| Dear Ralph Klein:
Watching your performance at the Conservative party leadership conference convinced me you are thinking hard about your legacy and want to be remembered as more than the man who slew a deficit. After your comments about businesspeople making poor politicians, I know you are not thinking about a future in the car parts industry.
Now legacy isn’t meant to be a dirty word, although it is by the time most politicians are done with it. Dirty or not, legacy drives politicians. When the rush of power runs low, daydreams of chapters in history books help ease the mind-numbing hustle of day-to-day politics, and they grow stronger each year.
Not guilty you say? Take a look in the mirror. Only thoughts of your legacy could drive you to wade into the poisoned water for another fight on health care reform. You remind me of the bull that lets a wound halfway heal before ripping the scab off for one last itch-relieving lick. Health reform in Alberta has been going along just fine the last few years because you decided to leave implementing the less controversial parts of the Mazankowski Report to the bureaucrats, health authorities and a few committees.
Everyone got to work on reform instead of arguing over ideology. Now, without waiting a few years to see if the changes are making a difference, you plan to change how Albertans pay for their health care and throw the Canada Health Act aside to bring the discipline of the market to health services. It smacks of ideological tinkering.
In the name of change, the current $1,000-a-year health care tax (call it a premium if you have to), will be obsolete. A new-fangled system of medical savings accounts, certain to be as full of bureaucratic entanglements as a gun registry, will take the place of the imperfect but tried-and-true health care tax. It hasn’t happened yet and it already reminds me of electricity deregulation.
By linking our health care premiums to how much we use the system, medical savings accounts are meant to make us all think twice about making trips to the doctor or emergency room. Well, you of all people should know how little thinking goes into how people see and use our health care system.
I’m no health economist, but I have been making money off people’s dreams long enough to learn a thing or two about folks and money. The truth is health care and economic reasoning are uncomfortable bed partners. This discomfort creates the great fear over medicare funding with which you are all too familiar. It will also undermine the savings your medical savings accounts are meant to produce.
This is how my 50 years of business experience sees it: People hate losing a bird in the hand, even if avoiding the loss will save them money. You offer someone a pricier product with more gadgets, and the thought of losing the gadgets wins over increased monthly payments. You tell Albertans they have $1,000 in tax rebates waiting for them at the end of the year if they avoid the doctor and hospitals, and healthy folks will think more than twice about getting that ache or mole checked out. The chronic abusers will treat it like an all-you-can-eat buffet. The more they use the system, the more value they get out of the $1,000 rebate they never hope to see.
Experts point to Japan, Sweden and France as places where such user contribution systems seem to produce lower health care costs and healthier people. Participaction’s 60-year-old super Swede might have been a lie, but folks in all three of those countries have better diets or exercise more than Canadians, so it’s no surprise their health care costs less. If it wasn’t political suicide, you would produce healthier Albertans by dumping the medical savings account idea and giving people tax breaks to eat tofu and fish and ride their bicycles to work.
As for the marketplace bailing you out, I think your experience with the Health Protection Act proves that the private sector cavalry isn’t riding over this hill. Four years after a stand-up-drag-’em-out fight that gave us the lovely term "non-hospital surgical facilities," there are only 54 of them in Alberta. Most of them doing things they did long before Bill 11 – dentistry, eye surgery and abortions. Health care isn’t coffee and doghnuts. If the government isn’t prepared to mess with the marketplace with subsidies or a two-tiered health system, the market is saying there is no business case.
You want a legacy? Stick to golf courses, provincial parks, ski hills and new holidays. They worked for your predecessors.
Looking forward to Conscientious Health System User Day the third Monday of every March,
Buzz Angus
Web resources
· Prospect theory, February issue of Prospect — www.prospect-magazine.co.uk
· CHR Annual Report: www.calgaryhealthregion.ca/newslink/annual_report.html
· Alberta’s Working Prescription for Health Care Reform, Fraser Institute report - www.fraserinstitute.ca/admin/books/files/PPS49-ab-health.pdf
· Alberta Health reform page: www.health.gov.ab.ca/reform/team.html
· Alberta Health reform implementation team: www.healthreform.ca/HRIT_Final_Report.pdf
· Canada Health Act report on Alberta: www.hcsc.gc.ca/medicare/Documents/CHA0203-alta.pdf |
Copyright ©2004 FFWD. All rights reserved.