The Government Health Policy Framework
What Will It Mean For You?

The government has finally released a framework for its "Third Way" reform plan for health care. The 10 points they lay out are written in language that can be hard to decipher what they mean. Below is a point-by-point summary of the government plan and what it will mean for you and your family.

1. Paying for Choice and Access

Government Plan:
Allow individuals to pay directly for certain procedures in the private system. Allow doctors to work in both the private and public system at the same time.

What it means for you:
For you this will mean longer waiting lists in the public system. The government plans to allow some Albertans to queue jump if they have enough money. This will mean you wait longer while your doctor attends to those who pay. Allowing doctors to work in both the private and public system means there will be fewer doctors available for public patients.

2. Establishing Parameters for Publicly Funded Health Services

Government Plan:
Define which services and procedures should be covered by Medicare, and which ones should be de-insured.

What it means for you:
Many services you receive today through Medicare - and without direct cost to you - will be transferred to the private sector. You will have to pay directly for these procedures. The government does not say which services they will de-insure, but any service that isn't "essential" could be considered. Any "new" procedures or therapies will likely not be covered by Medicare in the future.

3. Creating Flexible Funding Options

Government Plan:
Explore alternative methods for financing health services, such as establishing private insurance for some procedures, setting up Medical Savings Accounts (MSAs), or co-payment options

What it means for you:
Any of the options listed mean one thing for you: more money out of your pocket for health care. It also means less access to needed health care. Under private insurance, a large U.S. insurance company will determine your eligibility for health care - and only after you have paid your premiums. MSAs require you to manage your own health dollars, making you choose between a small procedure today or saving up for a large emergency tomorrow. Co-payments mean you pay a portion of the cost for a procedure directly from your pocket. The bottom line? You pay more for less health care.

4. Reshaping the role of Hospitals

Government Plan:
Redefine the role of hospitals to restrict the number of things they do. Shift many routine and day surgeries to private clinics. Turn rural hospitals into primary care centres.

What it means for you:
You will be required to go to a private clinic for more and more types of procedures. Hospitals will be restricted to emergencies and more serious surgery - with other services going to private clinics. This will mean fewer doctors available in hospitals, fewer resources going to hospitals and confusion about where to go to get treatment. It will also increase the costs of performing procedures - as private clinics routinely charge more than hospitals for their procedures to cover their profit margin.

5. Expanding Capacity

Government Plan:
Expand capacity in the public and private systems to meet health care needs. Train more health professionals.

What it means for you:
This point is very vague and general, but it does point to a willingness to address long waiting lists by sending more procedures to private clinics. And what it means for you is longer waiting lists. Expanding private health care does not reduce waiting lists, it only spreads existing doctors and nurses between two systems. To expand capacity, we need smarter investment in public facilities, not create a parallel system with duplication of infrastructure.

6. Putting Patients at the Centre

Government Plan:
Give Albertans an active role in maintaining and improving their own health and deciding on their care and treatment. Continuously improve the health care system

What it means for you:
This point is little but vague sounding promises of making the system easier to understand and more patient-friendly. This is a worthy goal, but there are no specific policies or actions. For this to affect you and your family, real proposals will need to be implemented.

7. Promoting Flexibility in Scope of Practice of Health Professionals

Government Plan:
Strengthen cooperation between health professionals, building a more "team" model of health care. Remove restrictions to the roles of nurses, pharmacists and other professionals to allow them to take a more active role in clinical care and treatment.

What it means for you:
Allowing nurses and other professionals a larger role in health care will both increase the quality of care and lower costs. However, the government has talked about this for many years and is yet to move forward in any serious way on the issue. It continues to be nothing but rhetoric.

8. Implementing New Compensation Models

Government Plan:
Implement new ways of paying physicians to encourage better care and more inter-disciplinary collaboration.

What it means for you:
This has the potential to lower the cost of paying doctors. Most are paid through fee-for-service, which is not always the most effective way to compensate doctors. If implemented, this could reduce costs to the system, while keeping health services in the public system.

9. Strengthening Inter-regional Collaboration

Government Plan:
Increase sharing of services and procedures across Regional Health Authorities. Expand upon the model that establishes specialized centres for treatment (e.g. heart institute).

What it means for you:
This has some potential to make more efficient use of resources, and build areas of expertise in certain services, especially those performed less frequently. However, if you live in rural Alberta, this could mean the downgrading of your local hospital and long trips to the city for more significant medical treatment.

10. Deriving Economic Benefits from Health Services and Research

Government Plan:
Capitalize on Alberta's world class health care and health research by marketing to other jurisdictions around the world.

What it means for you:
More resources spent making money for companies instead of providing health care to Albertans. Helping a company sell a new innovation to another country will not shorten wait times or improve health outcomes for Albertans.

 

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