Last Updated:Friday - 09/24/2010
January 21, 2002
Keep health care for all
Former deputy prime minister Don Mazankowski's report on health care reform in Alberta is a many-headed hydra, filled with general ideas, but short on specifics. We know Mazankowski believes the health-care system is unsustainable without major changes, but we are left scratching our heads as to what precisely he would do to cut costs and increase revenue.
Still, four areas raised by the report call for comment.
First, Mazankowski wants provincial health-care premiums to be increased by 33 per cent. We say health-care premiums should be abolished and extra revenues should be obtained from gasoline taxes, tobacco taxes or income taxes. Health-care premiums are the most regressive tax in Alberta, falling heaviest on low-income families and much less so on the middle class and well-to-do.
Second, the report recommends debit-style electronic cards that patients could use to withdraw money for their health care from a fund established for each individual. If the balance runs out, people would have to pay their own costs or the province would pay those costs.
The fear is that senior citizens, those on low incomes and the chronically ill would be less willing to seek medical care because it would run down their accounts, leaving them defenseless to cover the costs of a major disease. The good news is that Health Minister Gary Mar is opposed to medical savings accounts. "Your access to the health-care system has to be based on your need, not on the thickness of your wallet," he has said.
Third is the Mazankowski report's contention that competition and market forces are needed in the health-care system to save money. Although it's not clear what this might mean, Mazankowski says he favours selling public hospitals to private owners. This implies a belief that a profit-run system will be more efficient and save taxpayers' dollars.
Lest Mazankowski forget, Alberta's hospitals were largely founded by unpaid orders of nuns who had no interest in profit, but plenty of interest in providing patient care. The common good can be achieved without profiteering.
Fourth is the report's desire that the health-care system emphasize wellness by measures such as feeding the poor and better health education in schools. The issue here will be how seriously the government takes this preventive approach, for it is one that holds out a long-term payback in health-care cost reductions. The federal government's ambitious Participaction program of the 1970s bore significant results, partly, at least, because of the government's willingness to spend a lot of money to make it successful.
A similar program today would have to deal with a rapidly growing fast food industry and a decline in people's physical activity. In the U.S., the percentage of the population suffering from gross obesity has increased from 15 to 23 since 1980. The result: a greater susceptibility to diseases such as cancer, heart disease and adult-onset diabetes.
Two-thirds of shoppers say they want to increase their consumption of fruits and vegetables, but they don't know how to prepare these foods.
The question here is whether the Alberta government is willing to get serious about preventive health - an area that should sharply cut health-care costs - or whether it will only pay lip service to the issue.
Private health care is not the way to put a stop to rising health costs. Following such a path will have negative long-term consequences for Alberta's society.
That's not to say some costly services can't be contracted out or that some non-essential services can't be de-listed. But a solution that is ideologically driven and that will force the poor to go without health care while entrepreneurs get fabulously wealthy should not become the Alberta reality. The common good is best served by a health-care system to which all Albertans have access.
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