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Bill 30 is again being discussed in the legislative assembly. Some thoughts...
The government again claims to care about transparency, yet there was no interest in salary disclosure until tensions rose between drs and the government.
While it is true that private facilities may provide physical space for additional surgeries, those surgeries also require additional health professional hours. Where will those come from?
The government keeps emphasizing that these procedures will be publicly paid. This is true. However, there will almost inevitably be public subsidization of these private facilities (see e.g. the government creating a Secretariat to assist with privatization).
The government suggests that concerns with profit-driven care equate with distrust in health professionals. No one has suggested this. The distrust is in private corporations who will have an obligation to deliver returns to investors.
The gov claims that public representation will make colleges more transparent/accountable. This will not be the case given that the gov will have a hand in appointing these public members. Ditto with HQCA. Gov's increased influence will undercut its expertise and credibility.
NDP drawing attention to concerns with public sector subsidizing private sector. See e.g. Health Contracting Secretariat that will use public $ to help attract corporations/reduce barriers to privatization
See also concerns with public subsidization of Health Resources Centre: parklandinstitute.ca/delivery_matte…
NDP correctly notes that language like "choice" and "innovation" mask the problems with what the government is proposing. Albertans will not be better off because of this.
UCP has claimed that NDP is fear mongering. This is false. They are raising evidence-based concerns with the impact that privatization will have on public wait times, cost, and quality. If the UCP had credible evidence to the contrary, then they would have produced it by now.
It is very difficult to reconcile the gov's supposed concerns with transparency with its middle-of-the-night debates on crucial health systems issues.
Instead of directly addressing the legitimate concern with public subsidization of private care, Premier instead chooses to go on about how he thinks the NDP is fear mongering. Deflection at its finest.
Premier now going on about how the NDP is repeating the same points. They are repeating the same concerns about privatization because they are legitimate and evidence-based. The complaint about repetitiveness is laughable as he is now repeating the same old info about dr pay.
Premier now suggesting that the NDP think profit is a dirty word. This is not true. Profit may be a good incentive in some contexts, but profit-driven surgical services will raise cost and quality problems.
Premier again going on and on about drs in Alberta being paid more. Even if the government's numbers were true (they aren't), cost savings can be achieved without being hostile to AMA and without private delivery (which will actually be very likely to drive up costs).
Premier claimed that this "isn't about ideology" and this "isn't about politics. If not, then show us the evidence for your plan. Show us how you will ensure that these facilities won't drive up public costs. Show us how you will regulate quality in these facilities.
Premier talking about how high paid drs are. Then why not go after the highest earners? Why impose billing changes that disproportionately affect family drs and rural drs?
Premier seems to not appreciate the difference between professional corporations and the kinds of corporations that this legislation will allow to bill for health services.
Premier claiming that NDP is out-of-touch, but they are the ones who are inventing the vast number of doctors who will staff the growing private sector.
Premier pretending he has no idea what NDP is talking about when they raise the public subsidization of private profits. Tell us... who is paying for this new Secretariat? The public system? And what is the role of the Secretariat? To help private facilities profit.
Premier now talking about virtues of ARPs. Yes, it is true, they can be effective. Unclear why those arrangements couldn't be developed in cooperation with the AMA, rather than by flowing funds through corporations.
Premier clinging to the claim that these private facilities will shorten waits. Yes, waits can be a problem, but there are ways to address wait times that have nothing to do with private delivery.
Gov clings to success of SK Surgical Initiative. That Initiative included privatization, but SK government targeted wait times in various other ways. Why not do those things? Also, wait times in SK went back up after gov withdrew $. Is this gov going to pump $ into waits?
Premier doesn't understand Chaoulli decision. In that case, a majority of the Supreme Court found that QC's waits+ban on private insurance violated QC law. Court was divided on Canadian Charter. Bill 30 has nothing to do with private insurance. Is that what the UCP plans next?
Premier characterizes sending 30% of surgeries to private facilities as "somewhat expanding" private delivery. This is disingenuous. Significant expansion in number of surgeries and kinds of surgeries sent to private sector plus changes in nature of corporate owners.
Premier is linking NDP's opposition to its relationship with unions. This is ridiculous. The opposition to bill 30 is grounded in evidence that has nothing to do with unions.
Premier going on about NDP relationship with unions. What about the gov's concerning relationship with corporations (perhaps including future corporate investors in chartered surgical facilities)?
Premier again returns to Chaoulli. Again doesn't understand that decision. Speaks about the case like the Court found a positive right to health care services. Also, characterizes Chaoulli as a suffering patient. Chaoulli was a dr who wanted to provide private services.
NDP talks about concerns with uncertainty in the health care system caused by unilateral termination of contract.
NDP raises cases of private delivery costing taxpayers $ (e.g. longer waits for cataracts in Calgary where there is much more private delivery, Health Resources Centre, Sask Surgical Initiative)
NDP explaining very important distinction between professional corporations and the kinds of corporations contemplated in Bill 30.
NDP acknowledges that some people wait too long for care and that we must address those people who fall through the cracks. But the answer lies in a robust public health care system and not privatization.
NDP replies to Premier raising Chaoulli case by noting that private health insurance for publicly insured services would undermine the public health care system. The evidence supports the concern with this kind of private health insurance.
NDP highlights transparency concerns that will exist around the contracts with chartered surgical facilities and inability to FOIP them.
NDP is correct. It is highly problematic to debate important issues in the middle of the night, but people are watching.
NDP highlighting concerns with quality of care in for-profit facilities. The evidence supports this. Evidence from various health facilities including hospitals (ncbi.nlm.nih.gov/pmc/articles/P…) and, more recently, in long-term care during COVID (cmaj.ca/content/early/…)
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