Cory Morgan: Alberta Leads the Way on Health-Care Reform, but Preventable Missteps Could Jeopardize Progress

Commentary

Alberta has always been a positive disrupter among provinces when it comes to pursuing health-care reform. In 2000, Premier Ralph Klein was in a pitched battle with federal Liberal Health Minister Allan Rock over the allowance of private MRI services in the province. Waiting times for medical diagnostics were rising across the country, and Klein wanted to allow private companies into the mix to reduce the load. The federal government threatened to cut Alberta’s health transfers in response. Klein held his ground, and his initiative spread. Private MRI services are now available in seven out of ten provinces in Canada, and people accept them without batting an eye.

Despite declining accessibility to health-care services across the country, any efforts to address the problem through private provision of services becomes a controversial flashpoint. Most countries that offer universal health care also offer more private provision models than Canada does, from specialized clinics to hospitals. Those countries also have much shorter waiting times for medical care than Canada.

Premiers and health ministers know that a mixture of private and public services could reduce waiting times, but they fear the inevitable ideological battle with unions and other advocates for fully socialized health care, so they tend to just keep increasing spending rather than pursuing reform.

Premier Danielle Smith has followed the Alberta tradition of trying to increase private involvement in the health-care system, but it hasn’t been going well. The UCP government tried to privatize community lab testing through a private company. Labs are different from hospitals, and a private company should presumably be able to find efficiencies that public providers can’t. Unfortunately, that wasn’t the case. Within a year, waiting times for lab services ballooned, and the private company had blown the budget. The government was forced to buy out the company, and taxpayers were hit with a bill of $109 million for the failed experiment, according to the auditor general.

So why did the privatization of lab services fail so terribly when MRI services expanded with private options?

According to the provincial auditor general, the province largely ignored procurement policies, and there was a failure in financial analysis prior to giving the contract to the private company. It appears that in their rush to expand private service provision, the government didn’t do due diligence and gave the deal to a company poorly equipped to provide the service.

The main element driving improvement in services when health care goes private is competition. Nine private MRI providers in Alberta provide services within the public system. The reason they are successful is that they compete and keep each other honest. If one of the providers were to fail, it wouldn’t lead to the sort of havoc that we saw with the government’s contract with that private company.

Now, Premier Smith is proposing to allow doctors to work both within and outside of the public health care system through Bill 11. Doctors would work a regulated minimum period of time within the public system, but then could do procedures and directly bill patients outside of the system. This could incentivize more doctors to practice in Alberta without increased costs to taxpayers. It will still raise controversy among health-care purists, however, and there will be protests against the bill’s implementation.

Hanging over the provincial government’s head is an ongoing procurement scandal involving Alberta Health Services and questionable procurement practices. The RCMP is now investigating, and there is a civil suit in the courts from the former CEO of AHS over the issue. This doesn’t make citizens comfortable with the government tinkering further within the health-care system.

All the stats in the world indicating better care through mixed provision models in health care won’t mean a thing if citizens don’t feel they can trust the government to manage it.

Most Canadians understand the benefits of capitalism and likely could embrace elements of it within the health-care system. But people also have a distaste for any appearance of crony capitalism.

An opportunity for health-care innovation that could benefit the entire country may be lost if the provincial government bungles the procurement process.

Rather than trying to quickly ram through new health-care provision models, the government should create a transparent policy for procurement processes and regulation of private providers. If the system isn’t competitive, we won’t see improvements, and if there aren’t guardrails, corruption could follow. Canadians could accept some people paying extra for enhanced health-care services if it leads to benefits for everybody. But they won’t tolerate anything appearing to profiteer on health care or giving unfair advantages to certain companies.

Alberta is standing up as an example for the rest of the country in health-care provision. It would be tragic if any preventable missteps set back these reform efforts.

Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times.