To summarize the privacy commissioner's thoughts re: bill 46. Netcare will now be managed and operated by the gov. This is not necessarily a concern but a "significant departure" with uncertain benefits. She wonders what consultation w/ health service providers occurred. 1/6
Rules around duties/responsibilities of gov will be elaborated on in regulations. She strongly advises consultation with her on this (which didn't happen pre-bill 46). This bill creates a situation where the gov has "the ability to significantly broaden access to Netcare" 2/6
This includes access out of AB or even CAN. Beyond drs in Lloydminster, she's unsure of the gov's intent but says this will make it difficult for her to "effectively investigate or hold accountable" those out of province and may limit the recourse available to Albertans 3/6
Current rules don't allow health info to be made available via Netcare for purposes like research, education, and management ("Restricted use helps mitigate privacy risk"). Amendments would allow access to Netcare for these purposes. 4/6
Currently custodians must consider pt's expressed wishes in including info in Netcare (can mask the info so only available in emergency). Depending on regulations, these expressed wishes may be limited. She requested detailed consultation on this. 5/6
She finds removal of privacy impact assessment for info shared between Alberta Health, AHS, and HQCA "shocking and disappointing." Some other topics discussed, but those are key issues. The letter: oipc.ab.ca/media/1111811/… 6/6
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Some thoughts on Bill 46... This main changes are to the Hospitals Act, Health Information Act, and Health Professions Act. The Hospitals Act will be repealed and public hospitals will now be regulated in the Health Facilities Act (HFA) along with private surgical facilities.
Part 2 of the HFA addresses private facilities (both those who provide insured and those who provide uninsured services). This remains unchanged since the passage of bill 30.
There's a new Part 2.1 of the HFA. Basically, the gov plunked all of the old Hospitals Act (e.g. hospital bylaws, privileges, hospital foundations, etc) into the HFA.
We won't know the results of the vote until tomorrow, but the UCP is finished debating the policy to allow a two-tier health care system. Some thoughts... 1/8
We heard the usual rhetoric about "choice" and "freedom", which is all fine and good if you can afford those choices and those freedoms. Given the link between health and wealth, those who cannot afford those choices would often be those who most need health care services. 2/8
Brian Peterson says that other countries have both systems and perform well. Classic correlation/causation problem. Systems that outperform Canada do not outperform because of privatization. Evidence doesn't support that argument. Also, most of those countries spend more. 3/8
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.
Some thoughts on this article, which suggests that the ruling in the BC private health care case is inconsistent with SCC jurisprudence and thus vulnerable to appeal: nationalpost.com/news/canada/b-…
While one of the parts of BC's law was similar to that challenged in Chaoulli (ban on private insurance), the BC case addressed other rules like limits on extra billing.
There are significant differences in Quebec's 2005 health system and BC's 2020 system. For example, while judges in Chaoulli disagreed on how to assess unreasonable waits, the judge in BC relied on benchmarks that didn't exist in Quebec in 2005.
A summary of and some thoughts on today's decision upholding BC's limits on private health care...
The plaintiff argued that the combination of long waits and limits on private care violated Charter. The Court found that "there is in fact expert evidence that wait times would actually increase" with privatization.
As expected, the court agreed that waits could engage the Charter-protected right to security of the person. Specifically, court noted that some patients wait longer than provincial benchmark to receive care.
The decision in a BC case seeking to strike down laws limiting private health care (including private insurance and extra billing) comes out tomorrow (apparently at 1pm). The decision is a rumoured 800 pages, but I will summarize and dissect it on twitter starting at 1.
For those not familiar with the case, Brian Day, a doctor who founded a private surgical facility in BC, is arguing that the combination of 1) wait times, and 2) limits on private care (similar to those in Alberta) violate the Charter rights to life and security of the person.
The court is likely to agree that waiting for care can, in some cases, threaten a patient's life and, due to the physical/psychological effects of waiting, violate security of the person. The SCC agreed with these arguments in a 2005 Quebec case (Chaoulli).