Laying it Out: Few wait less but we all pay the price

By Medicine Hat News Opinon on December 14, 2019.

The minister of health was up early last Saturday taking to Twitter to claim my column to be “an artful construction of an altered reality.”

As is becoming more and more clear every day, I absolutely do live in a different reality than Tyler Shandro, though I’ll remind you that mine has inflation, population growth and a pesky little thing called math. I don’t know, maybe his has more ponies, but I’ll let readers decide which exists and which is a continued smokescreen filled with perforated arguments.

Moving on.

Congratulations to the comparatively small number of Albertans who will now be able to jump the queue and pay for minor procedures in what is surely to be only the first of several UCP announcements of moving public services into the private sector. Not only will you be able to get into the operating room in record time, you’ll only have to pay whatever the clinic tacks on after the public coffer pays its share.

As for the majority who won’t be able to choose that route, you get the promise of shorter wait times due to removing certain people from the pool. And on the surface, it might even make sense.

But there’s a problem, and here comes the math.

If there are 100 procedures and four specialists, each must do 25 to get through the queue. If a private clinic opens with one more specialist, the easy math would suggest each has 20 surgeries to complete.

But a couple variables are key for this to work. First, the public sector must continue to use four specialists, while funding a significant percentage of a fifth. Second, the private clinic must do a proportionately equal share of surgeries, meaning 20 of the 100 patients have to be willing to foot the extra bill to get in.

These aren’t impossible scenarios of course, but the first requires more spending (Yes, Mr. Shandro, there is a health-care cut), and the second relies on the right number of Albertans ready and willing to pay.

Saskatchewan started doing this in 2010 and reported good results, touted in a 2016 Leader Post piece for its “stunning” effectiveness. However, the efficiency has dwindled as the number of patients grows (there are a lot of aging Baby Boomers) and the government announced this fall that it will ramp up spending to deal with wait times, which are now creeping back up.

The problem isn’t just a growing number of patients though. The problem is not enough of them are choosing to pay for it, and there aren’t enough doctors for the rest. The patient bottleneck at public facilities has returned and the only solution was to do nothing, or properly fund the system.

Here in Alberta, we already have the growing number of aging patients, we are mired in a downturn while Saskatchewan began its two-tiered experiment when the economy was excelling, and the government is cutting the health-care budget but won’t admit it even as everyone with a calculator tells them otherwise.

The UCP’s one argument for this move being good for the collective is reduced wait times, but like so many of the policy decisions already made, this one has “good for a few, bad for a lot” written all over it. And none of this even gets into the myriad reasons beyond efficiency that privatization is bad for the whole.

When has adding a profit motive made something less expensive? When has a profit-based business ever put the needs of its customers over the needs of its profit?

The need to make money constantly results in companies cutting corners, running short staffed and raising prices just to ensure sufficient dividends for ownership or shareholders.

Why are we even discussing the “benefits” of doing this when referring to Albertans – all Albertans – being or not being healthy?

There was a time not too long ago when Canadians simply knew private health care was bad news, understanding the fundamental right each and every one of us has for being alive and well. We all understood the value in sticking together.

We used to laugh at Americans while they argued over such a simple concept, never noticing that their government actually spends twice as much per-capita on health care than pretty much every other industrialized country, and they die younger.

Now it seems we are slowly being convinced that just going a little private is good for everyone. It’s not.

A two-tiered health-care system creates a two-tiered populace – haves and have-nots – and the more private we add the more divided we become. And the more we erode from public health care, the more private they’ll want to go.

Money has already divided us into categories of who gets stuff, and who doesn’t get stuff. If we let our health become “stuff” we give up control of it. And if we lose control of our health care, are we left in control of anything else?

Scott Schmidt is the layout editor at the Medicine Hat News. Contact him at sschmidt@medicinehatnews.com. All opinions are his own and do not necessarily reflect those of the News’ editorial board.

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