The answers to the main problems facing Alberta’s health care system, Daniele Smith said in an article published under her name last year, lie in user fees, co-payments, privatization and the sneaky withdrawal of services covered by health insurance by redefining them.
The document – title Alberta’s Key Challenges and Opportunities – was published by the School of Public Policy at the University of Calgary in June 2021.
At the time the newspaper was published, Alberta’s new premier was still chairman of the Alberta Enterprise Group, a business advocacy organization with close ties to the province’s conservative parties, past and present. .
Seemingly unreported by the media, the paper was spotted recently by economics blogger Bob Ascah, a retired senior Alberta Treasury Department official and former director of the University of Alberta’s Institute for Public Economics. ‘Alberta.
The article begins with the silly claim that Albertans are culturally different from other English-speaking Canadians and an amateurish history of the province aimed at suggesting that our so-called entrepreneurial character and entrepreneurial spirit are the source of this character. supposedly unique.
Understandably, given her longstanding fundamentalist market ideology, Smith sees government as the root of all economic problems, complaining that the challenges facing Alberta’s health care services have arisen because “we We had a bureaucracy that followed the crowd and lazily took the path of least resistance, locking down the entire economy and blaming Albertans for not doing enough to avoid getting sick.
It’s not just biased. It is categorically false.
Nonetheless, now that we’re getting to know her better, it seems at least possible that Mrs. Smith actually believed this when she wrote it.
However, this drivel soon leads to the real purpose of the exercise: advocating health care policy prescriptions like the privatization programs and tiny health care spending accounts that were mentioned in his Party leadership campaign. United Conservative.
Despite its obvious scholarly flaws, Ms. Smith’s article is illuminating because some of her worst ideas are sketched out in more detail than we’ve seen so far.
Mrs. Smith was obviously working on it long before it was known that there would be a campaign for the leadership of the UCP, let alone the fact that she would participate in it.
The document correctly diagnoses the central problem of Alberta’s finances: we are stuck in the proverbial roller coaster of royalty prices.
However, Ms Smith immediately goes on to say, “We want gold-plated services and we don’t want to pay taxes for them anymore.”
Whether or not core health care services in Alberta are “gold plated” is another matter altogether, but it is true that Conservative governments in Alberta have relied on inherently unstable resource revenues to pay for services. which should be covered by taxes, although Ms Smith clearly does not see raising taxes as the ideologically correct answer.
So what is the way forward, according to Ms. Smith, as expressed in her article?
Well, for starters, “reinventing government” to be more like a for-profit corporation.
She calls on Alberta to “wean Albertans permanently from their dependence on energy royalties,” saying a combination of spending cuts and investment income generated from the money saved would wipe out Alberta’s deficits.
Now, this was written long before Ms Smith was in a position where she had to buy Albertans’ votes with their own money, so it’s fair to say that her proposed spending cuts won’t see the light of day, at least until unless the UCP manages to get re-elected.
‘The next step to closing the gap’ in healthcare funding, she continues after several pages of figures that show signs of being processed with the help of a professional calculator of the kind she allegedly worked with as a Fraser Institute apparatchik, “is to generate $4 billion new user fees.”
“We can no longer afford universal social programs that are 100% paid for by taxpayers,” she argues. “The only option is to empower people to use more of their own money to pay for their own way and to use the power of innovation to deliver better services at lower cost.” (Don’t hold your breath for the second part of this idea to ever be realized.)
The following paragraph explains what Ms. Smith means when she talks about a “patient-centred” health care system, as she consistently does. Just as “choice” means paying for access, “patient-centred” doesn’t quite mean what it sounds like either.
“What the government needs to do is create corresponding health spending accounts for all Albertans,” she explains. “The government should commit to up to $375 per person and challenge individuals and employers to do the same.”
“By taking responsibility for their health and empowering people to do so,” she chuckles, “this should result in less strain on the hospital system and better management of chronic care that will drive down costs.
Better, she continues,once people got used to the concept of paying out of pocket for more stuff themselves then we can change the conversation about health care.
“Instead of asking what services will the government remove from the list …we would rather ask which services are paid for directly by the government and which services are paid for from your health spending account. (Which is only $375 a year, remember.)
“My view is that the entire GP budget should be paid for from the Health Spending Accounts,” she continued. “If the government funded the account at $375 a year, that’s equivalent to 10 visits to a GP, so there can be no argument that it would compromise access on the basis of ability. to pay.”
(I await answers from genuine experts – albeit suspicious of the Smith government – as to how likely this claim will play out as intended.)
“But we could go further,” Ms Smith continues confidently. “I think it’s (sic) time to redefining universality. … If we establish the principle of Health Spending Accountswe can also set up co-payments.”
Before going any further, dear readers, I urge you to speak with an American friend or relative about their thoughts on co-payments, as these fixed direct payments required before access to health insurance are known south of medicine. Line.
“It doesn’t have to be onerous, and it could be on a sliding scale,” says the future Premier of the UCP of Alberta in a reassuring tone.
“I don’t think Albertans are willing to pay a penny more for an underperforming health care system and watch their money evaporate without any improvement in performance,” she then asserted tendentiously. “I’m willing to bet most Albertans would be willing to pay up to $1,000 if it reduced wait times for life-saving treatment for themselves or a family member.
Ms. Smith then moved on to “re-engineering” service delivery. Having exploded the idea of utilities, she confidently states, “The only way to make substantial and meaningful changes to the way programs are delivered is to allow contracting out, competition and choice.
This model of health care, she explained, is how the government now manages education in Alberta – with charter schools, private schools and homeschooling not just tolerated, but actively encouraged. by the UCP.
“There should be similar options” for health care, she argues, laying out her idea of chartered hospitals, private hospitals and “home health care”.
Hell, she continued, we might even have “specialty birth centers, so new moms can have a personalized environment to provide the most enjoyable experience possible for welcoming their newest family member.” (But not, presumably, for $375 a year, or even 10 times that.)
If that worries you, Ms. Smith concluded, don’t. “That’s the beauty of entrepreneurship. Someone will devise a brilliant way of doing things differently that will not only deliver better patient care, but do it in a way that will reduce costs for all of us.
If you believe thisof course, investment opportunities await you in cryptocurrency, vet worm paste, and bridges across the mighty Peace!
NOTE: All italics in quoted passages in this post were added by me. GDD
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