Monday, February 07, 2011

Health Care Reform in Alberta - Who Has the Answers?

There is a major concern over access to health care in Alberta. The quality of the care once you are in the system seems to be very good but we need both.

The solutions offered by the culture war on the right in Alberta are difficult to follow but some changes proposed are a more "market-based"  and "competition" approach to the publicly funded health care system.  They don't like to call it privatization because they know that would be rejected in the next election. So they couch the language but you have to wonder if that  is just hiding the privatization approach.  It is hard to know what is really proposed and what is really going on with such language.   There will be a debate in the PC, Liberal and Alberta Party leadership campaigns around all this I am sure.

Comforting political reassurances from the far right that privatization is not on their political agenda do not align with past pronouncements of those who are proposing this "competitive" approach to health care reform.  Even Ted Morton of the hard right Calgary School is now claiming to be a "moderate" in the Progressive Conservative Party.  This re-packaging of the hard line right wing past of some in the PCs and the Wildrose Alliance is just too hard to swallow and sure does not pass the sniff test based on past performance and policy positions. Have these leopards really changed their spots?

Other fiscal conservatives bemoan that the cost of health care is eating up a growing percentage of the provincial budget and that is "not sustainable."  Is that percent of total government budget a good test of what we are committing to health care in Alberta?  We are a growing economy and I understand we spend a smaller portion of our GDP on health care now that we did in 1968 when it first came in - and we get a lot more services now that we did back then.  Isn't that a better measure of the cost of health care as a portion of the Alberta economy and not just of the government budget?

We have some political parties totally bent of reducing the role of government by starving necessary public services like health, seniors, children services and education. Ironically they see no problem is increasing subsidies and reducing rents to sunset energy sectors at the same time.  This excessive subsidy to business puts the burden of personal income tax and strangles the capacity of the government to do the job the citizens expect of it.  If you reduce the denominator of total government spending you increase the percentage attributed to health care but that isn't a public policy disaster as a is just arithmetic based on  a governing philosophy.

Look at it in another way.  Our rush to the bottom in tax rates and revenues with our ridiculously low royalty regimes and then we use a significant portion of non-renewable resource revenues to pay for current government operations means this generation is not paying its way and robbing from the birthright of future generations. Again this is intentional with the goal to drive down tax revenues and reduce the capacity for the public sector service providers to do their jobs.  Are there political forces in Alberta that want to be elected to that they can assure that the public system to provide necessary social services like education, health, and seniors services will fail?

Setting up the community based service providers, health care professionals and public sector services to fail by starving them of resources means we will then be told that the only saviour of the system will be market-based private sector providers.  There will be soothing words that competition will keep the private providers honest and costs low but all too often we see reduced services, higher costs and feigned competitiveness.

There is a strong role for the private sector in many parts of our society but it must serve the needs of the society not the other way around.  Solving the health care concerns in Alberta is very important but it is embedded in a much more foundational issue and that is what is the role of government in our society.  Citizens also have to come to grips with what is our personal responsibility for our life style choices and the implications for the quality and cost of heath care too.

All these elements have to part of the discussion and design of a health care system that gives us access, quality and value for tax dollars.  To reduce it to a private versus public health care debate is an over simplification of a complex social, cultural and political challenge.  For every complex problem there is a simple answer that is usually wrong.  Albertans should not be fooled by soothing over simplifications as we struggle to design a quality and sustainable health care system for now and the future.