, Alberta’s provincial health spending ranked second-highest (after adjusting for age and sex) in 2021, the latest year of available data, while Albertans endure health-care wait times that are longer than the national average. Nationally, Canada is a relatively high spender among universal health-care countries, yet ranks near the bottom for the availability of medical professionals, medical technologies and hospital resources. And Canadian patients suffer some of the longest delays for access to care in the developed world.
Put simply, Albertans spend more and get less than their counterparts in other developed countries when it comes to universal health care. The solution to this problem is to learn from countries such as Switzerland, Australia and Germany, which all deliver more timely universal care with comparable health spending to our own.
So what do these countries do differently? They all have private competitive providers delivering universally accessible services within the public system, and payment for such care is based on actual delivery of services, known as “activity-based” funding. Alberta’s new bureaucratic shuffle appears to bear little resemblance to these higher-performing approaches pursued elsewhere. And if the bureaucratic shuffle is the entire goal, then this reform will likely generate little to no improvement.
But again, perhaps the Smith government is setting the stage for meaningful reform. Before moving from a government-dominated health-care system (like we have in Alberta and every other province) to a higher-performing model with competitive patient-focused delivery, governments must first separate and clearly define the roles of the purchaser of health care and the providers of that care. The Alberta Health Services, which the Smith government will soon begin to dissect, directly provides, oversees and pays for health-care services (e.g. surgeries) in the province. This leads to a lack of transparency and the politicization of health-care decision-making.
A shift to multiple health authorities focused on the delivery of care, accountable to other authorities and the provincial government, has hints of the more transparent and contractual relationships between payers and providers that have reduced wait times and enhanced health system efficiency in a number of European countries. If that’s indeed the government’s goal, Albertans could soon benefit from an improved health-care system.
In other words, if this reform, to move from one large health authority to multiple authorities, is really about more clearly defining government’s role as the purchaser and oversight authority for universal health care, with authorities and providers being transparently accountable for delivering timely quality care to patients, then Albertans may well be on the road to shorter wait times and a higher-quality health-care system.
However, if this is the provincial government working from the same old playbook, with another administrative shuffle to distract Albertans from the real problems in the health-care system, then nothing will really change and patients will pay the price.
Author:
Alberta
Free Alberta Strategy petition demanding PM Trudeau fire Steven Guilbeault passes 13,000 signatures
News release from Free Alberta Strategy
Are you tired of watching elected officials flout the law and disregard public concerns with impunity?
Are you frustrated by a federal government that prioritizes arrogance over accountability?
If so, you’re not alone.
Over 13,000 people have signed our petition calling on Justin Trudeau to fire Steven Guilbeault.
Once one of Greenpeace’s most disruptive forces, Guilbeault has spent enough time in an orange jumpsuit to build up a reputation for deliberately ignoring both law enforcement and the courts.
Since then, his career has been marked by a troubling disregard for both legal boundaries and public sentiment.
In 2001, Guilbeault was found guilty of mischief for scaling the CN Tower in Toronto and displaying a banner.
He received a sentence of one year’s probation, was mandated to complete 100 hours of community service in Montreal, and was ordered to pay $1,000 in restitution.
The incident incurred approximately $50,000 in costs for the tower operators.
Shortly thereafter, Guilbeault orchestrated another audacious act, leading a Greenpeace team in a demonstration at the Calgary residence of then Alberta Premier Ralph Klein and his wife, Colleen.
They erected a banner, positioned ladders against the house, and ascended to the roof to install a solar panel.
The intrusion deeply unsettled Colleen Klein, who was alone at the time and feared a home invasion – she resorted to grabbing a broom for defense.
Despite his controversial background, Justin Trudeau’s decision to appoint Guilbeault as Minister of Environment and Climate Change raised eyebrows and elicited criticism.
Jason Kenney, then premier of Alberta, accurately predicted the consequences of Guilbeault assuming a significant role in Justin Trudeau’s cabinet.
“His own personal background and track record on these issues suggests someone who is more an absolutist than a pragmatist when it comes to finding solutions,” Kenney said.
It’s perhaps no surprise then that Guilbeault’s response to legal setbacks in his political career, such as the Supreme Court’s ruling on the unconstitutionality of his Impact Assessment Act, has been dismissive, indicating a stubborn adherence to his own agenda rather than a willingness to heed judicial guidance.
Instead of accepting that he was wrong and repealing the law, Guilbeault wants to pass minor amendments and pretend like the Supreme Court ruling never happened.
Worse, the amendments – buried 552 pages into a 686-page budget implementation bill – don’t fix the problem.
Guilbeault still has the power to control projects that fall under provincial jurisdiction.
Consequently, tensions between the federal and provincial governments have escalated, with Alberta poised to immediately challenge the amended legislation in court once again.
This charade is getting old.
This pattern of defiance and disregard for legal constraints has become wearisome, eroding public trust in the integrity of federal institutions.
The rotation of headlines proclaiming federal overreach and constitutional breaches underscores a troubling trend within the governing party, where arrogance appears to have supplanted prudent governance.
Guilbeault, with his checkered past and continued ignorance of the law since becoming Minister, are crippling public confidence.
A few months ago, we launched a petition calling on Justin Trudeau to see the light, and fire his most controversial Minister.
Since then, things have only gotten worse.
If you agree, and think Guilbeault should be fired, please sign our petition today:
Then, send this petition to your friends, family, and every Albertan so that they can sign too!
Regards,
The Free Alberta Strategy Team
Alberta
Fortis et Liber: Alberta’s Future in the Canadian Federation
From the C2C Journal
By Barry Cooper, professor of political science, University of Calgary
Canada’s western lands, wrote one prominent academic, became provinces “in the Roman sense” – acquired possessions that, once vanquished, were there to be exploited. Laurentian Canada regarded the hinterlands as existing primarily to serve the interests of the heartland. And the current holders of office in Ottawa often behave as if the Constitution’s federal-provincial distribution of powers is at best advisory, if it needs to be acknowledged at all. Reviewing this history, Barry Cooper places Alberta’s widely criticized Sovereignty Act in the context of the Prairie provinces’ long struggle for due constitutional recognition and the political equality of their citizens. Canada is a federation, notes Cooper. Provinces do have rights. Constitutions do mean something. And when they are no longer working, they can be changed.
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