1/13 Some thoughts on the Alberta government's approach to health care, including today's reforms contained in Bill 30...

2/13 The UCP relies on flawed reports (MacKinnon, E&Y). These reports were drafted with a view to recommending privatization and corporatization of health care and not with access and quality in mind. Many proposals in these reports aren't even justifiable on efficiency grounds.

3/13 Apart from health care services, the government has made cuts to education and other social programs that undermine the social determinants of health. The cuts to AISH are but one example:  https://www.cbc.ca/news/canada/edmonton/aish-alberta-jason-kenney-1.5346856. See also: the gov's attitude towards safe consumption.

4/13 The gov's push to privatize various aspects of the health system is concerning. Lab services. Mask distribution ( https://edmontonjournal.com/opinion/columnists/opinion-drive-thru-mask-giveaway-wont-prevent-covid-19). Virtual care ( https://edmontonjournal.com/opinion/columnists/opinion-albertas-virtual-health-care-app-plagued-with-problems).

5/13 The E&Y foreshadowed privatizing continuing care, which has been linked to quality concern ( https://edmontonjournal.com/opinion/columnists/opinion-covid-19-lays-bare-poor-conditions-in-long-term-care-homes). When people raised legitimate concerns with privatization and conflicts of interest, they have been threatened and bullied ( https://www.cbc.ca/news/canada/edmonton/alberta-minister-tyler-shandro-behaviour-vital-partners-1.5511288).

6/13 Bill 30 encourages private delivery of surgical services. The gov claims this would shorten wait times. While it may shorten waits for less complex cases seen in private facilities, what about those with complex medical needs waiting to be seen in public hospitals?

7/13 In other countries, more private care has increased wait times in pubic sector. Provider-owned private clinics can raise conflict of interest concerns. Private delivery doesn't generally save $ because of high admin costs and because less complex cases are cheaper to treat.

8/13 A previous attempt at private delivery in Alberta (Health Resources Centre) illustrates these concerns:  https://s3-us-west-2.amazonaws.com/parkland-research-pdfs/deliverymatters2.pdf. It cost taxpayers millions. A similar experiment in Sask had concerns:  http://www.friendsofmedicare.org/ucp_health_policy. See also:  https://ablawg.ca/2020/03/10/recent-health-system-reforms-sustainability-measures-or-a-push-to-privatization/

9/13 Bill 30 undermines the role of  @albertadoctors as the bargaining agent for doctors in Alberta. The gov has taken an aggressive, heavy-handed, and constitutionally suspect approach to negotiating fees with the AMA, including refusing arbitration:  https://healthydebate.ca/opinions/alberta-government-arbitration-doctors.

10/13 These bad faith negotiating tactics and unilateral changes to billing codes are harming access to health care services, particularly in rural areas:  https://www.cbc.ca/news/canada/calgary/rural-doctors-alberta-reduce-services-1.5538934. They have also irreparably harmed the relationship between drs and the gov.

11/13 Although there is evidence for the use of alternatives to fee-for-service payment for certain patient populations/medical practices, all of this should be done through @albertadoctors and not unilaterally by the gov.

12/13 Bill 30 increasing public representation in colleges not inherently bad, but who will the government appoint? Those who align with them politically or those with genuine interest in improving patient care? Potential concerns about increased gov control over @HQCA.

13/13 The direction Alberta's health care system is alarming and the health of Albertans will suffer. Unfortunately, these changes may only be the start, with the Fair Deal report advocating "innovation" (aka privatization) and undermining the principles of the Canada Health Act.