November 16, 2010

Mr. Anderson: Yeah. Thank you, Mr. Speaker. You know, I feel like we’re back at the first day of spring session. It’s almost like déjà vu with this bill. Back then the government finally came to the conclusion that everyone else in Alberta had already come to, the conclusion that we as a province had fallen behind the rest of the country in the area of competitiveness. Our investment climate, of course, had taken a big hit thanks to the ill-conceived royalty fiasco, our businesses were being hammered with overregulation, and the cost of doing business was going up and becoming uncompetitive with other provinces. Alberta was and still is losing its competitive edge.

Then I look and I remember that this government’s response to this problem was not to lower taxes or to implement stricter spending rules or to cut wasteful and ineffective government programs; they just made a new law. They even called it the Competitiveness Act, hoping that Albertans would mistake it for real, effective action on the issue of competitiveness in Alberta or the lack thereof.

Mr. Hinman: Bill 1.

Mr. Anderson: Bill 1. Albertans did not buy it. The Competitiveness Act was rightly panned as a do-nothing piece of legislation intended more as a PR exercise than a serious attempt at fixing a major and real issue. In many ways it typified this government’s statist approach to governing this province. There is no issue that more laws and more government cannot fix, which brings me to Bill 17.

Everybody knows, Mr. Speaker, that Alberta health care is in crisis right now. During the first week of fall session the Wildrose caucus released hundreds of emergency room horror stories, the details of which painted a graphic and disturbing picture of the sorry state of health care in this province: broken bones being treated in hallways; pregnant women getting cervical exams in open triage units; patients vomiting blood in the middle of emergency rooms while waiting hours and hours for care; people dying in hospitals before even seeing a doctor; a young man leaving hospital in a desperate and suicidal state only to commit the tragic act soon after not being able to receive care. As our caucus leader, Danielle Smith, often says, these are the types of stories that you would expect to hear in a Third World country. You would not expect them to happen in this province, in Alberta.

In the days and weeks that followed we heard from more and more doctors and other health care professionals about just how deep the entrenched issues in health care have become. The government promised more beds, but the Alberta Health superboard said that there wasn’t enough money to staff them and operate them. The government announced new ER wait times, but doctors said it would take a Christmas miracle to meet them. The government claimed the centralized superboard is working, but the Auditor General found nearly a billion dollars misallocated and criticized the superboard for building facilities with no funding agreements in place. They said we’d have more beds, they said we’d have more health care, but what we got was a bunch of empty buildings and no staff to staff the beds so desperately needed.

So the government is doing what it always does when confronted with an issue of monumental concern to all Albertans: it makes a new law. The Alberta Health Act has all the hallmarks of a PC government bill designed to try to persuade people, to try to convince Albertans to believe that they are actually doing something to fix the problem. It’s even got “health” right there in the title, just like the Competitiveness Act. But even a cursory read of the bill reveals that it has very little, if anything, to do with actual health care delivery and it will do little, if anything, to help our health care system.

The centrepiece of the legislation appears to be this so-called patient charter. The health minister has twisted himself into a pretzel over the last couple of weeks trying to explain what this patient charter would actually mean for patients. Albertans were probably pleased when they first heard of the idea of a charter – I know I was: “Oh, good, a charter; this ought to help” – an entrenched document that would guarantee them rights when it comes to health care delivery and legal recourse should those rights be violated. After you scratch the surface of this bill a little bit, you discover that this so-called charter is not legally binding in any way. It doesn’t entrench any rights, it doesn’t guarantee any level of care, and it doesn’t give Albertans legal recourse for anything. It’s a deliberate attempt by this government to fool Albertans, and it’s a pretty poor attempt. All it will end up doing is shielding the minister from the real issues that Albertans are facing in their health care system.

Then there’s the health advocate. Again, it sounds like a pretty decent idea on the surface, somebody whose job it is to act as a voice to government on behalf of patients who experience difficulties in the system. But it didn’t take long for the gloss to come off that promise. We soon found out that this advocate isn’t accountable to Albertans through the Legislature; it’s accountable to the minister who appoints him or her. Given how this government treats those who have dared to shine light on the incompetence and mistakes this government has performed in the past – the recent dismissals of the Utilities Consumer Advocate and the Chief Electoral Officer, to name two examples – it’s hard to believe that this so-called advocate will have any real impact whatsoever on patient care.

It’s kind of ironic, then, that the report this act is based on is called Putting People First. I think it would be most appropriately titled Putting the Minister First or maybe even Putting Headlines First because it clearly has nothing to do with putting Albertans first or certainly will not accomplish that goal. Beyond protecting and empowering the minister and giving the appearance of taking action, I’m at a loss to describe what this bill accomplishes for anybody.

Fortunately, there is a party in this province that is actually endeavouring to come up with a plan for reform of this health care system, this tired and outdated health care system that we keep clinging to as if it’s going to one day work if we just pump more money into it. There’s one party that is actually going to propose some ideas that will reform the system into one that works and one that will fix health care or, at the very least, improve it greatly from where it is right now. Unlike this government, which can’t seem to do anything beyond commissioning reports that they put on shelves and let collect dust and task forces and studies that do nothing, we are putting forth real ideas.

First of all, there absolutely needs to be more patient choice and competition in the health care system. We have some already. Our doctors are private. They compete with one another for patients. So we do have some competition in our health care system, but we need a lot more. We’ve seen what this government does to private facilities that perform procedures faster, better, and cheaper than public hospitals do. They put them out of business.

That’s what happened at the HRC. Some of our best doctors at our highest performing health care facility surgical centre in the province for hip and knee replacements were told one thing by the government. They relied on that representation and acted on it. The rug was pulled out from underneath them once they did so, and they found themselves insolvent. An absolute disgraceful performance and something that is causing even longer waits for people with hip and knee surgeries: we just shut down our most efficient and effective hip and knee replacement centre. It is absolutely nonsensical. It is no wonder that we’ve seen ERs that are bursting at the seams, that we see waiting lists continue to increase. This government is actively shutting down health care providers and funneling everybody into an already overcrowded system. One of the examples of this is the McCaig centre, where they opened up was it two surgical rooms. Well, they just shut down six at the Grace hospital under HRC. How does that help anybody? It doesn’t.

This type of mismanagement is simply not sustainable. The system itself is not sustainable. The massive hikes in health care spending over the last few years prove it. Eighteen per cent last year. Think about that: 18 per cent. How on earth can we justify spending that much money in year-over-year increases? Are we going to fix the system or not? It’s not about plowing billions and billions and billions more into health care; it’s about making sure that the billions that we’re already spending are spent prudently and properly, that people are competing for those dollars, putting patients first, getting the patients to come to them, and trying to offer the government the lowest price possible for completing those services.

What this government and the other opposition parties, for that matter, fail to realize is that Albertans don’t care how their health care is delivered as long as it’s safe, it’s timely, and they don’t have to take out their credit card to pay for it. They don’t care who delivers it. They just want good health care. I don’t know why we devolve every time into this stagnant debate and start fearmongering, throwing out that we want to privatize everything, that we want a two-tier system. That’s not what we’re talking about. We’re talking about what doctors across this country are talking about, what the Liberal MP just put out. What was the Liberal MP’s name in Ottawa, the former Reform MP?

An Hon. Member: Keith Martin.

Mr. Anderson: MP Keith Martin.

We’ve got to put these tired arguments away. There are some people in all parties, Keith Martin being one of them, Danielle Smith in this party being another, in this debate. We’ve got to put it behind us, this idea that we can’t change, that we’ve got to stick to the old style, monolithic way of delivering health care. It’s not working, guys, and people are suffering because of it. So let’s put that old argument away because it’s not doing anyone any good.

Now, that’s exactly what our party and our caucus are proposing. We would open up the system to greater competition to allow for more patient choice within the five key principles of the Canada Health Act. That’s the only way our health care system will deliver the care Albertans need at a cost to the taxpayer that is both reasonable and sustainable.

We will also dismantle the health care superboard and gradually return delivery of health care to local decision-makers. There is no doubt that you can create some efficiencies for purchasing prescription drugs, for example, on a bulk basis. We can definitely have that as an option for regionally run hospitals to use. However, that doesn’t mean you need a massive superboard to run everything. You pick the parts where it makes sense to have, you know, a more centralized decision-maker or centralized entity helping out, but you don’t put it all under the centralized decision-making when so much of it would be much better run locally.

Alberta Health Services was ushered in to replace health regions two and a half years ago with promises of streamlined delivery, less administration, and lower costs. It is absolutely beyond refute – there’s no argument – that it has not worked. It has not resulted in those things. They may have cut bonuses somewhere or the number of executives they’ve had with certain titles, but the cost of health care went up 18 per cent last year, and there were no positive improvements in the system. How is that more efficient? It’s not. Centralizing delivery of essential goods and services doesn’t work. It never has; it never will. We don’t allow the state to dispense food or clothing for the precise reasons we see in our hospitals today: long lines, high prices, and shortages of supply.

The Wildrose will end the health care monopoly in Alberta by decentralizing decision-making and entrenching patient choice as the cornerstone of our health care system. A Wildrose government would redirect more of the health budget to expand home-care services, make it easier to build and operate assisted living and longterm care facilities, and introduce a kinship palliative care program that would compensate family members for giving end-of-life care to loved ones in their homes. We would track and publicly disclose waiting lists and costs for all procedures as well as the treatment outcomes for all health facilities openly and transparently. Empowering patients with this information will allow them to make better choices and will provide incentive for doctors, surgical centres, and hospital administrators to provide better service. These are just a few of our ideas, and they will draw a stark contrast between the Wildrose and what this government does if it continues to act in this way, in this do-nothing way.

We will be putting forward several amendments to Bill 17 later on, and I certainly look forward to debating them in this House, but I have to make myself as clear as possible for my constituents and for Albertans. If we do not start getting this right, we are going to continue to see Albertans unnecessarily suffer and unnecessarily die in some tragic cases. It’s happening. This is not some kind of alarmist view. It’s being documented everywhere. We need to fix it, Mr. Speaker.

The Deputy Speaker: Standing Order 29(2)(a) allows for five minutes of comments or questions. The hon. Member for Calgary- Varsity.

Mr. Chase: Thank you. I have a question. This government was withheld federal transfer payments when doctors were extra billing, so I would like to know from the Wildrose representative where he stands on extra billing, the idea of a voucher system, and competition, private health care delivery as opposed to the tenets of medicare, which talk about publicly funded, publicly delivered, publicly administered.

Mr. Anderson: Well, as the hon. member knows, that’s not what the Canada Health Act says. It says: publicly administered. It does not say: publicly delivered. There’s a big difference.

But I will say that we’re not talking about a two-tier system here. That’s the big scare card that goes out. That’s not what we’re talking about. We’re talking about: the money goes in from the taxpayer to the government. Okay? Then people, when they get sick, have to make choices about where they want to get their health care done. They would go to the place of their choice, and the money would follow them to that hospital or surgical centre or doctor or whatever.

It’s all public money, so we’re not talking about skimming and two-tier, where somebody can bypass the queue. It’s all the same queue. People all have to line up in the same queue. We’re just talking about making sure that there are more options on the end of health care, delivery options, so that people can make their choices, so that private deliverers and nonprofit deliverers can come into the system with their money and invest it in the system. I mean, look at the Health Resource Centre: tens of millions of dollars invested from private money making a piece of infrastructure that was doing fantastic work.

Ms Blakeman: Only when subsidized.

Mr. Anderson: That’s not true, hon. member. The building was not subsidized. It was the Grace hospital, but it was changed and altered and renovated by private money, and that’s a fact. You can sit down with Dr. Miller and talk to him about how it went. The fact is that they were delivering those services for 40 per cent cheaper and 40 per cent faster than the public system. Now, in every case is that going to happen? Is private delivery always going to be more efficient to the government than public delivery? No. There’ll be some cases where that’s not the case, clearly, but the point is that you let them compete. The government says: “We’ve got 5,000 hip and knee surgeries, replacements that we need done. Public hospital, public surgical centre, private surgical centre, nonprofit surgical centre, compete. What can you do? Who can deliver this at the lowest cost and still do it most effectively?” Let them compete for the business.

You’ll find that although there is a profit margin in private delivery of sometimes 5, 10 per cent, depending on what you’re talking about, there’s a massive waste margin in the public system. That’s 30 per cent or 40 per cent, as we see with the HRC example. There’s waste. There are margins everywhere. Sometimes it’s waste margins; sometimes it’s profit margins. The point is: make them compete. Make them compete for the public dollars. That makes the deliverers of health care accountable. It makes public managers of health care accountable. It makes doctors, nurses, and everybody involved in the system accountable.

I respect very much the hon. Leader of the Opposition and what he said earlier. This is the big difference. They think, the Liberals and the PCs, that you just need to get a better central planner, a central manager, that you just need to manage it better, and it would all work out. But on what planet? Where is that the case? Look at Europe. Is that what they do in Europe? No, it’s not. They don’t have one monolithic public deliverer of health care. They don’t. They have multiple, competitive delivery, and it works for them. It’s still universal health care, but it works for them because they have competitive delivery.

We’re one of the most monolithic systems in the world – certainly, in the developed world we are – and we have some of the worst health outcomes and waiting lists. That has to change, but it’s not going to change if we continue to go down this path of, you know, fearmongering and “privatization is going to kill the whole system” and agendas. No one wants to see the ridiculousness that is going on south of the border. No wants that health care system. It’s a joke. No one wants to see people dying because they can’t afford to pay for it. That’s not what we’re talking about. We’re talking about making positive changes.

Video:

Making Health Care Work for Albertans
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