Wednesday, December 01, 2010

For Alberta Being the Best in the World is NOT Good Enough

I have read the leaked Government of Alberta Power Point presentation "Alberta's Health Legislation: Moving Forward"  It is a document that begs a lot of questions and raises some legitimate suspicions about the political intent of the Stelmach government on just how secure is the future of publicly funded health care in Alberta.

Bill 17, the new Alberta Health Act is now passed with Closure invoked by the Stelmach government.  I expect to hear very little about it now. The government wants to shift our attention to the "Becoming the Best: Alberta's 5-Year Health Action Plan" and not have us dwell on any boogie-man fears of a secret strategy of privateers out to make our health care system the private property right of some insurance companies.

I have not yet read the Five Year Action Plan.  It was just released yesterday. But I will read it with great interest.  At first is sounds like a revision of the Olympics motto with words like  "more, faster, quicker, reduced, best" as the hooks. There is only one small mention of a wellness aspect and that is a 32% increase in child immunization rates...what ever that means.  We need much more attention to prevention and wellness in our health action planning.  Don't you think?

I know Minister Zwozdesky had some resistance getting this Action Plan through Cabinet. But all the publicity and pressure over Raj Sherman and the leak of  July strategy document I am sure that forced the hands of the foot-draggers in Cabinet.  After all what is the point of a five year stable funding commitment if you don't have a five year plan to be able to prove you are using the money wisely?

I will comment more on both document in future blogs.  Let me say for now, on the leaked "Alberta Health Legislation: Moving Forward" it is difficult to understand the document because it is terse and in bullets points.  There is not much narrative to help one really understand the integrity and intent of the policy approach being proposed.  Some stuff is very good and other stuff is veiled political framing of a privatization agenda.  Minister Zwozdesky says this is "not his document" and he rejected it because some elements were contrary to the Canada Health Act.  Go figure!

From that statement by Minister Zwozdesky, it is safe to conclude this government document is must then "belong" to former Health Minister Ron Liepert.  Is sure sounds like his free-market competitive Fraser Institute approach to health care. Given the clear comments from Minister Zwozdesky that he rejected the leaked "Moving Forward" document, we can hopefully conclude that the public health care system in Alberta is safe from ideologically driven privatization agenda - at lest for now..  That sense of safety for the public health system in Alberta only goes up to the next Cabinet shuffle, when ever that might be.  If Minister Liepert performs as badly in Energy as he did in Education and Health, a shuffle could be sooner than later.  Who replaces Gene Zwozdesky in the Health and Wellness portfolio will tell us a great deal about the integrity and true intent of the Stelmach government on the privatization of the public health care system in Alberta.

As for the Five Year Action Plan, at first blush is it all about targets, measures and percentage but almost entirely aimed at the acute care end of the spectrum. The care and compassion, respect for professionalism in the system is not readily apparent.  Fair enough but we also need a culture shift to include encouraging personal action on disease prevention, wellness and well-being too.  Albertans must take personal responsibility for their health care and that is about each of us taking steps in the areas of prevention, including lifestyle changes as necessary.  Health care is not just all about the system.  Much of it is about us, our values and attitudes.

I get put off when I see policy documents aspiring to be the "best."  Like in this document title: "Becoming the Best:Alberta's 5-Year Health Action Plan." Stating Alberta's goal to be the "best-performing publicly funded health system in Canada is to merely measure ourselves relative to others.  That is a mugs game and is more sloganeering than a soundly reasoned policy objective.  With all the wealth in Alberta and our highest per capita spending on health care we should already be the best in Canada...but on what measures?  Life expectancy and wait times are important but not very sophisticated outcome aspirations.

We know economic wealth translates into good health outcomes.  Given the enormous wealth and potential in Alberta we should have the aspiration to be the best health care system for the world, as well as the best in the world.  That better aspiration for Alberta to be the best health care system for the world can happen in terms of investment in other areas like prevention, teaching, research and innovation.  Now that is something to strive for in addition to value for tax money and, quality care and better access times...all of which are essential but not sufficient for live up to our potential.

To close let me invite you to watch this interesting video.  It is just over 4 minutes and shows how the wealth of a country is correlated to life expectancy.  Watch it and ask yourself why the Alberta government sets its health care sights so low and narrow given our potential.  (H/T to Kim Bater for the link)