All posts tagged Alberta Health Services

Pack the Senate with cheats, then call for reform, then take off for Peru? Good plan!

by David Climenhaga on May 22, 2013 in Alberta Health Services, Allaudin Merali, Senate Abolition, Senate of Canada, Senator Mike Duffy with 4 Comments

Prime Minister Stephen Harper, not pictured because he’s pretty well disappeared, has heeded the touristic lure South America, illustrated above. Below: Canadian Parliamentarian Joan Crockatt and U.S. Representative Davy Crockett. Note to Globe and Mail: There is a difference! Below them: Allaudin Merali.

Prime Minister Stephen Harper was apparently grinding away at his Conservative caucus yesterday morning about the need for Senate reform.

An interesting strategy, his!

First you pack the place with self-entitled cheats and porkchoppers like Mike “The Puffster” Duffy, then you argue that their misdeeds are proof the institution needs reform!

If nothing else, this suggests Calgary Centre MP Joan Crockatt was sticking right to the party strategy handbook when she suggested in a now-ntorious Tweet that her Conservative Party is more ethical than all those other parties because some of its unethical senators resigned from caucus when they got caught.

Of course, this doesn’t mean very much when they can be expected to go on reliably voting for the same things as they would as caucus members while try to insinuate their way back to insider status, at least until they reach 75.

Ms. Crockatt’s risible suggestion prompted general hilarity among the chattering classes nationwide – and probably would have gone international had it not been for the antics of Toronto Mayor (and future Conservative senator?) Rob Ford, who was already occupying the Canadian Curiosity slot on foreign newscasts.

(By the way, here’s a note for the Globe and Mail’s editors, if such a thing is still employed by our National Paywalled Website: Unlike Davy Crockett, the late U.S. Congressman of a similar name, it’s Joan Crockatt, with an A.)

Let it be said nevertheless that Ms. Crockatt might be well advised to follow the example of former avid Tweeter Pat Martin of the New Democratic Opposition and shut down her Twitter account for the duration, or at least hand it over to a reliable aide.

Speaking of reliable aides, that brings us right back to the prime minister’s current sea of troubles.

I expect Mr. Harper’s suggestion at a studiously public caucus meeting yesterday morning that any of his MPs who are just there for reasons of self interest should “leave this room” was mainly greeted with discreetly rolled eyes.

“I know that like me and my family, you are scrupulous about paying personal expenses,” Mr. Harper is said to have added, presumably with a poker face and to a largely silent room, before quickly jetting off to the much friendlier environs of Peru and Colombia, leaving Question period to underlings.

Mr. Harper’s problem is that, right now thanks to Senator Duffy and others, the public has taken a fairly jaundiced view of his government, and he knows it. And nowadays who can blame them for a little cynicism, when just a few layers of the onion are peeled back yet the PM refuses to acknowledge any responsibility or even knowledge of what was going on among his closest aides right in his own office?

Instead, quite typically, Mr. Harper blamed the NDP and the Liberals for his self-inflicted troubles – and privately, no doubt, the “liberal” media as well. You know, those well-known social democrats like PostMedia’s Andrew Coyne and the editorial Board of the Globe and Mail, for whom l’affaire Puffster has been too much to swallow even with their usual tolerance for bad-tasting Tory potions.

Despite Mr. Harper’s not-entirely-successful attempts to “distance himself” form his stinky Senate appointments, the PM had very little to say before his hasty departure about the one issue that would have benefitted from the disinfectant properties of a little sunlight.

To wit: the unethical and possibly illegal payment of $90,172 by the former chief of the prime minister’s staff, Nigel Wright, to Senator Duffy.

Mr. Wright fell on his sword on Sunday morning to protect his prime minister after his effort failed to bail out the Harper Government by quietly paying off Senator Duffy’s improperly claimed away-from-home living expenses.

Alas for Mr. Harper – who has replaced Mr. Wright with a callow former National Citizens Coalition hack rather like himself who used to walk around wearing a picket sign reading, “Liberal, Tory, Same Old Story” – the issue just won’t fade away.

Indeed, the only way to make it go away forever is to fix the Senate. And unfortunately for the PM’s “reform” talk, the only way to fix the Senate that will actually work is to abolish it.

 

Contracts? Contracts? Who cares about contracts?

Meanwhile, out here in Alberta, Premier Alison Redford has vowed to forestall the inevitable and force former Capital Health and Alberta Health Services CFO Allaudin Merali to go to court if he wants to try to get his half-million or so dollars in severance.

Alert readers will recall how Mr. Merali’s expense account became a cause célèbre and a huge embarrassment to the Redford Government in August 2012 when CBC investigative reporter Charles Rusnell published the results of a Freedom of Information search revealing “how he spent tens of thousands of dollars on lavish meals at high-end restaurants, bottles of wine, even a phone for his Mercedes Benz car.” Mr. Merali left the employ of AHS soon thereafter.

Yesterday, Calgary Sun political columnist Rick “The Dinger” Bell quoted Ms. Redford as saying, “If people think they are entitled to something in a contract and other people don’t think they’re entitled to it I guess they can hire lawyers and take legal routes and go to court.”

In other words, she said: “We are not going to voluntarily do anything with respect to his severance. … We are not going to simply sit back and take a look at what he may or may not feel he’s entitled to without resisting that.”

There are just four problems with this plan:

  1. Alberta Health Services signed a contract with the guy that says he’s owed the money
  2. Outrageous as his expenses may have seemed, all of them appear to have met the lax the rules for executive expenses in effect at the time he was a Capital Health Region employee
  3. He was rehired and then fired by another employer, AHS, and there’s no evidence his expenses at that organization broke any rules
  4. Canada, even the part governed by Ms. Redford’s Progressive Conservative Party, still has an independent and impartial judiciary

In other words, while Ms. Redford’s attitude is pretty typical of Alberta’s Top Tory Dogs – that is, the law is for you, not for us – sooner or later we Alberta taxpayers are going to have to pony the money up to Mr. Merali.

Yes, we can understand that by getting caught by the CBC successfully claiming expenses that offended ordinary voters, Mr. Merali embarrassed the government and incurred the premier’s wrath.

But we can also understand that Alberta taxpayers are not very well served by a legal fight against Mr. Merali’s claim, which as far as can be seen is entirely legitimate and backed up by a long trail of paper.

All Alberta’s premier is doing with this posturing, it is said here, is pouring good money after bad.

Unless, that is, she is slicing the facts extremely finely, since it will be AHS that has to pay up, and not technically “her” – that is, on the principle of l’état c’est moi, the government of Alberta.

On the other hand, if she is proposing to get involved in the affairs of AHS, that is not necessarily a bad thing either.

She could start by telling AHD Board Chair Stephen Lockwood to stop defending bonus pay for the health agency’s remaining executives on the grounds “it would be wrong from many perspectives to not compensate them as per their terms of employment.”

You know, completely unlike Mr. Merali.

This post also appears on Rabble.ca.

Redford Government just can’t seem to stop fumbling health care expenses frenzy

by David Climenhaga on April 19, 2013 in Alberta Health Services, Alberta Politics, Alison Redford with 2 Comments

Alberta Health Minister Fred Horne, right, helps Premier Alison Redford get ready to face Opposition questions about Alberta Health Services expense accounts. Alberta politicians may not appear exactly as illustrated. Below: Health executives Michele Lahey, Sheila Weatherill, Alison Tonge. 

The clueless ineptitude of the Redford Government dealing with Alberta’s continuing health system expense account brouhaha is matched only by the belligerence of the Opposition in portraying the situation as an outrage and a scandal.

Since mainstream media now routinely refer to the matter that way – “Redford, opposition trade barbs over Alberta Health Services expense scandal,” is how the Edmonton Journal headlined the story yesterday – it’s fair to say the opposition strategy is working.

Whether it’s in answers to questions in the Legislature, management of issues by Premier Alison Redford’s newly hired phalanx of former Ontario spin doctors, the juvenile quality of a stream of mean-spirited Tweets from the deputy premier’s BlackBerry, or just the Progressive Conservatives’ apparent inability to predict when the next embarrassing story is about to break, her government seems to be operating without a clue in a cartload!

Rudimentary issues-management skills should have allowed Ms. Redford to step out of the way with aplomb when the two latest loads of stuff hit the proverbial fan. Instead, she got splattered!

The first one was this week’s revelation that in 2008 a senior Capital Health Region executive had a trip to the Mayo Clinic in Minnesota for cancer tests, which by the sound of it weren’t needed, approved by her boss as a legitimate expense to be paid by the public.

“I was instructed to go for a further consultation at the Mayo Clinic by my boss to ensure that I was clear of the condition. As it was not my decision, it was funded by my employer,” former CHR vice-president Michele Lahey told a local newspaper after she was tracked down at the private hospital where she now works in the United Kingdom.

“I do not believe I have done anything wrong,” she added. So no, she wouldn’t be repaying the money – and, as Health Minister Fred Horne admitted, the government concluded it didn’t have a leg to stand on when it pondered trying to collect the $7,800 from her.

Ms. Redford wasn’t even thought of as a potential premier at the time this happened, let alone the occupant of the office. Mr. Horne wasn’t the minister either. And, for heaven’s sake, Alberta Health Services hadn’t even been created – and when it was it was supposedly in part to fix just such problems.

Yet Ms. Redford and her advisors let that ball just sail by. Even the fact it originated with a Freedom of Information filing apparently failed to alert the government the story was about to break.

Still, since it also looked as much like a case of line jumping as one of expense account shenanigans, the government could plausibly have pleaded it was looking into that through the Health Care Preferential Treatment Inquiry led by retired judge John Vertes.

Alas for them, they’d already closed that affair down – apparently over the wishes of Judge Vertes – managing to make the whole thing look like a cover-up on top of everything else.

You have to admit, it takes real talent to bungle things this badly! And we’re still less than halfway through the story!

The second punch in the one-two combination came in the form of the next revelation, that another former senior health executive – this one hired for Alberta Health Services by former CEO Stephen Duckett, the fellow fired in November 2011 for misusing an oatmeal-raisin cookie – had been allowed to expense $1,200 in medical tests needed to get permission to move to Canada.

Surely the government could have blown that one off with the excuse it’s standard practice to do such things when recruiting top executives from abroad?

But, no, perhaps from bad luck, perhaps by bad management, they seem to have managed to drop that ball too. Maybe they forgot because, barely three years after she was hired as strategy and performance VP, Alison Tonge had also packed up and moved back to the U.K.

Now it’s been revealed by the Calgary Herald AHS paid Ms. Tonge at least $426,576 to go away!

This too happened before Ms. Redford’s watch began, but no matter. You’d think the government would have figured out by now the FOI requests just aren’t going to stop until journalists have pumped that well dry, so they might as well release everything and make a virtue of necessity. Don’t count on it, though, because strategic thinking doesn’t seem to be part of the Redford Government’s repertoire.

Yesterday afternoon, former Capital Health CEO Sheila Weatherill threw up her hands at this and said she shouldn’t have authorized Ms. Lahey’s trip to Minnesota, so she’d personally pay back the $7,800 – the cost plus inflation. Maybe she’s just nostalgic for the days the local media used to treat her with adulation.

A gleeful Mr. Horne – who may or may not have come up with the idea himself – told the media he had Ms. Weatherill’s cheque in hand.

Not that this is likely to end the feeding frenzy any time soon. Somebody’s bound to do so anyway, so it might as well be me that points out this still leaves Ms. Weatherill with $1,492,200 of her controversial 2008 buyout – and that’s not counting her $1.7-million executive retirement plan and her pension!

Since all three opposition parties have got their teeth into a good thing with this stuff, we can’t reasonably expect any of them to stop as long as the headlines keep coming.

And as we get closer to the next election in 2015, it’s safe to predict the Opposition will up the ante.

In particular, the Official Opposition, the far-right Wildrose Party under former Fraser Institute intern Danielle Smith, which has no more use for public health care than most of Ms. Redford’s caucus and cabinet, is joined at the hip with Prime Minister Stephen Harper’s Conservative Party. As is well known, Mr. Harper’s Robocall Party has negative campaigning implanted deep in its political DNA.

If in the run-up to the next election in 2016 the Wildrosers don’t stoop to the kind of advertising we just saw welcome Justin Trudeau to his new role as federal Liberal leader, it will be an astonishing development.

So if Ms. Redford and her insiders can’t up their game, we are led inevitably to two conclusions:

First, the next three years will see politics in Alberta descend to a whole new low of American-style viciousness – the fear of which made former Premier Ed Stelmach throw up his hands and quit in 2011.

Second, if the premier can’t get her act together, the possibility of a Wildrose government – which seemed laughably unlikely a year ago as Ms. Redford’s PCs celebrated their comfortable election victory – every day seems more like a probability.

This post also appears on Rabble.ca.

AHS chair to politicians: Do as I say, not as I do!

by David Climenhaga on April 12, 2013 in Alberta Health Services, Alberta Politics with 2 Comments

10-4 Good Buddy! Why is Stephen Lockwood, above, getting to drive this truck, while Chris Eagle’s got the airbrakes ticket? Just wondering. Senior Alberta Health Services officials may not appear exactly as illustrated. Below: The real Stephen Lockwood; Stephen Duckett, with his politically fatal cookie.

The newish chairman of the board of Alberta Health Services, this province’s massive public health agency, was in the media yesterday advising elected representatives to keep their paws off day-to-day operations of the health care system.

A culture of political interference is creating big problems, Stephen Lockwood complained to a local newspaper, and Something Must Be Done. Probably a lot of Albertans nodded their heads in agreement with this without thinking too carefully about what Mr. Lockwood was actually saying.

“If you guys want to set the policy, OK, but you can’t be interfering in the daily operations,” Mr. Lockwood told Alberta’s politicians, as channelled by the Edmonton Journal. (The italics, however, were added by me.)

And if you don’t like it, added the Okotoks trucking company executive and lawyer not long after the AHS budget was released, “you can direct us or you can replace us.”

Well, OK … I guess.

But isn’t that exactly what Mr. Lockwood is doing?

Let me explain. Alberta Health Services has a president and chief executive officer – a physician by the name of Chris Eagle – who is paid considerably more than half a million free-floating Canadian Credonias every year to operate the massive $13-billion-plus agency, which is a branch of the provincial government in all but name.

Dr. Eagle was appointed, it is true, when the guy previously in that job started to annoy some of the same elected politicians that Mr. Lockwood is unhappy about.

Back in November 2010, that fellow, an Australian PhD economist by the name of Stephen Duckett, finally committed a major blunder with an oatmeal-raisin cookie and the politicians who had hired him and then grown tired of him had the opportunity they’d been looking for to skid him all the way back to the Antipodes. Nowadays, safely back in Australia, Dr. Duckett happily works for a policy think tank and receives reams of positive media coverage.

Dr. Eagle’s job, like that of Dr. Duckett before him, is to run the day-to-day operations of Alberta Health Services within the budget he is given by the board, which in turn gets its funding from the government.

Meanwhile, Mr. Lockwood was jumped up last fall by essentially the same Progressive Conservative politicians from mere membership on the board to its chairmanship. This was really done to replace former chair Ken Hughes, who had quit to run in the spring of 2012 for

Premier Alison Redford’s government. Mr. Hughes was successful, by the way, and is now Ms. Redford’s energy minister. (There was also briefly an interim chair, someone named Catherine Roozen.)

The job of the board, all members of which are appointed by the government, is to set the policy of Alberta Health Services.

Therefore, as Mr. Lockwood says of the government, the same may be said of the Board: it has no business interfering in the day-to-day operations of AHS. That’s management’s job.

Let me say that again. The board of AHS has no business running the day-to-day operations of the organization, and Mr. Lockwood as the chairman has no business acting as if he is the CEO – which he appears almost every day to do by acting as the chief spokesperson for the organization and involving himself in matters as picayune as parking at individual hospitals.

That, by the way, is why it shouldn’t be a problem for the chair of the board to be a political appointee from the trucking industry, a Q.C., or both, instead of a doctor of medicine or, say, health care economics. That’s because the chair’s principal jobs are to chair board meetings and contribute to the creation of general policy at those meetings – jobs that don’t require medical or health administrative expertise.

But it’s pretty obvious that Mr. Lockwood is making CEO type decisions about daily AHS operations.

So Mr. Lockwood may be right when he suggests that, in the words of the Edmonton Journal’s reporter, “for the system to succeed, there needs to be a better separation between policy-makers and health operators.”

But he needs to remember that his job is as a policy maker, not that of a health operator, and that dictum surely ought to apply to him as well.

On the other hand, if Mr. Lockwood is acting as the CEO, we have a right as the people footing the bill for all this to wonder what we’re paying Dr. Eagle $590,000 plus bonuses to do.

And maybe it’s just me, but I keep asking myself where the heck Dr. Eagle is in all this.

I mean, seriously, can you imagine Dr. Duckett keeping his mouth shut if Mr. Hughes had tried to sideline the entire management of AHS and personally run the province’s health system. Not likely!

Beyond that, if the choice really is as Mr. Lockwood describes it, are we better off having things run by politicians who are directly accountable to us at least once in a while, or by political appointees who are not?

This post also appears on Rabble.ca.

Alberta Health Services trimmers toss out a couple of market-fundy myths to save cash

by David Climenhaga on March 15, 2013 in Alberta Economy, Alberta Health Services, Alberta Politics, Alberta Teachers Association, Budget Deficits, Health Care, Public Education, Public Services with 2 Comments

Alberta Health Services Board Chair Stephen Lockwood demonstrates how to trim a provincial health care budget. Actual AHS board members may not be exactly as illustrated. Below: The real Mr. Lockwood in his official AHS portrait.

Two pernicious and slightly dissonant myths that cloud discussion of public health care are the idea that to get the best public-sector managers we must pay excessive private-sector style salaries and perks and the plainly preposterous notion the private sector always does everything better.

So it was interesting how Stephen Lockwood, the apparently cold-eyed and pragmatic trucking company executive from Okotoks picked by the Progressive Conservative government of Premier Alison Redford to lead the Alberta Health Services Board, tossed both ideas over the side the instant he was told to get serious about appearing to save money.

In other words, whatever Board Chair Lockwood’s other flaws may be, he can apparently add and subtract.

The AHS news release yesterday outlining Mr. Lockwood’s cost-cutting plans in the face of a smaller-than-anticipated provincial increase to the AHS budget – 3 per cent, versus the expected 4.5 per cent – was one of a phenomenal six press releases issued by the massive province-wide health agency today. (Hint to AHS cost cutters: if your PR department is trying to get in the Guinness Book of Records for the most news releases in a single day, perhaps some of them should be reassigned to front-line health-care duties!)

Actually, the release implied the plans were jointly cooked up by Mr. Lockwood and CEO Dr. Chris Eagle, but one has the unshakeable feeling that on this one that it was Mr. Lockwood calling the shots. It’s also a bit of a stretch to call the contents of this release news, since the key points were all released once before in a meeting with the Calgary Herald editorial board at the end of February.Regardless, the statement lists eight “initial administrative cost savings,” and the stuff that made the lead of the newscasts were promises to freeze management pay for three years, reduce administrative expenses by 10 per cent over all, and deeply chill the hiring of new administrative employees not deemed to be “mission critical,” whatever that means.

Of course, mission criticality may turn out to be a pretty elastic concept, although not likely in the first year – which when you think about the budgeting process is really the only year of this packet of promises that has any meaning.

Still, here’s a little wager, despite the constant repetition of the mantra that we have to pay top dollar to get top managers, not many of these top managers will immediately decamp for other top jobs.

If I am right, perhaps we should bear this in mind when we set the management salaries of a whole range of senior public jobs in future, including university presidents, health system vice-presidents and government deputy ministers.

Oddly enough, from the market fundamentalist perspective not usually advocated in this space, the iron law of supply and demand would suggest demand is high worldwide for physicians, nurses, practical nurses and other front-line medical professionals and that therefore their pay is probably too low.

The same cannot be said of managers, who are a dime a dozen even if we pay them more than that.

Meanwhile, buried in Point 8 of the release was a notation that, to immediately save money, AHS would now be “cutting expenses incurred for the use of consultants and external facilitators.”

One could argue it’s about time.

It’s well established that with its massive purchasing power and many economies of scale – and without the need to pad corporate bottom lines with profit – single-payer public health care is far less expensive and much more efficient than for-profit health. Health care marketizers and highly ideological right-wing governments just hate this well-established fact, and are endlessly creative but not terribly successful in their efforts to wiggle past it.

Public health care agencies like AHS that instead of using their own skilled public sector workforce go outside to the private sector to “save money” rarely achieve that goal, and often end up costing themselves and taxpayers far more.

That Mr. Lockwood immediately spotted that bad habit as exactly what it is was should be a useful yardstick of the truth behind the risible claim private operators do key jobs better than public employees.

After all, he’ll have the before and after cost and quality comparisons right in front of him for future reference when the cash starts flowing again.

+ + +

After much puffing and blowing, teachers and government reach deal

After all their wary circling and a tentative jabs, it appears Alberta’s schoolteachers’ union and the Redford Government reached a tentative collective agreement yesterday that everyone can live with – well, maybe everyone except some school boards, whose association was predictably screeching about the costs of the deal last night.

Details must await our commentary until the 35,000 eligible Alberta Teachers Association members have voted on the pact, which the union’s provincial executive has endorsed.

Expect the relative amity that have long characterized the relationship between the government and the ATA to quickly return once the agreement is signed.

This post also appears on Rabble.ca.

Why is Alberta’s medical queue-jumping inquiry uninterested in dramatic 1990s case?

by David Climenhaga on February 26, 2013 in Alberta Health Services with 1 Comment

Dr. Ron Bridges of the Helios Wellness Clinic testifying yesterday in a screen grab from CBC’s broadcast. Below, Dr. Ciaran McNamee, who hasn’t been called to testify.

What are we to make of the fact Alberta’s preferential health care access inquiry has failed to call a witness who was at the centre of one of the most spectacular allegations of medical queue jumping in recent years?

Really, yesterday’s report by the Canadian Broadcasting Corp. that the often strangely passive inquiry has decided not to bother asking Dr. Ciaran McNamee to testify about what happened to his lung surgery patients simply boggles the mind.

Dr. McNamee told the CBC he is “willing to co-operate, in any form or fashion.”

But the inquiry’s lead council, Michele Hollins, told the national network that Dr. McNamee – who today works as a lung surgeon in Boston, where he also teaches at Harvard University – “is not being called to testify because it was decided his information was ‘dated’ and would provide little useful information about queue-jumping that may be occurring now.” (Emphasis added.)

Just wondering, but isn’t the point of holding an inquiry to look into what happened in the past, with the idea of preventing it from happening again in the future?

Back in the spring of 2011, the CBC revealed that Dr. McNamee, once the head of thoracic surgery at the University of Alberta Hospital, had sued the former Capital Health Region, claiming he’d been improperly hounded out of his surgical practice for complaining publicly about his patients’ long waits for surgery in the late 1990s. He also claimed CHR officials had improperly questioned his competence and even his sanity.

This was one of the incidents that led to calls for a judicial inquiry into bullying and intimidation of medical professionals in the Alberta health care system.

Dr. McNamee’s allegations became public at about the same time as Dr. Raj Sherman, now the leader of the Alberta Liberals, claimed in the Legislature that 250 people had died, many from lung cancer, while on a 1,200-name surgical waiting list in the 1990s.

In 2008, the CHR had been rolled into Alberta Health Services, the massive province-wide health authority that is only one baby step away from being an actual branch of the government.

“CBC News has learned that in the course of McNamee’s lawsuit, there was an allegation that his budget for lung surgery had been all, or in part, effectively taken over by other surgeons at the hospital,” the network reported, cautiously adding, “that allegation also was not proven.”

Unfortunately for those who would like to cast a light on what was going on in Alberta’s health care system back in the 1990s, the lawsuit was settled out of court in 2001 and Dr. McNamee was bound by a convenient non-disclosure agreement – unless he is subpoenaed to testify.

So what about it? “If the commission wishes to subpoena me, I will co-operate, and I will respect their mandate,” Dr. McNamee told the CBC’s interviewer. But the inquiry led by retired Justice John Z. Vertes, apparently, just isn’t all that interested.

In a blog post on the Alberta Liberals’ website, meanwhile, former party leader Dr. David Swann, who like Dr. Sherman is a physician, accused the inquiry of “deliberate avoidance of the most dramatic allegations of queue jumping.”

Dr. Swann can get away with a strongly worded statement like that without risk of being held in contempt, by the way, because the inquiry is not a real judicial inquiry with independent powers, but comes under the authority of the provincial government and reports to Health Minister Fred Horne. Likewise, Mr. Vertes, who has retired, no longer has the full powers of a judge.

Whether or not this has any effect on the actual independence of the inquiry, as suggested by Dr. Swann, is another matter entirely. But it certainly affects the public’s perception of the inquiry’s independence – and circumstances like the apparent willingness of Dr. McNamee to testify and the peculiar lack of interest by the inquiry to hear him, add to it.

“Many of his lung patients were ‘bumped,’ allegedly by other surgeons given preferential access, resulting, allegedly, in preventable deaths among his patients,” Dr. Swann wrote.

Meanwhile, as is well known, the inquiry has stumbled across some evidence of queue jumping in the here and now – the case of the mysterious ability of healthy patients of the $10,000-per-year Helios Wellness Clinic in Calgary to receive cancer screens in mere weeks that took all others years to get.

In testimony yesterday, a letter from senior AHS gastroenterologist Dr. Mark Swain entered as evidence said the health agency found “clear evidence” that one of the Helios doctors’ patients were the beneficiaries of preferential access to the tests.

In testimony reported by the Calgary Herald, Dr. Swain (referred to by the Herald as Dr. Mark Twain, in case you’re wondering, an easy mistake to make) told the inquiry Dr. Ron Bridges was assigned more endoscopy time than was normal for physicians who used the public cancer-screening clinic and benefitted from a “highly unusual” booking process. Dr. Swain’s explanation: “He’s not seeing sick patients.”

For his part, Dr. Bridges testified that he had no idea his patients were getting preferential access. Earlier, Dr. Bridges’ lawyer had tried unsuccessfully to prevent the report referring to patients being entered as evidence.

Well, this is all very interesting, if not exactly a shocker given last week’s testimony about the relationship between Helios and the public colon cancer-screening clinic located in the same Calgary building.

But if this inquiry is really supposed to get to the bottom of queue jumping in the health care system, it’s pretty clear Dr. McNamee needs to be called and asked about what happened back in the 1990s – even if that means discomfort for powerful people with connections to the Progressive Conservative government.

This post also appears on Rabble.ca.

Renting seniors’ beds is a formula for failure – and it’s time for Alberta to stop doing it

by David Climenhaga on February 25, 2013 in Alberta Politics, Health Care, Seniors' Care with 4 Comments

Fresh air and yogurt might have helped these guys live to be 160, but if they’d lived in Alberta, instead of Russia, where could they afford to sleep? Below, seniors care in Calgary, back in the day, before oldsters all carried tennis racquets, rode bicycles and looked like fashion models, only with white hair. That photo actually shows seniors at the Lacombe Home in Calgary and comes from the the Sisters of Providence Archives in Edmonton

Do you remember that promise by the Alberta government to build 3,000 seniors’ beds? It turns out they only planned to rent them!

The problem with renting beds from private companies, of course, is the same as with any form of privatized medicare: it ends up costing a heck of a lot more than we were promised, and delivering much less.

It also turns out the Alberta government’s bad bargain with private care operators means the fragile seniors who end up occupying the beds are subject to eviction!

Back in June 2010, Alberta Health Services sent out a news release that said the province-wide health agency would be working with the government to “add more than 3,000 continuing care beds over the next three years across the province as part of a strategy to increase access and care choices for seniors.”

“These spaces,” the release also said, “are in addition to the more than 19,500 continuing care spaces currently in Alberta.”

Never mind for a moment that despite its largely fictional arm’s-length relationship, AHS is in all but title a branch of the Alberta government. And regardless of who is at its head, this province’s perpetual Progressive Conservative government has for years been committed to privatizing as many seniors’ care beds as possible as quickly as possible.

This fact, presumably, is both as a sop to its well-heeled friends and backers in the secretive corporate nursing home industry and the sincere belief it can download the costs of this area of health care onto the elderly and their families, thereby having a better chance on delivering on the Canadian political class’s irrational obsession with balanced budgets regardless of the state of the economy.

Since 2006, PC governments under various premiers have spent at least $320 million of your money on this effort to subsidize supportive living beds in private facilities. Since the accounting can be pretty murky, it’s possible they’ve spent quite a bit more.

The exorbitant fees residents pay, in turn, flow directly into the pockets of private, for-profit health care corporations who are quite prepared to play with their elbows up in negotiations with residents, families, employees and the government itself.

So it has turned out that wherever the promised new seniors’ beds were built, they were put in place by private operators, often with the help of large subsidies provided by taxpayers.

And notwithstanding the suggestion made in AHS’s 2010 news release that they were being added to the provincial seniors’ bed total, the ones in publicly run facilities inevitably seem to be closed almost the instant a privatized facility opened nearby. Fragile residents were then forced to move.

Just since last summer, we’ve seen well-run public facilities closed in the Alberta communities of Carmangay, Grande Prairie, Bashaw and Stettler, and their residents shuffled off to privatized care centres.

The minute this happens, in turn, costs to the residents go up – often way up.

But how’s this working out for the government, you wonder? Not very well, I’d say.

For one thing, cheapskate private nursing home operators will do anything they can to suppress the wages of their employees.

In Alberta, this has resulted in employees joining unions to protect themselves. Since employees of private care facilities can legally strike in Alberta, unlike their counterparts in the more cost-effective public sector, this has resulted in a series of labour disputes that lend a sense of continual crisis to health care in this province – the very atmosphere the Redford Government surely needs and wants to avoid.

Not only that, while the disputes can be ugly – members of the Alberta Union of Provincial Employees have been locked out of a nursing home in Calgary for eight months now – but the unionized employees have tended to be successful.

The reason for this is pretty simple: right-wing think tanks can publish all the bogus studies they want, but the reality of the market in this province is that there’s more demand than supply for these kinds of workers. This is especially true of professionals like Registered Nurses and Licensed Practical Nurses. With the average age of the population increasing, it’s likely to stay that way.

Indeed, this is so obvious that it’s hard not to suspect that these private companies really aren’t negotiating with their employees at all – but are using labour disputes as a lever to pry more money out of taxpayers.

Since the levels of transparency and accountability in the private sector are in no way like those in the public sector, it’s hard to say for sure if this is what’s going on. Private operators feel no shame about hiding behind their supposed need to protect commercial interests to hide whatever it is that they’re up to.

But it was sure hard not to wonder if something like this was going on when a Toronto-based company called Symphony Senior Living Inc. wrote AHS in late January and said it wanted to end its contract to provide supportive living beds for seniors in Red Deer.

Symphony happened to be involved at the same time in negotiations with its employees’ union, and in the Jan. 21 letter made public by Alberta NDP Leader Brian Mason, the company told AHS that if it had to pay the going rate for health care workers, it intended to downgrade its operations into a more-profitable residence for healthier seniors.

Accordingly, the letter said, it was giving AHS and the supportive living residents 12 months to find a new home – in other words, handing them an eviction notice in all but name!

So when the Alberta government gave away that $320 million of our money to private companies, did these corporations have to promise to keep providing supporting living and long-term care services? We don’t know, because their contracts are secret.

Are private operators required to repay their grants if they decide to pull out to offer more profitable services for which a healthy market exists?

Can we taxpayers, who provided all this money, be assured that these private operators won’t unilaterally yank these beds we built out of service whenever there’s more money to be made doing something else with them?

Is this a sensible way to run seniors’ care – an activity the need for which is never going to go away as long as there are human beings living in Alberta?

The private sector, for profit-model doesn’t work for health care. We knew that already, which is why the privatizers have such a hard time getting their schemes for U.S.-style health care past voters, even when they rebrand them as “European.”

What should also be obvious is that seniors’ care for the very fragile elderly is a health care service.

Seniors’ care in Alberta belongs in the public sector – which is transparent, accountable, treats residents and employees alike with decency and dignity, and delivers better services to taxpayers at a better price.

This post also appears on Rabble.ca.

One single Alberta government bargaining agency is likely to end badly for Redford PCs

by David Climenhaga on February 24, 2013 in Alberta Politics, Labour Relations with 4 Comments

Premier Alison Redford, in lab coat, centre, and her Progressive Conservative cabinet get ready to bring Consolidated Bargaining to life. Actual Alberta politicians may not be exactly as illustrated. Below: Albert Einstein, the well-known genius, and Charles Darwin, who gave us the idea for the Political Darwin Awards.

Chances are good the Alberta government’s announcement it will consolidate all bargaining with all unionized provincial public employees into the hands of a single lead negotiator will end badly for Premier Alison Redford’s Progressive Conservative Party.

This is a government that has never understood the meaning of the phrase “unintended consequences” and that has a fatal attraction to the idea of grand unified schemes that are supposed to solve all its problems forever – and never do.

This is the government, after all, that under premier Ralph Klein had the bright idea of gaining control over hospital boards by consolidating them into huge regional health authorities that would run the public health care system in a way the government could avoid taking any political responsibility for unpopular decisions.

When that didn’t work out quite the way it hoped, Mr. Klein’s brain trust dismissed the health regions’ elected boards and consolidated them into even larger and more expensive entities. At the same time, the PCs consolidated the unions in the province’s hospitals into huge region-wide bargaining units, which had the effect of giving them more power.

When that didn’t work out the way the next premier, Ed Stelmach, liked – mainly because some of the senior executives of the new and larger health regions swung their weight around too effectively – the government created a massive province-wide entity called Alberta Health Services and hired a smart-mouthed Australian economist to run it.

Well, we all know how that worked out. That’s right, not as expected.

First of all, of course, the Australian economist turned out to have a politically fatal predilection for saying what he thought while his mouth was full of oatmeal cookies.

But AHS also cost more. Its management was bloated and bad at solving problems. The government tended to get blamed more often and more quickly for its failings. Plus, it increased the strength of the unions it consolidated into single units.

Examples: Three years ago, Mr. Stelmach was crystal clear, about 20,000 Registered Nurses employed by AHS must take zero pay increases in bargaining. The nurses settled for zero per cent, two per cent and four per cent over three years. One year ago this month, hospital support workers alone proved with a half-day wildcat strike at 20 hospitals that they could bring the system to its knees.

The Alberta government may imagine consolidated bargaining can control such outcomes. In fact, it will hand more power to its employees.

Arguably, the PC government has done a little better in education and the government service. In the former field, it managed a single deal with the province’s 40,000 teachers that lasted five years and only devolved into the chaos of multi-board negotiations recently. A case can be made if they’d only tried a little harder, they could have done it all again.

Indeed, just to show that the government isn’t paying any attention, Education Minister Jeff Johnson is trying to get all the teachers and school boards back at a single bargaining table before the creation of the new consolidated bargaining shop.

Meanwhile, in roughly the same time frame, the government also maintained labour peace pretty successfully with the union for Alberta’s 21,000 direct government workers through several rounds of negotiations – suggesting that the negotiation system run by the Public Service Commission wasn’t broke, and therefore wasn’t in need of fixin’.

The PCs haven’t done nearly as well with the province’s 10,000 or so physicians, who only sort-of-bargain collectively, but who seem to have a knack for getting up this government’s nose and making it do stupid things.

So now the Consolidation Gang is going to fix the bargaining problems with health care workers of all varieties by creating a massive centralized bargaining authority – and bringing the teachers and the government workers, not to mention the employees of government boards and agencies, into the mix as well.

And they think this is going to help?

Well, we’ll see, I guess. In theory, one could argue, the idea as described by Deputy Premier Thomas Lukaszuk has some merit. But right from the get-go it’s hard to imagine it won’t have the effect of making it very difficult for the government to point the finger at someone else if its negotiations with any group of public workers go off the rails for any reason.

So I would say Unintended Consequence No. 1 for the government is likely to be serious and swift political consequences for the bumps and potholes that are fairly typical on the road to any collective agreement.

Unintended Consequence No. 2, it is said here, will be that rather than co-ordinating public sector bargaining, the new agency will probably discombobulate it.

Fighting over control of the bargaining agenda between the government’s super-bargaining agency and the front-line human resources staff in health care, education and the government service will grow worse, and more bitter.

It’s hard to imagine that public service unions won’t be able to make that disunity on the other side work well for their members.

In health care, the government made AHS an arm’s-length, independent agency and hired people to run it. Those people will not take kindly to being told what to do, line by line, minute by minute, nickel by nickel. More unintended consequences are likely to follow.

You don’t have to be Albert Einstein to understand insanity is doing the same thing over and over again and expecting different results, but apparently it sure helps not to be a PC premier or cabinet minister. And you don’t have to be Charles Darwin to figure out what could happen next.

This post also appears on Rabble.ca.

Edmonton’s homeless shelters home to body lice, ‘refugee-camp-like conditions’

by David Climenhaga on February 15, 2013 in Alberta Economy, Alberta Politics, Homelessness with 7 Comments

Alberta’s perpetually mismanaged boom-and-bust economy makes homelessness worse, as hopeful immigrants flock here in hopes of a better life, and find nowhere to live. At least this guy has warm boots. Below: Dr. Stan Houston and Dr. Mat Rose.

Welcome to Alberta, the Richest Place on Earth, where body lice are showing up on residents of homeless shelters, an affliction normally associated with Third World refugee camps.

Earlier this week, University of Alberta infectious diseases specialist Dr. Stan Houston warned colleagues in an email of “a very powerful health indicator of the kind of poverty we are seeing (and creating) in this, one of the wealthiest political jurisdictions in the world.”

To wit, said Dr. Houston: “Last week, for the first time in my life, including seven years in Africa, I saw a patient of mine with a body louse infestation. He had been living in city shelters, so there has to be more where that came from.”

Dr. Houston added that he had immediately notified public health authorities.

The appearance of body lice in Alberta is significant for two reasons, he observed:

1)    “This is a marker of extreme, refugee-camp-like conditions.”
2)    Body lice, unlike the much more familiar head or pubic louse, can transmit several potentially life-threatening diseases, although the ones that showed up here don’t appear to have been doing so.

Let’s repeat one point for emphasis: “This is a marker of extreme, refugee-camp-like conditions.”

This indicates “really severe deprivation of people living in really awful conditions,” Dr. Houston added in a CBC story following up on his email to colleagues.

And Dr. Mat Rose of Edmonton’s Boyle McCauley Health Clinic told the CBC reporter he’s been seeing an increase in body lice infestation cases this year, up to as many as three times a week.

These reports are really not an auspicious beginning to Alberta’s new era of austerity, which was officially announced by Alberta Premier Alison Redford in her Sad Sack State of the Province Address a few days before Dr. Houston made his troubling discovery.

In fairness to Alberta’s Progressive Conservative government, it has actually funded some effective programs to create housing for the homeless that are making progress getting people off the streets and into permanent shelter.

Homeward Trust Edmonton has conducted counts of the number of homeless people in Edmonton since 1999, and that census of the homeless suggests progress is being made.

The count conducted on Oct. 15 and 16, 2012, indicated there were 2,174 homeless individuals in the city, including 223 dependent children – down from 2,421 in 2010 and well over 3,000 in 2008.

But such advances are easily derailed by Alberta’s perpetually mismanaged boom-and-bust economy, which as the Edmonton Homeless Commission notes, attracts immigrants to the region who expect work will be easy to find and discover a much tougher reality.

Moreover, while some progress is clear, the severity of the problem may not be. Homeless numbers are naturally difficult to pin down with confidence, and there have long been rumours – never confirmed – of a policy by Edmonton city officials enacted with the assistance of local police to roust homeless people from known camping spots in the North Saskatchewan River Valley the nights before the annual homeless count.

Regardless, it’s really former premier Ed Stelmach who deserves credit for moving the issue of homelessness to the front burner and ensuring funding began flowing into housing – an initiative that insiders attribute to the former premier’s strong Ukrainian Catholic religious faith.

But with Ms. Redford in the premier’s office – and the far-right Wildrose Party really driving the province’s policy bus – there should be serious concern that policies influenced by Mr. Stelmach’s social gospel worldview will turn out to have fallen on stony ground, where they sprang up quickly but did not take root.

As Albertans now know, the PCs’ commitment to “sustainable and predictable funding” for essential provincial programs turned out to be a mile wide and an inch deep.

In the face of a downward fluctuation in petroleum prices and the entirely foreseeable Wildrose Party screeches about the horror of deficits and the need for immediate cuts, Ms. Redford and Finance Minister Doug Horner seem to have immediately caved.

Both parties are now dominated by neoconservatives, after all, with agendas that are not strikingly different on most counts.

We’ll know more when the Budget Speech is read on March 7. But as this is written, Alberta Health Services employees are braced for an announcement of significant reductions in the government’s promised 4.5-per-cent funding increase that was supposed to ensure health care in Alberta could operate on a sustainable predictable basis.

When the inevitable impact of what will in effect be a significant cut in the face of population growth and inflation begins to be felt, stand by for the usual calls from the Wildrose benches for more privatization and delisting of services as a solution.

That the Wildrose Party would end up setting the agenda for Alberta anyway was always the danger when the Redford PCs persuaded large numbers of progressive voters to support them in keeping Wildrose Leader Danielle Smith out of the premier’s office.

Now that this is coming to pass, it is hard to imagine that the Third World conditions among this province’s poor will not grow worse as a result.

This post also appears on Rabble.ca.

Why is Alberta studying seniors’ care at the same time as it’s privatizing it?

by David Climenhaga on January 23, 2013 in Alberta Health Services, Alberta Politics, Health Care, Seniors' Care with 8 Comments

Coming soon to seniors’ centres in Alberta, a new model of elder care? Below: Health Minister Fred Horne.

See correction below.

On Monday, Alberta Health Minister Fred Horne announced a year-long project to study seniors’ residential centres and figure out the best way to fund and run them.

Sounds good, lots of Albertans must have concluded, before getting on with their business confident the administration of seniors’ care under Premier Alison Redford is in good hands.

But if Mr. Horne and the provincial Health Department are really serious about assessing the financial sustainability of the 400 or so seniors’ facilities, weighing various funding models and exploring what type of services and programs they ought to offer, why is Alberta Health Services plunging ahead and closing publicly run seniors’ centres right and left, pushing the residents into private facilities?

If this were a serious public policy study, wouldn’t decisions that logically flow from the study’s conclusions need to wait until after it has been completed?

Yet since last summer, AHS has announced (as quietly as it can get away with) that it’s closing well-run public seniors’ centres in the communities of Carmangay, Bashaw, Grande Prairie and Stettler. Count on it there will be more to come in the weeks and months ahead.

In each case, elderly and vulnerable residents and their families have been told they have no choice but to move to a private-sector facility being built with government subsidies in the same community, or, in some cases, to be scattered to the four winds in locations right out of the community.

It is very difficult to avoid the conclusion Mr. Horne and the Redford Government have already made up their minds about what to do with the province’s publicly run seniors’ centres. Likewise, it is impossible to avoid the thought Alberta Health Services has already received its marching orders from the government and is getting out of the business of running seniors’ centres altogether.

If so, just for starters, what is the government doing spending even the insignificant sum of $70,800 of our tax money to get the University of Alberta and a couple of seniors’ organizations to “study” what to do next when they’ve already decided on a course of action? Is this the distraction before the sleight-of-hand illusion?

In fact, if you’ve been paying attention, it’s been perfectly clear since the Broda and Mazankowski reports in 2000 and 2002, led respectively by dependable Conservatives Dave Broda and Don Mazankowski, where Alberta’s Progressive Conservative government intends to go with seniors’ care.

And that place is not the excellent public care that Alberta seniors have enjoyed in the past, but mainly into private, for-profit facilities that are intended to move the costs of care from the public to individuals and their families.

In other words, they plan to “unbundle” health care and housing from one another to pass the costs of caring for the province’s most vulnerable citizens to their estates and their families – or, if you wanted to take a particularly cynical view of it, to redirect their modest estates from their families’ bank accounts to the wealthy operators of private, for-profit seniors’ residences.

To the market fundamentalist worldview, this makes sense – although the costs of running a private for-profit health care system for a vulnerable sector of the population are inevitably much higher and the quality of service delivered to residents will surely be worse.

Each of the four closings announced since last summer will result in an immediate decline in the quality of care when the re-designated facilities are no longer required to have a Registered Nurse on the premises at all times.

But at the heart of the Broda-Mazankowski approach is a long list of items and services that in publicly run facilities were covered by the operator but which now will have to be paid by residents and their families: call bells, laundry, furniture, medical supplies and equipment, diabetic supplies and equipment, dressings, personal care supplies, dental care, vision care, glasses, medically required transportation, snacks, and of course, pharmaceuticals. The costs can run to thousands of dollars a year.

In additions, under the new model, many services that were provided on site – physiotherapy, rehabilitation, Registered Nurses, physician visits and recreational activities – are all likely to move to more expensive and inconvenient locations off site.

The costs to taxpayers, it is said here, will not decline as much as the government claims or imagines – but instead of helping citizens, the cash will go into the pockets of wealthy businesspeople.

It’s enough to make one pine for the days when Stephen Duckett, the Australian PhD health economist with a professionally fatal addiction to cookies, ran Alberta Health Services. For all his sins, at least he understood that from both cost and social perspectives, it made better sense to keep seniors’ care in the public health care system.

Undoubtedly, he was told to drop that idea poste haste by his boss, the health minister of the day.

There were also some rather mysterious references in Mr. Horne’s remarks Monday to what “the untapped capacity of senior centres might be across the province” might be.

What do you want to bet that what he has in mind might be as places to locate the Redford Government’s much ballyhooed but likewise vaguely defined “family care centres”?

If this speculation is true, it would provide a plausible excuse to further subsidize the operations of the for-profit landlords, and perhaps also offer a justification for banning strikes by their unionized employees – who, as things stand, can’t legally strike at publicly run seniors’ centres but can walk off the job at the privatized facilities this government is hell-bent on encouraging.

The bottom line – an appropriate enough a metaphor given the circumstances – is that notwithstanding its commitment to public primary health care, this government continues to be dedicated to the wholesale privatization of long-term care for seniors in Alberta.

If that makes you feel uncomfortable, don’t look to the Wildrose Party for help, because they stand for exactly the same thing – plus the privatization of whole swaths of primary care.

If Albertans want to protect the excellent system of seniors’ care enjoyed by previous generations, they are going to have to elect political parties that are genuinely committed to the idea caring for the elderly is part of health care. I don’t think I have to tell you who that would be!

CORRECTION: I am reliably informed (as readers can see in the comments section) that the seniors’ centres referred to by Health Minister Fred Horne that this study will be looking at are community centres, not long-term care centres. This is my error and I own it. However, most of the points made in this piece about the seniors’ care model in Alberta are valid, so, rather than a tortured rewrite or a craven retreat, I’m just going to leave the piece stand with this correction. Alberta Diary, as the saying goes, regrets the error … and so do I. DJC

This post also appears on Rabble.ca.

Inquiry testimony suggests pricey private clinics – nudge-nudge, wink-wink – really can engineer preferential access

by David Climenhaga on January 18, 2013 in Alberta Health Services, Alberta Politics, Health Care with 2 Comments

Wheeling and dealing: Staff of private clinics use advanced clinical techniques to decide which patients go to the front of the line for quick medical tests. Alberta medical insiders may not appear exactly as illustrated. Below: Retired judge John Vertes, Alberta Health Minister Fred Horne.

What appears to be the first confirmed example of methodical and systematic queue jumping uncovered by Alberta’s Health Care Preferential Treatment Inquiry emerged this week and, lo and behold, it involved the operations of a private medical clinic.

This should not surprise us. After all, in a fair and well-run public health care system, what else do these private, for-profit clinics that are cropping up throughout Western Canada have to offer for the thousands of dollars in annual fees they charge patients other than insider connections and the promise of preferential treatment?

Still, the story of how patients – or perhaps we should say customers – of the exclusive Helios Wellness Centre in Calgary got enhanced and accelerated access to colonoscopy tests at a publicly run cancer screening clinic is an intriguing one, and we can only hope the inquiry led by former justice John Vertes will see fit to probe, as it were, a little deeper.

Testimony to the inquiry earlier this week outlined how non-urgent patients referred by Helios to Calgary’s Forzani and MacPhail Colon Cancer Screening Centre were fast-tracked for tests after waits of about three weeks, while other patients had to wait up to three years for non-urgent tests.

A former clerk from the Forzani and MacPhail clinic, run by Alberta Health Services and the University of Calgary Faculty of Medicine out of Calgary’s Foothills Hospital, testified that her bosses ordered her to move patients from Helios – located in the same building – to the head of the public line.

Referrals from Helios were booked as urgent, testified the former clerk, Samantha Mallyon. “It was just common practice with the Helios patients to make sure they were a priority,” Ms. Mallyon explained. Helios paperwork even had its own special tray.

Other clerks offered similar testimony, and told of being discouraged from making a big deal of the way things were run.

In response, a Forzani clinic manager opted for the tried and true managerial defence and accused the staff of going rogue – a suggestion Mr. Vertes seemed to find quite fanciful.

Be that as it may, over the past few years a slew of private clinics have opened in this part of the country, taking healthy amounts of cash up front from what one witness at the hearing termed well-heeled “executive patients” for a range of personal care services plus health care treatments that the clinics can bill back to the public health insurance system.

The additional fees these clinics charge, generally, are for non-medical services such as such as diet advice, fitness coaching, genetic testing, chiropractic treatments, acupuncture, cosmetic procedures or whatever their operators wish to provide – up to and including tarot card readings, presumably.

Naturally, they offer a nicer ambience than the average doctor’s office or walk-in clinic, and some of them, no doubt, even have free Starbucks coffee in real china cups.

A recent advertorial misleadingly published as if it were legitimate news by the Edmonton Journal for the Copeman Clinic, a controversial example of this type of enterprise, tried to take advantage of criticism of its business model by misrepresenting the arguments of critics of two-tier health care as being only about the clinic’s décor and ambience – using that as a setup to brag about the clinic’s décor and ambience.

The true substance of the criticism of this approach is that in return for the steep up-front service fee, clinic doctors are able to use the public health insurance system to subsidize enhanced access for those with the ability to pay extra – which opponents of these clinics argue is a violation of the Canada Health Act.

To be covered by medicare, services covered by public health insurance must be must be billed in exactly the same way as any other physician’s bills, according to the same rules. Those rules certainly include no queue jumping for tests and treatments.

Regardless, the clear implication of the clinics’ pitch to potential customers goes far beyond just quick access to a doctor and a nice chair to sit in while you’re waiting. Never stated explicitly, but as clear between the lines as a nudge and a couple of winks, is the implication they can get you quicker and better access to insured medical services as well.

Now we can all see, thanks to this week’s line-jumping inquiry testimony, that there may in fact be more than a little truth to this.

Naturally, some of the usual suspects – Alberta Health Minister Fred Horne, for example – say that are shocked by this, and offended as well. But the true test of the level of their concern is yet to come – what they’re prepared to do about it.

In the mean time, Mr. Vertes and his inquiry owe the people of Alberta more than just this glimpse behind the usually closed doors where the wheeling and dealing among medical insiders goes on.

We need to know who scratched whose back, and how, to get preferential Helios patients jumped to the head of the line.

From there, we might be able to figure out if it’s happening elsewhere, and what to do about it.

But to get there, inquiry counsel is going to have to smarten up and adopt a less passive and incurious attitude than they have shown up to now.

This post also appears on Rabble.ca.

← Older Entries