Lorian Hardcastle Profile picture
Sep 30, 2020 12 tweets 2 min read Read on X
Contact your MLAs and people you know who are UCP members and encourage them to vote against this nonsense at the annual general meeting. The following (flawed) rationale is offered for the resolution to embrace private finance...
First, a reminder to the government that healthcare isn't merely an "expense". It is an investment in a healthy and productive workforce.
Second, to suggest that drs are "upset" because there is "no more money" is inaccurate and disrespectful. I have yet to talk to a dr who doesn't acknowledge AB's fiscal issues. Anyone I've talked to is most "upset" about the government's heavy-handed and disrespectful treatment.
It is interesting to see someone acknowledge that "Patients are limited to treatment options as doctors threaten to leave" when the gov has denied that drs are leaving. The gov only has itself to blame for drs leaving.
This rationale neglects to consider the fact that other countries have struggled with a so-called "hybrid system" and regulating how drs spend their time in order to ensure adequate human resources in the public system.
Private insurance will not result in patients "divert[ing] themselves from public waitlist to the benefit of all patients." This statement suggests an ample supply of drs to treat private patients. How can this be reconciled with the acknowledgement that drs are leaving?
This statement sounds like a child wrote it: "People using Private Tier System...would effectively pay a user tax (fee for service) shifting some burden from the public tax revenue
to private payments."
If patients are merely paying a user fee and not the full cost of the service, the public system would still be paying the same amount. The patient would merely be paying on top of that.
Also, extra-billing/user fees are contrary to the Canada Health Act and would thus actually cost the province money in federal transfer payments. Just as BC, who lost over $32 million for allowing private clinics to extra bill.
"This could help the economy recover more efficiently by creating choices, for both physicians and patients, in time
and public costs to the Public Health System." Unclear what "choice" has to do with the economy. Evidence suggests this would not save the public system any $.
*ask

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More from @Lorian_H

Nov 18
Watching the press conference on "refocusing" the health system (ie breaking it up into 4 organizations).

Primary Care Alberta will start its work today. AHS replacement called Acute Care Alberta will begin work in early spring (later than originally announced). /1
She says Albertan's deserve improved access. Unclear how this will improve access, as they have not presented any evidence for this model and new bureaucratic structures don't tend to speed things up.

AHS & other acute care providers will be accountable to Acute Care AB. /2
Transition team comprised of AHS execs & Dr. Chris Eagle ("external special advisor").

Primary Care AB's initial work will be to implement corporate policies and processes, develop operational plans and set vision, mission & performance targets./3
Read 13 tweets
Oct 28
Bill amending the Alberta Bill of Rights introduced. New provisions:
Right for individual with capacity not to be subjected to or coerced into receiving medical care, treatment, or procedures without consent unless likely to cause substantial harm to themselves or others. /1
Right to freedom of expression, broadening the scope of Albertans’ rights protected beyond written and spoken language to include other expressive activities.
Right to acquire, keep and use firearms in accordance with the law.
Expanded property rights. /2
Currently applies to laws but would now apply to all provincial gov action, including policies and programs, and to organizations that operate under extensive government control, such as municipalities, police services, and some activities of hospitals. /3
Read 17 tweets
May 14
Bill 22 (Health Statutes Amendment Act) now tabled. Broadly, will enable transition from Alberta Health Services to 4 new organizations, each responsible for a different silo of the health system (it remains unclear why gov is moving away from an integrated model) /1
4 agencies (primary, acute, continuing, mental health & addiction) will deliver or arrange delivery (contract out?) services, evaluate & adjust to meet needs, implement ministerial plans, ensure integrated transfers within & between sectors (will be a huge job!). /2
Minister of Health will be "oversight minister" and set strategic direction and sector ministers will be responsible for each of the 4 sectors /3
Read 8 tweets
Nov 15, 2023
Manning report on covid has dropped. Notably, the panel's mandate wasn't to look broadly into the management of covid, but more narrowly to look at governance in a public health emergency. /1
I'm not going to disparage any specific person, but it is fair to say that the panel's composition seems designed to reach particular conclusions on the issues. /2
Report immediately mischaracterizes who makes decisions in a pub health emergency by putting Cabinet at the top of the list and saying cmoh is merely "highly relevant". Although that's what happened during covid, the law is quite different (for now...see bill 6). /3
Read 30 tweets
Nov 8, 2023
Watching the presser on changes to the health system...

Smith highlights challenges with staffing and surgical wait times, but unclear how their proposed reforms will fix any of this. Says that current system lacks accountability and falls short on putting patients 1st /1
Delivery system will now focus on 4 areas, each with their own organization: primary care, acute care, continuing care, mental health & addiction. Calls current AHS structure "scattered" and "rigid". Will apply province-wide to avoid pre-AHS regional fragmentation. /2
Smith says this new model will be more responsive to issues, better able to mange performance, more accountable, more adaptable to innovation, and responsive to make space for local input. Unclear how the new model will facilitate these goals. /3
Read 20 tweets
Nov 2, 2023
Gov announced forthcoming changes to the Public Health Act today that will give cabinet greater power over decisions during a public health emergency. Some thoughts... /1
First, clarity over the role of the CMOH was much needed. This should have been fixed much, much sooner when it became clear that what was happening during covid (i.e. cabinet making decisions) was out of step with the law (i.e. CMOH making decisions). /2
Two questions required attention. First, who ought to make decisions during a health emergency (CMOH, cabinet, combo)? And second, how much independence should the CMOH have (e.g. a bureaucrat reporting to the Minister of Health or able to disclose recommendations publicly)? /3
Read 10 tweets

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