AB Premier reveals plans to transfer hospitals from AHS

[Halifax Tar]

I think the issue is that once we have the public/private healthcare system, and the private side pays their folks more $, then naturally more healthcare specialists will go to those private companies rather than the current public hospitals, etc. So eventually, unless there is a way to gatekeep how many go private or the govt pays more (which I’m sure will happen), it will essentially become private healthcare.

This isn’t necessarily a case of “let it fail”, because if it fails then we’re talking about healthcare. You and I may be able to afford private healthcare, but how about those making less than us? If they get subsidized then we’re just doing a half-job of public healthcare.

Because I work with so many Americans and see their system (Tricare aside), I have a different opinion of public, private, and dual healthcare. It is definitely possible to get better service in the US because it’s run like a business, and if you don’t want to go to clinic A, you go to clinic B.

However, when I ask how much they pay for co-Pay, health insurance, and still have to select their clinics or hospitals based on what place takes which insurance (they default to “use the military hospital if at all possible” due to a myriad of reasons), it gives me pause.

I support a private health care system, and I will get behind public support in a private system for those who are unable to look after themselves; people with disabilities.

 

[Remius]

I prefer something like Australia’s Hybrid system. With opt in systems and incentives and levys.

 

[Good2Golf]

Agreed, I would like the option for my dependents to use private health care, and myself when I am back on civi street.

I think the issue is that once we have the public/private healthcare system, and the private side pays their folks more $, then naturally more healthcare specialists will go to those private companies rather than the current public hospitals, etc. So eventually, unless there is a way to gatekeep how many go private or the govt pays more (which I’m sure will happen), it will essentially become private healthcare.

Dual system healthcare is already in Canada. Imaging and bloodwork aren’t the only services that you can get if you choose to pay for it.

No one province health insurance pays for ALL medical services. Guess what? If the government isn’t paying for it and you are (whether by having a private health care insurance provider or out of pocket)…IT’S A TWO-TIER health care system! How could anyone argue it isn’t?

There are over 100 private health clinics in Canada that provide up to major surgery, and while some provinces own most of their hospitals, some barely own any.

Canada

View Canada’s health care system profile - including goals, strategies and functions of universal healthcare coverage to ensure quality of care for citizens.

www.commonwealthfund.org

Funny that AB NDP describe the Premier’s move to privatize some hospitals as destroying the basis of the province’s health care system, yet by all accounts I hear, Ontario is providing decent enough care to Ontarians (relative to many/most other provinces…still needs improvement to support its healthcare workers more) with mostly privatized and non-profit run hospitals.

It (private healthcare/two-tier also) isn’t the great chasm of bankruptcy and death that some (many?) are making it out to be.

I ran through the numbers if I were to move to the US…Florida, specifically (where my sister lives and teaches high school). Income/tax/HMO fees considered, even paying $1200-1500/mo for health care, I’d be ahead of the game money wise. Canada has lost its health care shine a lone time ago…the smelly corpse of the rotting Canadian healthcare Unicorn is stinking up the place…

 

[IKnowNothing]

Funny that AB NDP describe the Premier’s move to privatize some hospitals as destroying the basis of the province’s health care system, yet by all accounts I hear, Ontario is providing decent enough care to Ontarians (relative to many/most other provinces…still needs improvement to support its healthcare workers more) with mostly privatized and non-profit run hospitals.

It (private healthcare/two-tier also) isn’t the great chasm of bankruptcy and death that some (many?) are making it out to be.

It strikes me that the biggest barrier to discussions on healthcare reform is proximity to the states/ association of private delivery with the US model. Widespread medical debt, people being denied care, the "fat" in the model- it's a non-starter. But.. there are many countries that do universal healthcare better than us, many of them incorporating private delivery/hybrid systems. Lets learn from them.

 

[Good2Golf]

It strikes me that the biggest barrier to discussions on healthcare reform is proximity to the states/ association of private delivery with the US model. Widespread medical debt, people being denied care, the "fat" in the model- it's a non-starter. But.. there are many countries that do universal healthcare better than us, many of them incorporating private delivery/hybrid systems. Lets learn from them.

Family friend’s sister-in-law is a physician in Rome. The Italian healthcare system from what I’ve seen during visits to see them is actually pretty darn good and not a wallet busting capability.

 

[Brad Sallows]

Every acknowledgement that private enterprises might pay health care workers more is an acknowledgement that we are exploiting the public aspects of the system to suppress the compensation of health care workers. This is done because the insurance companies (federal and provincial governments) want to minimize their payouts.

What's the customary news template for "greedy companies minimizing costs on the backs of workers"?

 

[lenaitch]

yet by all accounts I hear, Ontario is providing decent enough care to Ontarians (relative to many/most other provinces…still needs improvement to support its healthcare workers more) with mostly privatized and non-profit run hospitals.

I'm not sure I would agree with that. A little less than 20% of Ontarians don't have a family doctor, and some areas are now publicly saying that they never will in their lifetime. Along with regular closures of emergency departments and other services in smaller communities.

 

[Good2Golf]

Family doctor shortages are worse in many other provinces…and I did qualify it about still needing more support to healthcare workers. The shortage of family doctors in Ontario (and honestly every other province) is the continuous down loading of medical funding pressures from federal to provincial levels in a disproportionately lower amount than population increases and health care worker qualifications and remuneration.

I’d be very interested to see the case for the Ontario government to buy all the private and not for profit hospitals in the province and run them as provincial crown facilities as a means to address lack of family doctors (which primarily practice through a myriad of private clinics, not even at a hospital).

 

[MilEME09]

Gotta love she specifically mentioned Covenant Health, which Stelmach and Shandro are members of its board of directors. Sounds like selling off hospitals to elite friends to me.

 

[SeaKingTacco]

Gotta love she specifically mentioned Covenant Health, which Stelmach and Shandro are members of its board of directors. Sounds like selling off hospitals to elite friends to me.

You do realize Covenant Health is a Not for Profit, religious based organization, right?

 

[dapaterson]

You do realize Covenant Health is a Not for Profit, religious based organization, right?

As registered charity, their financials are available through the CRA Charities portal.

According to their last disclosure, they have 3 employees paid $350K+, 6 paid $300K-349K, and 1 paid $250K-299K (statutory requirement to disclose top 10). Security Challenge

 

[IKnowNothing]

As registered charity, their financials are available through the CRA Charities portal.

According to their last disclosure, they have 3 employees paid $350K+, 6 paid $300K-349K, and 1 paid $250K-299K (statutory requirement to disclose top 10). Security Challenge

Is that unreasonable for executives managing a 990 million dollar per year enterprise?

I can't speak specifically to how well Covenant is run, but a quick skim of their financials shows 39 of that 990 going to admin- just under 4%. That's not crazy- and to me that leans to the good side of privatization. Talented individuals selected, promoted, and compensated for delivering high quality care in cost efficient, sustainable (long term viability, not greenness) manner seems like the right way to incorporate the best parts of meritocratic private enterprise without a public good being hijacked by shareholder profit motive. It's a question of objectives and alignment

 

[MilEME09]

You do realize Covenant Health is a Not for Profit, religious based organization, right?

Yes still sounds unethical to me

 

[SeaKingTacco]

Yes still sounds unethical to me

Ok, you are right.

The Alberta Premier has a dark plan to hand over the entire AHS to the Vatican.

Better?

 

[Remius]

At the end of the day, health care across the country is a mess. I don’t bemoan some provinces trying new things to try and fix it.

 

[Brad Sallows]

a public good

A public good "is a good that is both non-excludable and non-rivalrous."

We might casually refer to the public provision of entitlements as what they are - public entitlements. See the article for "capital good".

Until we get to a point at which health care goods and services are immediately available to everyone on demand, health care isn't a public good.

There's a point to this pedantry: to not lose sight of the fact that an entitlement for one person imposes obligations on others to provide it. Canadians are unable to meet the obligations and unwilling to govern themselves so as to meet the obligations. We elect governments which promise and introduce more entitlements than we can provide while simultaneously cleaving to unnecessary ideological limitations on how the obligations might be more efficiently met.

 

[PrairieFella]

Ok, you are right.

The Alberta Premier has a dark plan to hand over the entire AHS to the Vatican.

Better?

Deus Vult

 

[Good2Golf]

As registered charity, their financials are available through the CRA Charities portal.

According to their last disclosure, they have 3 employees paid $350K+, 6 paid $300K-349K, and 1 paid $250K-299K (statutory requirement to disclose top 10). Security Challenge

So just a bit more than a Toronto Police constable making a 1/4 Mil with overtime, then?

Ok, you are right.

The Alberta Premier has a dark plan to hand over the entire AHS to the Vatican.

Better?

So worse than a Canadian PM with a dark plan to hand the country over to China?

 

[dapaterson]

So worse than a Canadian PM with a dark plan to hand the country over to China?

You'll have to be more precise.

 

[Blackadder1916]

. . . but a quick skim of their financials shows 39 of that 990 going to admin- just under 4%. That's not crazy- and to me that leans to the good side of privatization. . . .

My quick skim of their financials (the CRA charitables form) doesn't reveal that. Maybe I skimmed too quick but I couldn't find the "39" going to admin. Going to the "5010" line (Total expenditures on management and administration) - amount is blank.

What did catch my attention was the numbers of part-time vs full-time employees (and compensation totals). My immediate supposition was that accounted for the high use of part-timers in continuing care facilities (one of the negatives noted during Covid time), but on looking at Covenant's "report to the community", the light bulb went on and I realized that "Covenant Health" is a distinct and separate 'charitable' entity from "Covenant Care" and "Covenant Living".

As to the efficiency of Covenant's administration costs, it is briefly touched on in this Edmonton Journal article that presents the viewpoint of the Alberta Medical Association president.

'There's no evidence driving it': Alberta Medical Association president slams hospital transfer plan

Alberta Medical Association president Dr. Paul Parks calls the plan to have multiple providers "ill-advised" and will bring "added chaos."

edmontonjournal.com

“There’s no evidence driving it. In fact, it’s counter to the objective evidence specifically relating to having two health authorities in the Edmonton Zone which have performed worse on all the objective measures than the Calgary Zone,” Parks said.

One of the difficulties, Parks said, is that Alberta Health Services is mandated to be publically transparent when they have service interruptions but, as a private provider, Covenant Health has not had to disclose issues.

With Covenant Health’s duplicate administrative system and CEO, the province pays more money in bureaucracy and red tape in the Edmonton Zone than in any other Alberta Zone because of two separate, distinct health authorities, he said.

Edmonton is the only zone that has two health authorities, and the province’s experiment with multiple providers in the Edmonton Zone hasn’t been a success, Parks said.

“And now they’ve added chartered surgical facilities to it. The Edmonton Zone has the worst flow metrics and hospital admission and overcrowding because of this lack of co-ordination,” Parks said. “You then have multiple service providers that only have to take care of a piece of the pie, and they can just say, ‘No, we don’t do that kind of care. It’s not our mandate.’”

and brings up one of the concerns of a 'faith based' entity providing some health services.

Parks also pointed to reproductive and end-of-life issues where he foresees a clash between a faith-based provider and public interests.
“The fact that there are difficulties in co-ordinating and co-operating in care is what’s complicated access issues in Edmonton,” he said.

and swings round to the fact that whomever operates the facilities, it will still be a single funder.

“Regardless of which administrative body is going to take care of our acute care facilities, the issues are still actually mostly at Alberta Health, in regards to resources funding, and adequately resourcing and adequately funding and workforce planning for these hospitals. Those are all at Alberta Health, and those are items that any health authority that’s trying to manage the hospitals don’t have direct influence over.”