Archive for August, 2009

The promise of community care for the mentally ill: a cruel fraud

The “community care” model.

I’m going to go out on a limb and say something that will offend some fine people whom I respect. To wit: The promise of community care for the mentally ill is a cruel fraud.

Coupled with the concept of deinstitutionalization – closing institutions for the mentally ill – community treatment has never worked. It will never work. It will always – always – result in large numbers of the mentally ill being turned out into the streets to fend for themselves in increasingly desperate circumstances.

The results for the mentally ill, their families and loved ones, their friends – and sometimes just those of us who have the bad luck to sit beside them on the bus – can be catastrophic. The results for taxpayers are increased costs – spent in the justice system, instead of on health care.

Supporters of community care for the mentally ill, psychiatric professionals, government officials struggling to keep budgets under control, operators of for-profit residential “care facilities,” and many others with many motives, honorable and not so honorable, will protest that community care could work – probably work even better than institutionalization – if it received adequate resources.

Who can argue with this assertion? Certainly not those of us who are not experts in the field. But this is why the community-care model is a fraud: it will never work because it will never get the resources it needs. You don’t have to be an expert to understand this!

Come on, people! Consider what mental health care has to compete with for funding, in health care alone: multi-million-dollar MRI machines for rich people who hurt their knees skiing and their backs playing golf, just for one example.

Which do you think is going to get the big bucks from governments of the rich, by the rich and for the rich – which is all we have in North America nowadays? Something that powerful people with connections demand, now, or something that a group of people who are mostly poor, atomized and unable to speak for themselves, or even act in their own basic interests, desperately need?

And that’s just in the realm of medicine. Don’t forget that also competing for suddenly scarce government megabucks are those subsidized private businesses called P3s that build billion-dollar highways, consortiums set up to construct ritzy sports arenas, stakeholders in failing auto assembly plants and a zillion and one other enterprises that benefit people who know how to speak for themselves and grease the wheels of government.

Saying that community care for the mentally ill could work if we only devoted adequate resources to it is like saying that free love would be no problem if only we could all stop being jealous. Yeah, it’s true. And it’s never going to happen on this green earth, even with adequate supplies of penicillin.

State and provincial authorities in North America have been closing down major psychiatric institutions since the 1950s. Deinstitutionalization is always accompanied by promises that these facilities will be replaced by community care. These promises are never kept, and most mentally ill people are left to fend for themselves.

Now, as they face a financial crisis as much of their own making as caused by recession, Alberta’s prodigal Conservatives are proposing to save a few bucks by closing many beds at Alberta Hospital Edmonton, a world-class psychiatric facility. And, guess what, they’re promising us they’ll put proper community supports in place first.

What makes us think that Alberta will be different from any other Canadian or U.S. jurisdiction where these promises were made and not kept? I apologize for using bad language, but all this promising is, in the words of a psychiatrist of my acquaintance, “just bullshit!”

I believe that Dr. Stephen Duckett – the antipodean economist hired by the Alberta government to turn health care in this province on its head – is an honourable man. But he is promising something that he can’t deliver when he says, as he did in his most recent blog for Alberta Health Services employees, that “our commitment to our patients is clear: No hospital spaces will be closed unless and until community-based beds and services are in place.”

I also believe that Dr. Duckett – who is a PhD economist, not a physician, by the way – is mistaken when he calls Alberta Hospital Edmonton “a care model out of touch with contemporary best practice.” Intentionally or not, he’s conjuring up an image of the insane asylums of yore, not the world-class psychiatric treatment centre that AHE is today.

And while I don’t doubt Dr. Duckett’s word when he says “we are currently consulting with staff at Alberta Hospital Edmonton on what appropriate services might look like,” I do wonder which staff members he is talking to, because several of the institution’s psychiatrists are on record saying he’s never talked to them.

Right now, even before there have been any bed closures at AHE, Alberta has fewer acute care psychiatric care beds per capita than any other Canadian province. Waiting lists to get into AHE’s programs are long.

Without the programs at AHE and without the chimerical community supports for the mentally ill that we’ve been promised, whatever we save on funding AHE will be more than made up for by increased costs for policing, courts and jails.

And when our jails have become mental institutions of last resort, you can bet that the mentally ill they house won’t be getting the treatment they need – or once could have had at AHE.

In his blog, Dr. Duckett stated: “I recognize that there are concerns about whether or not the community spaces will be created. To that I say: Watch us.”

Will I be watching? You bet I will! If Dr. Duckett somehow manages to pull off this promise, I’m going to make a fortune … selling umbrellas to pedestrians to protect them from flying pig droppings!

If Quebec had used Internet voting in 1995, Canada would be two countries today

This column appeared in today’s edition of the Saint City News.

We have a wonderful thing in Canada: a democratic system in which we can have confidence.

Our next-door neighbours in the United States can’t make this boast. There are strong reasons to suspect the results of both the 2000 and 2004 U.S. presidential elections were strongly influenced by fraud, if not actually stolen.

But no matter how mad it makes me when Canadians elect governments I personally don’t approve of, it’s impossible to make a case they didn’t actually mark their ballots that way once they got inside the voting booth.

What’s the difference between the two countries? Two things: electronic voting and paper ballots.

The United States has electronic voting machines, and you can’t trust their paperless results. Canada counts federal and provincial votes on paper ballots, and you can trust the numbers.

If there’s evidence of voter fraud in Canada, or if an election is “too close to call,” you’ve got actual ballots to recount. If you don’t believe the first recount, or there’s a dispute over which ballots were properly marked, you can get an impartial and independent judge to oversee the recounting. Scrutineers for all candidates can watch the counting, and yell if they feel anything is amiss. Voters may vote as they please, without father, husband or big brother peering over their shoulder.

Ultimately, while there is plenty partisans can do to influence Canadian elections in questionable ways, citizens at least can trust the results of the count.

That’s why my blood ran cold recently when I saw in the media that Elections Canada is considering adopting “Internet voting.” More than considering it – “hiring resources, developing a timeline and researching e-voting experiences over the Internet,” one story said. A plan is afoot to try “e-voting” in a by-election in 2013, then introduce it more generally after that.

Do you feel good about this scheme? You shouldn’t. If you’re uncomfortable trusting your Visa or Mastercard number to Internet security, why would you trust something as precious as your democratic franchise?

If you have confidence in the technology – guess again. Voting machines are bad enough, but Internet voting was made for hacking because data must be transferred electronically over vulnerable phone and cable lines. Moreover, voting outside polling places opens the floodgates to votes being coerced, bought, or just stolen while Grandma sleeps. Insecure home and laptop personal computers make the system even more vulnerable.

What’s the reason for this scheme? It can’t be speed or efficiency, because accurate initial counts at polling stations are very quick in Canada. As anyone who watches election night TV coverage knows, full results are usually posted less than hour after the last poll closes.

We’re told e-voting will encourage computer-savvy young people to vote, and get a larger percentage of the populace to participate by making it easy for them to cast their ballots without getting off their duffs.

Sorry, but that dog won’t hunt. One of the reasons young people don’t vote is because they cynically suspect their votes don’t really make much difference. If that’s true now with a voting system we can trust, imagine what it will be like with a system designed to encourage election theft, bullying and vote buying!

The system we have may not be perfect, but it won’t be fixed by introducing changes that can break it wide open. Indeed, if Quebec had used Internet voting in 1995, Canada would be two countries today.

I can think of only two good reasons to support Internet voting in Canada: Either you stand to make money by selling the software, or you want to steal an election!

This is a bad idea. We need to stop it right now.

The Big Apple: Disneyland for Grownups

Manhattan, unlike the last time I was here in 1980, is safe, clean and crowded.
Crowds are out day and night…
…To take in the sights, and lights, like these in Times Square.
So this is the reason I have little to say about Alberta today.

The answer to Vancouver’s ‘mental health crisis’ – Alberta Hospital Edmonton

Building No. 9 at Alberta Hospital Edmonton.

When Alberta Health Services announced Friday it is “continuing the evolution of community-based mental health treatment in the province, and is accelerating its move away from a largely institution-based system,” many observers quickly concluded that the inevitable end result will be more mentally ill people dumped into the streets. Especially so, since the practical expression of this policy, AHS conceded, would be closing beds at Alberta Hospital Edmonton, a world class psychiatric institution.

The province-wide health board, of course, vehemently denied this. “I can tell you categorically that none of these patients is going to end up on the streets,” Dr. Patrick White, the AHS mental health services director, asserted in a media interview.

Others, such as physicians who run programs at Alberta Hospital Edmonton, Friends of Medicare, psychiatric social workers, unions and opposition politicians, insist that the consequences of this policy will be dire.

Whom to believe?

AHS, and the government whose policies it carries out, would like you to think all the people complaining about what it admits is a cost-saving policy are simply “the usual suspects,” people and groups who benefit from the situation as it is and whose oxen are about to be gored, or soft-headed “liberals” who have never seen a penny they wanted to pinch.

If you’re inclined to accept the official line on this, would you believe … the police?

Now, Alberta police forces are silent on this issue for the moment – although I’ll bet some individual police officers have pretty strong opinions on the plight of the mentally ill in our streets. However, a January 2008 report by Detective Fiona Wilson-Bates of the Vancouver Police Department makes some very interesting observations that are directly relevant to what is now happening in Alberta.

In Lost in Transition: How a Lack of Capacity in the Mental Heath System is Failing Vancouver’s Mentally Ill and Draining Police Resources, Det. Wilson-Bates provides some pretty blunt commentary on the reasons severely disturbed citizens are ill served by the system in B.C., and the impact of that situation on police resources and, ultimately, taxes.

It’s worth quoting from this report at some length, I think, and worth considering what the same policies have wrought in other jurisdictions where, for the same cost-saving reasons, governments have adopted a policy of “de-institutionalization.”

On the resource implications for the Vancouver Police, she writes: “Mental Health Act cases and and ‘disturbed person’ incidents alone required the equivalent of more than 11 full-time frontline police officers. Accordingly, the estimated direct annual cost associated strictly with Mental Health Act arrests and incidents coded as ‘disturbed persons’ would be at least $1.1 million.”

On the community facilities mentally ill patients were promised when B.C. psychiatric institutions were closed: “…Despite the promise of replacement facilities for the mentally ill in the wake of de-institutionalization, these beds have not materialized. Currently in Vancouver there are no treatment facilities to accommodate people who require a moderate to long stay (i.e., over three months). Moreover, there are no options for long-term care in the Lower Mainland. Compounding this is the fact that hospitals in Vancouver are simply not equipped to handle long-term psychiatric patients and primarily take a ‘crisis care’ approach.”

On the impact of the reduction in beds at psychiatric institutions: “…The reduction in beds at Riverview (psychiatric hospital) and the lack of support services in the community to replace those lost are significant contributing factors in the current crisis.”

On how police respond: “…The result is the criminalization of people who are mentally ill. When patrol members respond to reports of a person who is known to be mentally ill screaming obscenities and being physically aggressive with pedestrians, they are more inclined to take the offender to jail in the absence of reasonable access to mental health services.”

On the overall effect of this situation: “It is clear that many Vancouverites with mental health issues are poorly served by a system that is failing. VPD officers, along with the mentally ill citizens with whom they come in contact, are bearing the burden of a mental health system that lacks sufficient and effective resources and adequate information sharing, often with tragic consequences.”

Now, that’s just in Vancouver, of course. But ask yourselves, Albertans: Do you really think it’ll be any different here?

There’s more to Det. Wilson-Bates’s report, of course, and it’s well worth reading. In her conclusion, she makes some recommendations about how the situation might be fixed. No. 1 on her list of “what’s needed” is as follows: “A mental health care facility that can accommodate moderate to long-term stays for individuals who are chronically mentally ill.”

You know, just like Alberta Hospital Edmonton.

Say what? Mental health patients to be moved to acute care beds?

Historic Building No. 1 at Alberta Hospital Edmonton.
Below, the hospital’s entrance; its landmark water tower; Building No. 12; the Rose Sinclair Pavilion (Building No. 5); and Building No. 9.

Was it just me, or did I hear a report not so long ago that Alberta has too many patients who don’t require acute care taking up space in our hospitals’ acute care beds?

Isn’t this supposed to be why we have a “crisis,” in health care funding, part of why our health costs are “out of control”?

The argument that inappropriate patients must be moved out of acute care beds has most certainly been used to justify the creation of privately run assisted living facilities and the like. After all, we’re told, they’re a great way to make sure acute care hospital beds are used efficiently for what they were intended to do.

What’s more, moving continuing-care patients out of scarce acute care beds means acute care patients who have been hanging around hospital emergency wards can be moved into them, reducing those scandalously long waiting times in Emergency…

I mention all this because of a seemingly unrelated announcement. Did you notice on Friday how Alberta Health Services quietly published a little news release saying that it is “continuing the evolution of community-based mental health treatment in the province, and is accelerating its move away from a largely institution-based system”?

“Uh-oh,” I thought when I heard this. In most places, “community based mental health treatment” is a euphemism for turning the mentally ill into the streets and forgetting about them. The trouble with the mentally ill, of course, is that they mostly don’t vote, and those that don’t have families to support them are mostly poor as well, so it’s extremely hard to get politicians, especially Conservative ones who don’t have to use public transit, to give a hoot about them. The people the mentally ill bother, of course, are mostly poor too.

However, that’s not the case here in Alberta, the news release assured us. AHS had to base mental health services in the community, see, because they’ve decided “not to proceed with the redevelopment of the Alberta Hospital Edmonton (AHE) site.”

If this sounds to you like a bank telling its poor and elderly customers that they’re closing their local branch “to serve you better,” well, I’m sure nothing could be further from the truth. …

Anyway, a “patient family handout” linked to the release helps us answer this question: “If AHE closes, where will its patients be put?”

This is something you might wonder if you were a mental health patient – or the parent, spouse or child of one – contemplating the meaning of Friday’s announcement. In fact, you might ask the same question if you’re just a citizen with no involvement with mental illness at all, other than needing a strategy for getting to and from work through the increasingly dangerous streets of Edmonton or Calgary.

The answer in the handout was not particularly reassuring. “Care for the mentally ill has evolved significantly since the early 1900s when mental hospitals were the major site of treatment and care for the mentally ill,” the handout explains, conjuring up horror-movie images of gothic institutions for the criminally insane. (To the author’s credit, he or she resisted the temptation to note that AHE, founded in 1923, was then known as the Institute for the Feeble Minded.)

“Therapeutic advances in the form of medications and treatment philosophies have allowed us to do a better job of providing care and support in the community,” it adds. I am sure there is some truth to this – but, as noted above, many of us can be forgiven if we suspect that most North American jurisdictions, infected by the virus of neocon voodoo economics, have used these alleged advances in treatment as an excuse to save money by turning the mentally ill into the streets.

AHS vows that this is not so: “I can tell you categorically that none of these patients is going to end up on the streets,” asserted Dr. Patrick White, mental health services director of the province-wide health “superboard,” according to a story in yesterday’s Edmonton Journal.

So where are they going to go? Well, the AHS news release says this: “Patients with mental illness will be transitioned from Alberta Hospital Edmonton to capacity in the community or acute care hospitals depending on need.” (Emphasis added.)

So there you have it. Capacity in the community – whatever that means – or acute care facilities.

Of course, in a year or two, we’ll be told that the mentally ill will have to clear out of those acute care beds to make way for acute care patients.

Then they’ll end up on the streets!

“Alberta Health Services is working hard to ensure we are providing the right care in the right place,” the handout says.

I guess we’ll see about that. Some of us may even have the opportunity to experience it first hand, one way or another.

Free Saturday bus rides a smart move by St. Albert Transit – but not smart enough!

This column ran in todays edition of the Saint City News.

St. Albert Transit is offering free rides within our city on Saturdays this month. This is bound to generate angry letters from readers who see it as a waste of money.

To me, it’s a smart policy that could bring real benefits to St. Albert Transit, plus our city and society. But some people are sure to argue it’s a subsidy for bus riders. They’ll ask, why we are subsidizing a transit system that runs 80 per cent empty most of the time? Some of them will fume: “I don’t use the bus. Why the heck should I pay for it?”

Then they’ll hop in their car and head out to visit Aunt Hattie on roads heavily subsidized by other taxpayers. Their car, of course, will be 80 per cent empty. Or maybe they’ll take their RV and head to Saskatchewan down highways and across bridges subsidized by taxpayers to the tune of literally billions of dollars!

If their vehicle is made by General Motors, Chrysler or Ford – or if it’s made in Canada by Toyota or Honda – they can be confident the manufacturer received massive subsidies from Canadian taxpayers.

The automobile subsidy runs wider and deeper than that, of course – it includes taxpayer support for ambulances, enforcement, fuel refining and winter road clearing, plus the massive deficit passed to future generations for the environmental costs of millions of cars. (And you didn’t like St. Albert’s idling bylaw!)

If we switch to some other kind of motive power – say, electricity – the power to charge up our vehicles will come from plants paid for by taxpayers.

None of this is news. It’s the job of the people we elect to make decisions about what – and who – society is going to subsidize. It’s our job as citizens to scream if we think they’re making bad choices.

But will our hypothetical driver recognize the road he’s using was a choice politicians made between subsidizing drivers and riders. Not likely. More likely he’ll think bus riders are a “special interest group” while he is merely exercising his rights.

As a society, we need desperately to get drivers out of cars and onto public transit. This would cut air pollution, reduce energy use, make living in suburban cities like St. Albert more affordable and, yes, save money on roads.

That said, while I accept the argument, I’m reluctant to give up the convenience and comfort of my personal wheels. For public transit to work, it needs to be inexpensive, reliable, safe, and available at all hours. Alas, that is going to cost money up front.

Getting back to St. Albert, the decision to attract a few more commuters by offering “free samples” on Saturdays makes sense. The cost will be minimal, because the buses will be running anyway. The potential for attracting new customers is real.

But this experiment is too small to reap significant benefits. For a start, St. Albert Transit should offer free rides into Edmonton. How else are weekend riders going to learn how well the system connects to Edmonton’s? Free rides could also be tried on Sundays.

Beyond that, the regional transit network could eliminate fares on key downtown commuter routes, drop fares for routes on particularly busy roads, or offer free fares on smoggy days. All these things are done elsewhere in the world, to beneficial effect. They cost a little up front, but save money for taxpayers down the line.

Don’t bet on it happening here, though. Canadian politicians can’t seem to get past a business model for public transit that says letting riders travel for less than the full cost of the trip is a subsidy – but that building roads and highways isn’t!

Random thoughts on Canadian and U.S. health care: Part IV

You thought the NEP was expensive? Sabotaging Canadian health care could carry a very steep price.

What happens to Alberta if we succeed in destroying Canada’s system of public health insurance?

I’m not sure that this is a question asked by anyone but me. But I reckon it should be.

Let’s imagine that Premier Ed Stelmach and Health Minister Ron Liepert succeed in their efforts to largely privatize our public health care system – and, in the process, thorough the provisions of the North American Free Trade Agreement, manage to seriously undermine public health care in other provinces as well.

How will voters in other provinces – especially Ontario and Quebec – react to this? And what are the political and financial implications for Alberta?

Since they value public health insurance, I think it is a given that voters elsewhere in Canada will be very angry. They will understand that, because of NAFTA, privatization in Alberta assuredly means privatization in their provinces too. It seems to me quite likely that their inevitable anger will translate into a desire to punish Albertans for subverting something that most Canadians truly value.

It also seems likely that Canadians elsewhere will do whatever they can to preserve public health care – even if it has been made more expensive because an unwanted parallel private-sector system bleeding off personnel and creating costly inefficiencies to pander to a wealthy few.

Where could the money be found to achieve these goals? Alberta’s oil wealth might be one place Canadians look.

In the wake of a successful corporate assault on Canadian public health care, aided and abetted by Alberta voters and their representatives in the provincial Legislature, I think it will be easy for political activists in Central Canada to look to a tax on our hydrocarbon resources as a way to keep Canadian public health afloat.

They’ve taxed them before, and if we provide them with enough arguments, they’ll tax them again. So much the easier if we allow them to throw a dash of green into the mix by continuing our irresponsible environmental practices.

And if we don’t like it? I suspect they will say, “tough luck,” “suck it up, Buttercup,” and maybe even “serves you right, [INSERT EXPLETIVE HERE]s.” After all, from their perspective, all we ever do is whine anyway, no matter how rich we get. We are extremely unlikely to elect very many representatives from a political party that would consider such a tactic, and hence we won’t have a voice at the table to say, “Now just a darn minute!”

Indeed, one likely consequence of such a turn of events will be the banishment of the Alberta-led Conservatives from power in Ottawa for another generation.

Most Albertans, of course, don’t want public health care ruined either. But we do keep electing governments that think that’s a worthwhile goal. So at the very least, we should redouble our efforts to make it clear to our MLAs and MPs that, whatever else they do, they should keep their hands our health care. Longer term, maybe we should think about electing representatives who don’t want to destroy public health insurance!

Otherwise, if you thought the last National Energy Program was bad, watch what happens when we’ve really cheesed off the rest of the country!

On the blackboard, 300 times: ‘I must obey the courts!’

If you want to mess with a court, play badminton.

Do not – repeat, do not! – disobey an order of a Canadian court. Canadian courts have real powers.

Richard Ouellet (at left), a senior manager in the provincial department of Children and Youth Services, seems to have discovered this the hard way by defying an order of the Alberta Court of Appeal.

Yesterday, a Court of Appeal judge sentenced the senior government official to eight days in jail for civil contempt. Mr. Ouellet had failed to return a child to his foster mother after the court ordered the department to do so. Justice Jean Cote gave Mr. Ouellet an opportunity to avoid jail time – but only if he performs 40 hours of community service work and someone pays the foster mother’s legal fees.

In a democracy, understanding that the courts have real powers and you have to do what they say – no matter who you happen to be – should be pretty elementary. Indeed, if they taught civics in this province (which they don’t appear to do) this would be one of the useful things you’d have to learn in high school. (Hell if they did, someone would probably want to opt out under the provisions of Bill 44.)

Just in case you missed the lesson, let’s review: According to my favourite political science textbook, The Canadian Regime, by Patrick Malcolmson and Richard Myers, the fundamental principles of the Canadian judiciary are as follows:

  1. The courts are impartial. That is, they decide cases on the facts and the law, and should be free from prejudice for or against anyone who appears before them.
  2. The courts are independent. So Mr. Stelmach and Mr. Harper aren’t allowed to tell them what to do, no matter how much they think they know better. This is what really gets the goat of supporters of arbitrary measures by the government. When they invariably scream “activist courts” they usually mean independent courts.
  3. Citizens enjoy equality before the law. That is, the law applies equally to everyone, even if you’re a friend of the premier.

What’s more, the courts have real power to support these principles. So, for example, if you’re a high government official who doesn’t feel he has to obey a court order for whatever reason, they are allowed to clap you in irons. And, apparently, they’ll do it now and again!

That’s enough legal theory for now. The rest of this story is murky. It’s hard to imagine how a senior government official could have forgotten such an elementary point. The media reports leave one with a feeling there’s a hole in the story you could drive a Mac Truck through, but you can’t quite put your finger on it, maybe because it’s so big.

Who gave Mr. Ouellet the bad advice that he could ignore the court? (“He was possibly poorly advised,” said the judge, according to a report in the Edmonton Journal. Moreover, according to the judge’s ruling, this was a case of “carelessness,” not bad intent.) On what basis? Why wasn’t the child returned to his foster mom until the day before a contempt hearing was scheduled? Is ignoring orders of this type – or playing silly buggers with them – standard operating procedure for this government? Do government lawyers advise officials to do this sort of thing?

It seems to me that the problem with a province that massively elects the same party over and over and over again, no matter what, is that the big shots in the political elite that runs the place (and in Alberta that certainly includes their senior officials) forget that they don’t have a monopoly on power.

Most of the time, of course, they do, which is why it’s easy for them to forget, I guess. Usually, they can ignore the wishes and the sensibilities of individuals, or even whole communities.

But they can’t ignore the rulings of the courts, thank God. At least as long as we’re part of Canada. I’m sure it makes them mad. I’m sure they think it’s unreasonable. I’m sure they think it flies in the face of the very laws of nature.

But there it is! In Alberta, as in every other part of Canada, no matter who you are, you just have to obey the courts. It’s the law. You. Must. Obey. Court. Orders.

I don’t know about you, but I find that kind of refreshing.

The government is hiring, if only on the front line of tomorrow

Wanted: Albertans like this to serve on the front line of tomorrow. (Photo gratefully borrowed from Sexy People Blog.)

It’s great to see that, despite the recession, the government of Alberta continues to hire needed personnel.

Wait, you say? What about the hiring freeze at Alberta Health Services? What about the hiring freeze affecting employees of the Government of Alberta?

Oh, well… I suppose if you’re going to call nurses and child protection workers essential and claim they’re overworked you could gin up an argument that needed employees aren’t being hired. …

But, really, which is actually more important: some crabby old unionized intensive-care-ward nurse who always wants to claim overtime, or the people who will shape Alberta’s future?

Obviously, if we go by what the government of Alberta does, as opposed to going by what it says, we can quickly reach two conclusions. Conclusion 1: The hiring freeze only affects employees who deliver services that are actually needed by the public. Conclusion 2: The group that’s more important is made up of those mysterious personages who will shape our innovative future.

Leastways, while Alberta may desperately need more nurses and child protection workers, not to mention dozens of other important job categories, it is board members for four new provincial corporations and an advisory body that the government is advertising to hire. Everything else, apparently, is frozen, like the North Pole used to be in the good old days before global warming.

What’s more, they’re not leaving the job to the capable staff of the Government’s Corporate Human Resources office (which is a “business friendly” way of saying the Public Service Commission), they’ve hired Ray & Berndtson, a high-zoot executive search firm, to track down likely candidates.

Trust me, this won’t come cheap. (The people the government actually pays to do this work, presumably, are sitting around drumming their fingers, waiting for the price of a barrel of oil to go up again.)

If you don’t believe me, check out the Working Section of Saturday’s Edmonton Journal. The government’s advertisement – well, Ray & Berndtson’s if you want to be technical about it – is on page K1. There’s another version of the same ad in the Saturday Globe and Mail. It says, in part, “the creation of four new provincial corporations (Alberta Innovates – Health Solutions; Alberta Innovates – Bio Solutions; Alberta Innovates – Energy and Environment Solutions; and Alberta Innovates – Technology Futures) is a signal Alberta is committed to support research and innovation in these key areas defining Alberta’s success and social well being into the next decade.” Wow! Alberta is sure innovating nowadays! There’s also something called the Alberta Research and Innovation Authority, which needs board members as well.

The ad goes on: “Alberta seeks vision, energy and world class sector experience and credentials in their Founding Board members. The Government of Alberta invites nominations and expressions of interest from those who want to serve on the front line of tomorrow.” Click here to read Ray & Berndtson’s ad on-line.

I don’t know about you, but I’d just love to serve on the front line of tomorrow. I’ve got a funny feeling, though, that I’m just not the kind of fellow they have in mind.

As a dear friend of mine with many years of experience likes to say, there’s never a bad time to reward your friends!

Random thoughts on Canadian and U.S. health care: Part III

The NAFTA “free trade” deal is a key tool used by corporations to extend and protect privatization of health services.

If you thought stopping the Third Way was an exhausting battle, get ready for a bigger one.

I believe there is a strong possibility Premier Ed Stelmach’s provincial government will soon attack public health care with an intensity we have never before seen here in Alberta or elsewhere in Canada. Former premier Ralph Klein’s illogically named “Third Way” was just a warm-up.

The reason: Fed-up public opinion and an activist Democratic president south of the Medicine Line have the greedy and inefficient private U.S. health care system in an uncomfortable corner, if not quite on the ropes. Canada, especially Alberta, can become a second front in the U.S. health industry’s ugly, no-holds-barred fight against much needed health care reform in the United States.

Pouring part of their virtually unlimited resources into undermining Canadian public health insurance makes sense from the perspective of the U.S-based private “health care” industry for several reasons:

  • Anything they can do to hurt the credibility of the obviously more efficient single-payer system used in Canada in the minds of U.S. voters helps their cause. Hence the dishonest TV ads financed by Big Medicine now playing on U.S. television sets.
  • Any damage they can do to the efficiency and fairness of public health care in Canada – especially if it increases the clamour among the moneyed classes in this country for privatized health “solutions” – may reduce the pressure for a fair public health system in the United States.
  • Under NAFTA’s “free trade” Bill of Corporate Rights, private health care in one country can be used to sustain and increase the same thing in the others. As a last resort, then, more private health care in Canada is a hedge against the outright exclusion of private health care in the United States.

For all these reasons – plus the fact that corporations are always looking to expand their markets – it is likely we will see a renewed corporate push to privatize health care in Canada. U.S. corporations rightly see Alberta, of course, as the weakest link in the defence of Canadian public health insurance, so they will attack here the hardest.

So look for big U.S. bucks to flow into Alberta to back efforts to weaken public support for our public health care system. (Expect, moreover, that our Conservative government will extol ignoring the public’s wishes on this topic as “leadership.”)

And look for Alberta Health Minister Ron Liepert – widely believed not to be planning to seek re-election and hence more able to resist pressure from the public – to aggressively take the lead in the fight to wreck our health care system before our American cousins wise up and go Canadian.

Aug. 12: Political and financial implications for Alberta of more private health care.