There is a video just over 4 minutes that will make you smile to the core of your soul.
A small segment of joy for all of us as we work through some difficult times
Enjoy and share.
Thanks to Coralnet.org for making it available
Tuesday, December 07, 2010
Albertans Are Waking Up and Looking for Viable Political Options
My reading of the recent Environics poll of the political mood of Albertans shows that we are well into our winter of discontent- at least politically. Alberta voters have been a somnambulent since the 1993 election. Back then we found two politicians (Decore and Klein) who captured the public concern about Alberta's debt and deficit problem. The next election was about massive cuts or brutal cuts. In fact we did both kinds of cuts and we entrusted Klein more than Decore to undertake the dirty work.
Albertans are once again waking up politically and we are not too pleased with what we are seeing. We are in uncertain economic times, difficult social times, and now we are being targeted internationally as environmental bad guysover the "dirty" oil sands. This means there is a new volatility in the Alberta political culture. Daveberta has a blog post that shows the shifting tides and times in Alberta politics comparing December polls in 2008, 2009 and now.
What this trending tells me is Albertans are looking for policy options and political alternatives. Our discontent has been brewing for some time. Politically we are told the Wildrose Alliance Party is the only viable alternative to the Progressive Conservatives. The other traditional political parties, the Liberals and NDP, are apparently being passed over by the public as potential agents of change. Equally as interesting, according to Environics, is 17% of us are "Undecided" about voting intentions. That too is a significant sign of the shifting political sands in Alberta.
The current political narrative is also interesting. The media has covered the rise of Danielle Smith as the face and focus of the Wildrose, but has done almost nothing to expose and explain the WAP policies. The rush to the right by the PCs in an attempt to catch up to the Wildrose (or head them off?) leaves many of us with a sense of despair about the future direction of the province. The predominant political options are personality based. We get to choose between a young smart, urbane and articulate Smith versus the nice guy, over-his-head, inarticulate and very tentative Stelmach. But what about their governing philosophies and their visions for the future? When will that be considered and become part of the political conversation so can get beyond the pedantics of personalities?
The Environics poll has another vital piece of data that needs context. Stelmach's government has 34% support has stopped bleeding politically. But the bloom is off the Wildrose who seem stuck around 30%. Neither is strong enough to form a majority government if we believe this poll and it is the on-going reality.
We are living in economically uncertain times with the province anticipating the largest budget deficit in our history. We are into a shaky slow recovery tied directly to the fortunes of a seriously failing and faltering American market and threats of a double-dip recession. Even with that reality, Albertans have relegated the economy to the #2 spot of top policy concerns, down to 16% from 27% last Spring. The Alberta environment issues gets lots of media coverage but only 7% of Albertans think it is our major issue and only 8% of us are focused on oil sands development and royalties as the biggest thing on our policy plate.
What has happened is health care has vaulted to the #1 issue for almost half of Albertans. Some 47% of us think that it is the most serious policy issues we face now - compared to 27% who thought so last Spring. That sudden, dramatic and intense concern over health care is a potential game changer and could be a government changer too if is becomes a ballot question.
I think this focus on the politics of health care is more than a function of hyper media focus. It goes deeper - much deeper. Health care is an issue that integrates our personal concerns for care when we and our family need it and into a bigger-than-self compassionate concern for others who also need health care help. When it comes to health care we are all in it together and alone.
The lack policy transparency, the suspicion of some hidden privatization political agendas and the real and growing fear of continuing erosion of our highly valued Canadian health care system is making us all very nervous. The politics of health care is drawing our attention, triggering our fears and making us wonder what is really going on...and we are questioning who are to believe any more!
Health care is in systemic crisis, regardless of the denials by the political powers that be. There is a growing suspicion that some people with political influence and power are intentionally undermining the effectiveness of the publicly funded health cares system to insure it will fail. Once that public system failure is self-evident, the theory goes that private insurance will be promoted as the saviour of the failed public health care system. Such is the conspiracy theory, but if it exists, are we enabling privateers to use public funds for private privilege because of political indifference of citizens?
There is no viable progressive political alternative in the Alberta these days. There is no trusted countervail to the reactionary right wing tendencies of the PCs and the even more extreme Libertarian views of the Wildrose Alliance. But moderate and progressive is the political values space where most Albertans see themselves. Our Alberta based random sample research shows over 60% of Albertans hold Accountability, Integrity, Honesty, Fiscal and Personal Responsibility, Transparency and Clarity as the most important bundle of values we should use to evaluate our government's performance. This is not rocket surgery but we are far from seeing those values articulated in our political culture today. Nor are we seeing an attractive alternative political party emerge that speaks authentically to these majority Albertan values today.
I think that political alternative shortcoming is about to change in Alberta. This is partly because the political events surrounding Dr. Raj Sherman and his dogged determination to expose the political and administrative fault lines in our health care system. He is the lightening rod that is attracting public attention, focusing our fears, capturing our imagination and giving us political context so we can begin to understand what is really going on.
But the future of health care in Alberta is not about Raj Sherman. We now need to focus on what has become a broken system and we need to get it fixed - right and right away. We don't need the kind of anti-intellectual, anti-expertise of so-called "common sense approach" characteristic of the Klein era amateurs who were running health care based on Fraser Institute ideology. We need professionals and public servants with expertise, integrity and a public policy perspective to take over the mess and to look past the next election with their solutions.
Albertans have been looking for a galvanizing political issue and a trustworthy proponent of the public interest. I think the Environics poll shows health care is the galvanizing issue and Dr. Raj Sherman has become the trustworthy exponent of the public interest. We need a broader and better public discourse around a new narrative for Alberta and a viable progressive political alternatives to deliver on the promise and potential of the next Alberta.
Could that new narrative and promising new way of doing progressive politics be articulated and exemplified by the Alberta Party? Could the Alberta Party emerge as the viable political alternative that actually aligns with the values of most Albertans? I have to say it is early times but the numbers of people who are approaching me these days with a genuine curiosity about the Alberta Party, and who are joining up, is making me quite optimistic. The times they are a-changin' and only time will tell if it is change for the better or the worse. Over to you Alberta. Informed engaged active voters hold the keys to the future.
Albertans are once again waking up politically and we are not too pleased with what we are seeing. We are in uncertain economic times, difficult social times, and now we are being targeted internationally as environmental bad guysover the "dirty" oil sands. This means there is a new volatility in the Alberta political culture. Daveberta has a blog post that shows the shifting tides and times in Alberta politics comparing December polls in 2008, 2009 and now.
What this trending tells me is Albertans are looking for policy options and political alternatives. Our discontent has been brewing for some time. Politically we are told the Wildrose Alliance Party is the only viable alternative to the Progressive Conservatives. The other traditional political parties, the Liberals and NDP, are apparently being passed over by the public as potential agents of change. Equally as interesting, according to Environics, is 17% of us are "Undecided" about voting intentions. That too is a significant sign of the shifting political sands in Alberta.
The current political narrative is also interesting. The media has covered the rise of Danielle Smith as the face and focus of the Wildrose, but has done almost nothing to expose and explain the WAP policies. The rush to the right by the PCs in an attempt to catch up to the Wildrose (or head them off?) leaves many of us with a sense of despair about the future direction of the province. The predominant political options are personality based. We get to choose between a young smart, urbane and articulate Smith versus the nice guy, over-his-head, inarticulate and very tentative Stelmach. But what about their governing philosophies and their visions for the future? When will that be considered and become part of the political conversation so can get beyond the pedantics of personalities?
The Environics poll has another vital piece of data that needs context. Stelmach's government has 34% support has stopped bleeding politically. But the bloom is off the Wildrose who seem stuck around 30%. Neither is strong enough to form a majority government if we believe this poll and it is the on-going reality.
We are living in economically uncertain times with the province anticipating the largest budget deficit in our history. We are into a shaky slow recovery tied directly to the fortunes of a seriously failing and faltering American market and threats of a double-dip recession. Even with that reality, Albertans have relegated the economy to the #2 spot of top policy concerns, down to 16% from 27% last Spring. The Alberta environment issues gets lots of media coverage but only 7% of Albertans think it is our major issue and only 8% of us are focused on oil sands development and royalties as the biggest thing on our policy plate.
What has happened is health care has vaulted to the #1 issue for almost half of Albertans. Some 47% of us think that it is the most serious policy issues we face now - compared to 27% who thought so last Spring. That sudden, dramatic and intense concern over health care is a potential game changer and could be a government changer too if is becomes a ballot question.
I think this focus on the politics of health care is more than a function of hyper media focus. It goes deeper - much deeper. Health care is an issue that integrates our personal concerns for care when we and our family need it and into a bigger-than-self compassionate concern for others who also need health care help. When it comes to health care we are all in it together and alone.
The lack policy transparency, the suspicion of some hidden privatization political agendas and the real and growing fear of continuing erosion of our highly valued Canadian health care system is making us all very nervous. The politics of health care is drawing our attention, triggering our fears and making us wonder what is really going on...and we are questioning who are to believe any more!
Health care is in systemic crisis, regardless of the denials by the political powers that be. There is a growing suspicion that some people with political influence and power are intentionally undermining the effectiveness of the publicly funded health cares system to insure it will fail. Once that public system failure is self-evident, the theory goes that private insurance will be promoted as the saviour of the failed public health care system. Such is the conspiracy theory, but if it exists, are we enabling privateers to use public funds for private privilege because of political indifference of citizens?
There is no viable progressive political alternative in the Alberta these days. There is no trusted countervail to the reactionary right wing tendencies of the PCs and the even more extreme Libertarian views of the Wildrose Alliance. But moderate and progressive is the political values space where most Albertans see themselves. Our Alberta based random sample research shows over 60% of Albertans hold Accountability, Integrity, Honesty, Fiscal and Personal Responsibility, Transparency and Clarity as the most important bundle of values we should use to evaluate our government's performance. This is not rocket surgery but we are far from seeing those values articulated in our political culture today. Nor are we seeing an attractive alternative political party emerge that speaks authentically to these majority Albertan values today.
I think that political alternative shortcoming is about to change in Alberta. This is partly because the political events surrounding Dr. Raj Sherman and his dogged determination to expose the political and administrative fault lines in our health care system. He is the lightening rod that is attracting public attention, focusing our fears, capturing our imagination and giving us political context so we can begin to understand what is really going on.
But the future of health care in Alberta is not about Raj Sherman. We now need to focus on what has become a broken system and we need to get it fixed - right and right away. We don't need the kind of anti-intellectual, anti-expertise of so-called "common sense approach" characteristic of the Klein era amateurs who were running health care based on Fraser Institute ideology. We need professionals and public servants with expertise, integrity and a public policy perspective to take over the mess and to look past the next election with their solutions.
Albertans have been looking for a galvanizing political issue and a trustworthy proponent of the public interest. I think the Environics poll shows health care is the galvanizing issue and Dr. Raj Sherman has become the trustworthy exponent of the public interest. We need a broader and better public discourse around a new narrative for Alberta and a viable progressive political alternatives to deliver on the promise and potential of the next Alberta.
Could that new narrative and promising new way of doing progressive politics be articulated and exemplified by the Alberta Party? Could the Alberta Party emerge as the viable political alternative that actually aligns with the values of most Albertans? I have to say it is early times but the numbers of people who are approaching me these days with a genuine curiosity about the Alberta Party, and who are joining up, is making me quite optimistic. The times they are a-changin' and only time will tell if it is change for the better or the worse. Over to you Alberta. Informed engaged active voters hold the keys to the future.
Monday, December 06, 2010
Alberta Readers' Choice Awards Long List Announced
The Alberta Readers' Choice Awards has just announced the long list of 30 titles for the 2011 version of its $10,000 prize. Theses are all submissions from Alberta publishers from releases in the past year.
So the next step is for Librarians from all over Alberta to case votes for the Top 10 titles by the end of this year. Then the Jurors take over and read the Top 10 and we select 5 finalists which will be announced May 1, 2011. Then Albertans can get in on the action and vote online in the month of May to select the winner and that will be announced on June 11 at the Alberta Book Publishing Awards Gala in Calgary.
The Jurors (including me but that is a secret until January when all of the Jurors are announced) will no doubt be sharing our thoughts and opinions on the Top 10 titles on line as we select the 5 Finalists. This is a great event with the sponsorship of the Edmonton Public Library and the Book Publishers Association of Alberta
When we get to the five finalist, I hope Albertans pick up the spirit of the competition, buy the books, read them. Please share your thoughts on each book with friends, family and others in their various networks as well as online through Twitter. I hope you also get into promoting the online voting for your favourite book too.
I love books, book stores and libraries. I tend to get lost in them as my imagination get stirred by shared ideas and new senses of how to "see" things with the help of great writers. Alberta is a dynamic cultural and creative place in both arts and innovation. Recently the funding philistines have been busy undermining our sense of self and are starting to starve the provincial government support arts and innovation in the face of "fiscal pressures." If we did not give away our natural resources by under charging for royalties and other revenues we leave on the table we would not have any such self-induced fiscal pressures. I will comment more on that public policy problem at another time as I look in more detail at the future political direction for the next Alberta in the new year.
In the mean time, check out the long list of titles and if any of them catch your eye. BTW! Alberta books make great Christmas gifts. Full disclosure, I am an Alberta book publisher under the name Sextant Publishing, an imprint of Cambridge Strategies Inc. but we made no submissions to this competition, so there is no conflict in my serving as a Juror. If you are interested in what we publish and authors who are friends that we help promote go to the Bookstore link at Cambridge Strategies Inc.
So the next step is for Librarians from all over Alberta to case votes for the Top 10 titles by the end of this year. Then the Jurors take over and read the Top 10 and we select 5 finalists which will be announced May 1, 2011. Then Albertans can get in on the action and vote online in the month of May to select the winner and that will be announced on June 11 at the Alberta Book Publishing Awards Gala in Calgary.
The Jurors (including me but that is a secret until January when all of the Jurors are announced) will no doubt be sharing our thoughts and opinions on the Top 10 titles on line as we select the 5 Finalists. This is a great event with the sponsorship of the Edmonton Public Library and the Book Publishers Association of Alberta
When we get to the five finalist, I hope Albertans pick up the spirit of the competition, buy the books, read them. Please share your thoughts on each book with friends, family and others in their various networks as well as online through Twitter. I hope you also get into promoting the online voting for your favourite book too.
I love books, book stores and libraries. I tend to get lost in them as my imagination get stirred by shared ideas and new senses of how to "see" things with the help of great writers. Alberta is a dynamic cultural and creative place in both arts and innovation. Recently the funding philistines have been busy undermining our sense of self and are starting to starve the provincial government support arts and innovation in the face of "fiscal pressures." If we did not give away our natural resources by under charging for royalties and other revenues we leave on the table we would not have any such self-induced fiscal pressures. I will comment more on that public policy problem at another time as I look in more detail at the future political direction for the next Alberta in the new year.
In the mean time, check out the long list of titles and if any of them catch your eye. BTW! Alberta books make great Christmas gifts. Full disclosure, I am an Alberta book publisher under the name Sextant Publishing, an imprint of Cambridge Strategies Inc. but we made no submissions to this competition, so there is no conflict in my serving as a Juror. If you are interested in what we publish and authors who are friends that we help promote go to the Bookstore link at Cambridge Strategies Inc.
Friday, December 03, 2010
Stairway to Brand Heaven and Hell
Here is a great representation about how citizens/people feel about their relationship to politics and to politicians these days. Everyone has a BRAND. How is your brand doing on this set of values? How would you rate the political parties in Alberta on these brand values?
Looking forward to your comments.
http://www.flickr.com/photos/7855449@N02/2780450986/in/set-72157606844282993/
H/T Sharon Matthias for the link and thanks to David Armano for the image.
Looking forward to your comments.
http://www.flickr.com/photos/7855449@N02/2780450986/in/set-72157606844282993/
Thursday, December 02, 2010
Some Musing About the "Moving Forward"Leaked Health Policy Document
The cut and thrust of politics is heating up in Alberta, especially over health care. Now the discussion is moving towards the place it should about - the fixing of the system. The leaked "Alberta's Health Legislation: Moving Forward" document has been the catalyst for the policy discussion. It has been lead by Dr. David Swann, leader of the Official Opposition and the Liberal Party of Alberta and the recently rejected PC caucus member Dr. Raj Sherman.
The details of the debate are well documented in the main stream media so I will not repeat them here. The implications of the debate are what is interesting to me. I want to talk about the threat of a Two-Tier system that involves private insurance, and if docs can operate on both side of that street. I also want to talk about delisting health service elements contained in the Moving Forward document too.
Swann is pressing Stelmach on if there will be a two-tier health care system in Alberta. He wants a promise from Stelmach "in writing" he will not allow doctors to work in both the system, a public and private side, at the same time. There is nothing stopping doctors from option out of Medicare now and working strictly in a private patient pay system. There are lots of private sector elements in our health care system now. Any talk of keeping private enterprise out of health care is futile. That is all ready the case and it is working well. It is working well because there is a single-payer for health services, the government. If we allow private insurance to be purchased and to pay for medically necessary services we are into the feared and reviled two-tier system and the unnerving possibility of doctors playing both sides of the street and eroding the effectiveness of the public health care system.
THREATS OF A TWO-TIER HEALTH SYSTEM COMES AROUND AGAIN:
I do not expect Premier Stelmach to commit to writing that he will promise to not allow doctors to work in a private and public system at the same time...because there is no political will (today) to go to a two-tiered system. That is now. What about after the next election when the fear is major system changes will be imposed, including a private insurance possibility for health care. That is what the government plan is according so some interpretations of the "Moving Forward" leaked document.
If it is of any comfort, I received a fund raising letter from the Progressive Conservative Party today signed by Ed Stelmach as Leader. In it he says "Your government (his government) firmly believes we can build a better (health care) system without moving towards a two-tier system with privatisation of health care." Hardly a public statement since it is in a political party fund raising letter...but it is a commitment of sorts to the single-payer public health care system that we now have - and it is in writing. But as Ralph Klein used to say when he "changed" his political mind for political purposes"That was then. This now."
It has a bullet about health providers working to full scope of practice. That is a problem as Docs, Registered Nurses and Licensed Practical Nurses are all underutilized to some degree or other, due to the payment system that is used to pay docs. More on that at some future time. What Moving Forward talks about is providing health providers to opt-in and opt-out of the public health system as part of the new Health Act. I have not reviewed the just past Act but know that doctors can to that now. Why is it part of the "new" law?
The proposed policy shift in Moving Forward that is intended to bring "fairness" to this fictitious imbalance is to "Apply the same constraints to all health providers and allow government the flexibility to regulate health provider commitment in the public system." That is very abstract language indeed and fairness to physicians is compared to the way midwives and pharmacists operate in a partially publicly and privately funded arrangement. To meet the spirit and my sense of the intent to induce more fairness would mean we would need to make sure Midwives and Pharmacists would enjoy access to a fully funded public payer system for their areas of endeavour, including a fully funded drug program. That way they and the docs would be on a level playing field under the current arrangements.I don't see that sense of providing fairness to druggists and midwives to be involved in the Moving Forward proposals at all. This framing for "fairness" to doctors to allow them to play both sides at the same time, if there were a public and private system, is disingenuous at best and intentionally misleading at worst.
DELISTING:
Then there is the delisting section entitled "Process to Establish Essential Services." The issue is stated to be that there is not a clear process to determine essential services and current services are not based on a "regular, rigorous and evidence-based process." That used to be more true than it is today and some medical services have been delisted. There was a full review of what process should be used to see if medical services should be in or out of the public system done by an Expert Panel Chaired by Dr. Bob Westbury.
We at Cambridge Strategies were involved assisting with that review and there was a Progress Report issued to the Alberta government in December 2002.. The Expert Panel was commissioned by then Minister of Health and Wellness, Gary Mar. The mandate was "...to review the current basket of publicly funded health services and, on an ongoing basis, to review new health services to ensure that Alberta's publicly funded health services remain comprehensive and sustainable for the future, and provide the best value."
The idea was an expert panel would determine what services were to be publicly funded or not. Those determinations of what service was in or out of was also to be done in an open objective way using criteria established by the Expert Panel to determine what new diagnostics, treatments and drugs would be added to the system too.
The review and recommendations made by the Expert Panel were sound and soundly shelved by the Klein government. The next phase of actually setting up the process and structures to do a thorough and detailed review of current funding, new services, priority setting and specific services review was never allow to happen. This sense of intentionality and rationality over what health care services should or should not be covered by the goes back even further in Alberta.
Premier Don Getty set up The Premier's Commission of Future Health Care for Albertans that reported in December 1989. In Recommendation #8.0 sand " THEREFORE WE RECOMMEND that the Government of Alberta, in consultation with health care practitioners and consumers, define with is considers to be basic insured services covered by the Alberta Health Care Insurance Plan." I will be doing a series of comparisons with the new Alberta Health Act to the recommendations made over 20 years ago in the Premier's Commission on the Future of Health Care for Albertans to see what is same, similar new and missing. The old Premier's Council spent two years and made 21 Recommendations and 66 suggestions for action. The current Minister's Advisory Council on Health represents some very good work too. It made four Recommendations with a total 20 sub elements including 6 Principles. A thorough review and comparison will take some time but I think it will be helpful and useful for Albertans to have.
Perhaps the Stelmach government should revisit these reports and finally to stimulate a public conversation about what medical services Albertan want to pay for as a society or as individuals, and how they want to proceed to reconcile and rationalize the differences. The recent truncated public consultation over the past summer on the new Health Act was not a serious effort at effective citizen engagement. Premier Stelmach recently said about the new Health Act in the Alberta Legislature "The one thing that all members should focus on is the Bill (Bill 17 the Alberta Health Act just passed awaiting Proclamation) that we've debated in the house that says very explicitly that Albertans will have a say in the future direction of health-care delivery ..." Go to the link and read Section 14 and see if that provision satisfies your test of if it amounts to Albertans having a say in the future direction of health-care delivery.
There is more to be sceptical about in the Moving Forward document but this post is too long already. My advice is that Albertans better not suspend their critical thinking faculties about this and other public policy directions that may be lurking behind the confidential and closed doors of the government caucus. Time to use the cracks that Raj Sherman has caused to happen and that is letting some light shine in on what is really happening. Sunlight is still the best disinfectant.
The details of the debate are well documented in the main stream media so I will not repeat them here. The implications of the debate are what is interesting to me. I want to talk about the threat of a Two-Tier system that involves private insurance, and if docs can operate on both side of that street. I also want to talk about delisting health service elements contained in the Moving Forward document too.
Swann is pressing Stelmach on if there will be a two-tier health care system in Alberta. He wants a promise from Stelmach "in writing" he will not allow doctors to work in both the system, a public and private side, at the same time. There is nothing stopping doctors from option out of Medicare now and working strictly in a private patient pay system. There are lots of private sector elements in our health care system now. Any talk of keeping private enterprise out of health care is futile. That is all ready the case and it is working well. It is working well because there is a single-payer for health services, the government. If we allow private insurance to be purchased and to pay for medically necessary services we are into the feared and reviled two-tier system and the unnerving possibility of doctors playing both sides of the street and eroding the effectiveness of the public health care system.
THREATS OF A TWO-TIER HEALTH SYSTEM COMES AROUND AGAIN:
I do not expect Premier Stelmach to commit to writing that he will promise to not allow doctors to work in a private and public system at the same time...because there is no political will (today) to go to a two-tiered system. That is now. What about after the next election when the fear is major system changes will be imposed, including a private insurance possibility for health care. That is what the government plan is according so some interpretations of the "Moving Forward" leaked document.
If it is of any comfort, I received a fund raising letter from the Progressive Conservative Party today signed by Ed Stelmach as Leader. In it he says "Your government (his government) firmly believes we can build a better (health care) system without moving towards a two-tier system with privatisation of health care." Hardly a public statement since it is in a political party fund raising letter...but it is a commitment of sorts to the single-payer public health care system that we now have - and it is in writing. But as Ralph Klein used to say when he "changed" his political mind for political purposes"That was then. This now."
It has a bullet about health providers working to full scope of practice. That is a problem as Docs, Registered Nurses and Licensed Practical Nurses are all underutilized to some degree or other, due to the payment system that is used to pay docs. More on that at some future time. What Moving Forward talks about is providing health providers to opt-in and opt-out of the public health system as part of the new Health Act. I have not reviewed the just past Act but know that doctors can to that now. Why is it part of the "new" law?
The proposed policy shift in Moving Forward that is intended to bring "fairness" to this fictitious imbalance is to "Apply the same constraints to all health providers and allow government the flexibility to regulate health provider commitment in the public system." That is very abstract language indeed and fairness to physicians is compared to the way midwives and pharmacists operate in a partially publicly and privately funded arrangement. To meet the spirit and my sense of the intent to induce more fairness would mean we would need to make sure Midwives and Pharmacists would enjoy access to a fully funded public payer system for their areas of endeavour, including a fully funded drug program. That way they and the docs would be on a level playing field under the current arrangements.I don't see that sense of providing fairness to druggists and midwives to be involved in the Moving Forward proposals at all. This framing for "fairness" to doctors to allow them to play both sides at the same time, if there were a public and private system, is disingenuous at best and intentionally misleading at worst.
DELISTING:
Then there is the delisting section entitled "Process to Establish Essential Services." The issue is stated to be that there is not a clear process to determine essential services and current services are not based on a "regular, rigorous and evidence-based process." That used to be more true than it is today and some medical services have been delisted. There was a full review of what process should be used to see if medical services should be in or out of the public system done by an Expert Panel Chaired by Dr. Bob Westbury.
We at Cambridge Strategies were involved assisting with that review and there was a Progress Report issued to the Alberta government in December 2002.. The Expert Panel was commissioned by then Minister of Health and Wellness, Gary Mar. The mandate was "...to review the current basket of publicly funded health services and, on an ongoing basis, to review new health services to ensure that Alberta's publicly funded health services remain comprehensive and sustainable for the future, and provide the best value."
The idea was an expert panel would determine what services were to be publicly funded or not. Those determinations of what service was in or out of was also to be done in an open objective way using criteria established by the Expert Panel to determine what new diagnostics, treatments and drugs would be added to the system too.
The review and recommendations made by the Expert Panel were sound and soundly shelved by the Klein government. The next phase of actually setting up the process and structures to do a thorough and detailed review of current funding, new services, priority setting and specific services review was never allow to happen. This sense of intentionality and rationality over what health care services should or should not be covered by the goes back even further in Alberta.
Premier Don Getty set up The Premier's Commission of Future Health Care for Albertans that reported in December 1989. In Recommendation #8.0 sand " THEREFORE WE RECOMMEND that the Government of Alberta, in consultation with health care practitioners and consumers, define with is considers to be basic insured services covered by the Alberta Health Care Insurance Plan." I will be doing a series of comparisons with the new Alberta Health Act to the recommendations made over 20 years ago in the Premier's Commission on the Future of Health Care for Albertans to see what is same, similar new and missing. The old Premier's Council spent two years and made 21 Recommendations and 66 suggestions for action. The current Minister's Advisory Council on Health represents some very good work too. It made four Recommendations with a total 20 sub elements including 6 Principles. A thorough review and comparison will take some time but I think it will be helpful and useful for Albertans to have.
Perhaps the Stelmach government should revisit these reports and finally to stimulate a public conversation about what medical services Albertan want to pay for as a society or as individuals, and how they want to proceed to reconcile and rationalize the differences. The recent truncated public consultation over the past summer on the new Health Act was not a serious effort at effective citizen engagement. Premier Stelmach recently said about the new Health Act in the Alberta Legislature "The one thing that all members should focus on is the Bill (Bill 17 the Alberta Health Act just passed awaiting Proclamation) that we've debated in the house that says very explicitly that Albertans will have a say in the future direction of health-care delivery ..." Go to the link and read Section 14 and see if that provision satisfies your test of if it amounts to Albertans having a say in the future direction of health-care delivery.
There is more to be sceptical about in the Moving Forward document but this post is too long already. My advice is that Albertans better not suspend their critical thinking faculties about this and other public policy directions that may be lurking behind the confidential and closed doors of the government caucus. Time to use the cracks that Raj Sherman has caused to happen and that is letting some light shine in on what is really happening. Sunlight is still the best disinfectant.
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