New Health Minister Carries Heavy Baggage

October 12, 2011

Friends of Medicare would like to acknowledge Fred Horne�s appointment as Alberta�s Minister of Health this morning. �While we wish him the best, Mr. Horne carries a lot of baggage from his involvement with private health initiatives,� said David Eggen, Executive Director of Friends of Medicare.

Albertans know Mr. Horne as project manager for the Alberta Health Act, an aggressive attempt to lay the groundwork for more private health care in this province. Public pressure forced the government to back off on some of the more sweeping changes in this legislation, but the sentiment remains to promote more private contracts for public services, particularly in the area of senior�s care.

�Both Mr. Horne and Ms. Redford have stubbornly clung to this notion that more private health contracts would be good for the province�, said Eggen. �Evidence and common sense tells us that private health care costs more and does not deliver better health outcomes.�

�The appointment of Mr. Horne calls into question whether Ms. Redford will break away from this government�s long flirtation with private health care,� says Eggen. �Through his actions in the coming weeks and months, we hope Mr. Horne might be able to convince Albertans otherwise.�

Provincial Government Must Disclose Terms of Chartwell Contract for Seniors Housing

While the Duke and Duchess of Cambridge pay tribute to Canada�s military at a wreath-laying ceremony at the Rotary Challenger Park, 29 seniors, including many war veterans from the Colonel Belcher Seniors residence in Calgary are facing eviction.

At this point, the Alberta Government is still following through with the complex private health deal that allows Chartwell Seniors Housing REIT the option of converting affordable seniors accommodation units into expensive private condos.

According to Chartwell�s corporate mission statement, the publicly traded corporation (TSX � CSH.UN) �is a real estate investment trust focused on generating sustainable, stable and growing cash distributions from owning and managing a complete range of seniors housing communities.�

The Belcher deal is consistent with their goal �to maximize the value of its existing portfolio of seniors housing facilities.�

Friends of Medicare is calling up on the Provincial Government to publicly disclose the terms of the private health contract with Chartwell Housing REIT to determining if this sort of arrangement is an appropriate and efficient use of public dollars.

�Our province is desperately short of affordable seniors� care.� Says Dave Eggen, Executive Director of Friends of Medicare, �We can�t let these sorts of expensive and murky private health contracts slip by without close public scrutiny.�

Put care ahead of pursuit of profit

Recently there have been editorials and comments about the decision of Alberta Hospital Services to give more autonomy to five regions to make decisions closer to where they will impact people.

Generally this has been well accepted with a certain amount of � I told you so� in the debate of central versus local administration of services.

Hopefully it will put a stop to the endless approvals needed in the long chain of command on the way to that elusive goal of getting things done at the ground level.

However, this new level of management being created will answer to Alberta Health Services and not to the communities they make decisions for. Real accountability only comes from elected representatives �- a process our government abandoned years ago.

It is encouraging to have evidence that Alberta Health Services is listening.

However, I would like to bring attention to another serious issue. In the Advocate of May 11th, there is a letter to the residents of Michener Hill Extendicare and their families from the Alberta Union Provincial employees informing them of a possible strike.

A little history will connect the dots on this issue. Most of the staff involved were employees of Alberta Heath Services in the former Red Deer Nursing Home and Valley Park Manor that now sit empty at the will of the government. In order to obtain employment, they gave up their seniority and took a decrease in income to obtain work at Extendicare.

What they are asking for are wages and benefits consistent with what they had with their previous employer. That does not seem unreasonable.

So what is the obstacle? It is a six letter word � PROFIT. Money is being moved from the pockets of those who do the actual work caring for our seniors to those who make an investment in senior care services as a commodity for an expected profit. The bottom line becomes a factor and those who receive and give the care have to live with the consequences.

As a society, we are faced with this question: Is long-term care a social responsibility to be received as it is needed or something to be brought and sold on the open market? Our decisions will effect everyone who hopes to be a senior one day.

Brenda D. Corney

Red Deer

Red Deer Advocate

Unfair long term care rate hikes will be taken to court

Yesterday's Supreme Court ruling to allow James Darwish and the Elder Advocates of Alberta Society's class action suit against the Provincial Government is an important step forward to re-build adequate and affordable long-term care services in Alberta, says Friends of Medicare.

On Thursday, May 11 the Supreme Court of Canada ruled that a class action suit may proceed against the Government of Alberta for their decision to increase long-term care fees by 40% in 2003, thus beginning a process that has blurred the lines between long-term care and other forms of assisted living. This has left our province desperately short of long-term care spaces, and made seniors care and care for persons with disabilities increasingly unaffordable.

"This government has been charging unfairly for these health services for years" says David Eggen Executive Director of Friends of Medicare, "This ruling should serve as a wake up call for Alberta Health and Wellness to start providing the affordable long-term care services that our province so desperately needs."

"This government's long-term care policy has been destructive, and now it's one step closer to being illegal", says Eggen. " It's too bad you have to sue this government to force them to do the right thing."

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Friends of Medicare Supports Full Public Inquiry

Friends of Medicare is encouraged by a proposal by all opposition members of the Alberta Legislature to launch a full public inquiry into the operations of our public health system.

�Albertans are sick of the white wash from this government, and no one wants a witch hunt�, said David Eggen, Executive Director of Friends of Medicare. �A full public inquiry would be just the ticket to restore public confidence in our system.�

A full public inquiry would empower front line workers to share their knowledge to help improve public health delivery. It would also help to shine a light on capacity problems that lie at the root of most of our health system problems.

�We are short of long term care and acute care beds. A public inquiry could cut through the fog and let us fix this problem once and for all�, says Eggen.

Years of cuts and restructuring have left our public health system in a weakened state. Overwhelmingly, Albertans want their public health system improved and expanded, and a full public inquiry is an excellent first step towards achieving that goal.

Federal Support for Healthcare and National Pharmacare

Ms. Linda Duncan (Edmonton�Strathcona, NDP):

Mr. Speaker, Canada's universal public health care system is lauded worldwide. Sadly, universality of care is increasingly at risk, in part due to rising costs, including prescription drugs.

Worst affected are Canadians who are reliant on costly medicines, but can least afford them, seniors and others with low or fixed incomes. In Edmonton, almost 60% of those with low incomes are struggling to pay for necessary medicines.

Universal pharmacare would ensure more equitable access by all Canadians to affordable medicines and quality of life. The federal negotiating position for the next Canada health transfer agreement must include universal pharmacare.

Tommy Douglas, the father of medicare, did not intend to limit it to hospitals and doctors. Coverage of drugs and other services was to follow. Despite repeated proposals and pledges, Canada remains one of the few industrialized countries without a national drug plan.

I challenge every MP to stand with me and the friends of medicare and demand universal coverage for their constituents.

Stand up for Better Healthcare Tour Announced

Stand up for Better Healthcare

January 12, 2011

Friends of Medicare is pleased to announce a series of town hall meetings across the province featuring Edmonton Meadowlark MLA Dr. Raj Sherman as special guest speaker.

Events in Calgary, Red Deer, Lethbridge, Medicine Hat and Grand Prairie will be included in this tour.

�Friends of Medicare chapters look forward to hosting Dr. Sherman to encourage a frank, non-partisan discussion about health care in Alberta,� says David Eggen, Executive Director of Friends of Medicare. �Dr. Sherman has many insights to share, and is looking forward to hearing from Albertans about their concerns.�

These meetings are open to the public, and will include plenty of opportunity to ask questions and offer comments.

Dr. Sherman will be hosting his own town hall meetings in his Edmonton constituency and elsewhere. Venues will be confirmed in the next couple days.

Calgary January 29th 1:30 p.m.
Red Deer February 8th 7:00 p.m.
Lethbridge February 19th 2:00 p.m.
Medicine Hat February 19th 7:00 p.m.
Grand Prairie February 26th 7:00 p.m.

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David Eggen

Executive Director

Friends of Medicare

Stelmach backs off on goal of balanced budget

EDMONTON � Albertans can expect a tough budget next year as a struggling global economy threatens to keep the province in a deficit position longer than expected, Premier Ed Stelmach warned Monday. Despite repeated promises to return Alberta to balanced books by 2012-13, the premier backed away from that pledge in a year-end interview with The Journal. He said external economic factors are sapping the province�s revenue streams, making it difficult for his government to quickly erase the red ink. �We will definitely show a trend toward balancing (by 2012-13). Will it be absolutely balanced? If there is no recovery on the revenue side, we will be very close to balancing,� he said. �Even though employment is up, we�ve been hit hard by very low natural gas prices, a substantial increase in value of the Canadian dollar, and a struggling U.S. economy. And now you can add the fact that Europe is going through some difficulty.� In addition, the federal government may decide to cut funding to the provinces as a way of stemming its own fiscal shortfall, Stelmach said. Alberta is currently in the middle of three years of planned deficits. After going $1 billion into the red last year, the province is on track in 2010-11 for a $5-billion deficit � a figure that could have been much higher were it not for Alberta posting a record year in land sales to energy companies. The shortfalls are being covered by the province�s sustainability fund. The 2011-12 year was supposed to be the last for deficit spending, but since there is now a strong chance of the trend continuing, the government is under more pressure to keep expenditures in check, Stelmach said. He said there are signs of life in the energy sector with companies replenishing supplies of pipe and drilling equipment, but the government may not see the benefits of that for a year or two. �All indicators show that the revenue stream will recover in 2012-13 but it�s difficult to predict to what level,� the premier said. �What I can control is spending. We will continue to provide the supports for the most vulnerable, but it will be a tight budget.� He said the government has done a good job of balancing its operational budget, but is having trouble keeping up with the demand for new capital projects. He said he hopes to continue building transportation upgrades, new schools and health facilities since construction prices are good and such projects keep people working. �As one who saw (in the 1990s) all the demonstrations and hollering and the difficulty we had paying off the debt, I can tell you we�re not going back there,� Stelmach said. He said putting Albertans back to work is his top priority in 2011, a job that would be made easier with the development of new pipelines that can help carry Alberta�s resources to new markets in Asia. Besides the economy, Stelmach said he is also focused on getting his party ready for the next election. A recent poll showed the Conservatives and Wildrose Alliance with nearly equal support among decided voters. The Tories held a slim lead of 34 per cent to 32 per cent, despite a difficult fall session in which the government was hammered over health-care system issues. Stelmach shrugged off questions about the Wildrose threat, saying he has been working to implement policies that find an appropriate balance between the right and left sides of the political spectrum. He said a cabinet shuffle might occur in 2011 after he talks with caucus members about their plans to run for re-election. Some senior MLAs who decide to retire could be moved out of cabinet to give others a chance to prove themselves. �We will have nice quiet chats and talk about everyone�s future. There may be some who may be retiring, and if they do, then obviously we will have to make some changes.� The next election is expected in March 2012. Despite comments from opposition leaders that he may go to the polls earlier, Stelmach said he has no plans to change the date unless a major issue arises, such as the federal government attempting to interfere in the ownership or development of Alberta�s resources. Read more: http://www.edmontonjournal.com/business/Stelmach+backs+goal+balanced+budget/4005211/story.html#ixzz18m0Ae8NmTEST

Stephen Duckett - What Goes Around Comes Around

What Goes Around Comes Around

November 24, 2010

Stephen Duckett's dismissal as CEO of Alberta Health Services comes as no surprise, says Friends of Medicare, but the finger of blame for his downfall points to both the Tory government as well as to Mr. Duckett himself.

"Mr. Duckett took his direction from the Health Minister and the Premier", says David Eggen. "We must not let Mr. Duckett's dismissal deflect the blame from those who are actually responsible for the systemic problems in health care."

This is not to excuse Mr. Duckett for his inappropriate behaviour and actions, but neither should the public nor Mr. Duckett be surprised by what has happened.

"It's like the proverb about he who lives by the sword", says David Eggen, Executive Director of Friends of Medicare. "Stephen Duckett was hired by the Tories to slash and burn the existing health structure in this province, and he was hired to be the fall-guy when inevitably went wrong."

This crisis of leadership is the last thing we need when we have so many practical problems to deal with in our health system. Leadership needs to provide solutions, but it also needs to instill confidence that the health system will be there when we need it. Right now we are getting neither leadership nor clear answers from the provincial government.

"Mr. Duckett has been the wrong person to lead right from the beginning. The next step is make a sincere re-investment in public health care at all levels. This is what Albertans want, and desperately need right now."

Sherman bravely speaks up and gets kick out, Duckett makes a mockery of us all and stays in !

Why is it that Raj Sherman is suspended from caucus for speaking out for Albertans, while Stephen Duckett runs free? For Dr. Sherman, it was a little late, but once he got going it was clear he was speaking out with sincerity and genuine concern.

Mr. Duckett�s actions speak volumes about how insincere and disrespectful he is to the public. The �cookie incident� is just the latest in a long series of poor policy decisions and secretive actions that have damaged the proper functioning of our health system.

We recognize that Mr. Duckett has been hired to do the dirty work of this government, absorb the anger and frustration, and leave in a great flurry of smoke, accusation and severance money. At the very least then, lets trigger this plan for Mr. Duckett to leave now, so that the Conservatives don�t get a free ride all the way to next election. As for Dr. Sherman, lets support him now that he is out of the Tory caucus, perhaps he can provide us with information about what on earth we have been forced to endure over these past two years.

Albertans are owed an explanation so that this sort of assault on our health system is not allowed to happen again.

Albertans deserve a second opinion on The Health Resource Centre's empty boasts

After racking up millions of dollars in debt and leaving Albertans stuck with the bill, Networc Health, the parent company of the private surgical facility Health Resource Centre, is hardly in a position to boast as their medical director Stephen Miller was trying to do on Tuesday. Consider the facts:

According to the report of the interim receiver, in addition to the $765 000 in receiver costs, $1.3 million in secured debt, all facility costs through January 2011 including 906 000 in monthly rent, Networc health has unsecured debt of $8.4 million.
In the second report of the interim receiver (PriceWaterHouse Cooper) the salaries of the HRC senior management team are made public. The interim receiver "requested that the senior management team propose revisions to management compensation and, other than an offer from one of the management team to eliminate his car allowance, no proposal has been received...AHS has expressed to the IR its view that management compensation is excessive and should be curtailed...The IR recommends that the senior management be encouraged to revise its compensation."
The interim receiver projects that Networc health will incur $1.4 million in legal costs over the next 6 months.

David Eggen, Executive Director of Friends of Medicare, says this is an excellent reminder that private contracts for public services are more expensive, less efficient, and certainly less transparent than the public equivalent. "Let's not forget this private facility would be shut down and not delivering any medical services if Alberta Health Services wasn't forced to bail them out. The government should cut these investor driven private health schemes loose from the public purse before we wind up losing more money and compromising the security of our health system even further."

Albertans deserve a second opinion on The Health Resource Centre's empty boasts

According to the report of the interim receiver, in addition to the $765 000 in receiver costs, $1.3 million in secured debt, all facility costs through January 2011 including 906 000 in monthly rent, Networc health has unsecured debt of $8.4 million.
In the second report of the interim receiver (PriceWaterHouse Cooper) the salaries of the HRC senior management team are made public. The interim receiver "requested that the senior management team propose revisions to management compensation and, other than an offer from one of the management team to eliminate his car allowance, no proposal has been received...AHS has expressed to the IR its view that management compensation is excessive and should be curtailed...The IR recommends that the senior management be encouraged to revise its compensation."
The interim receiver projects that Networc health will incur $1.4 million in legal costs over the next 6 months.

Proposed changes to Alberta health Act need reassessment

Proposed changes to Alberta Health Act require reassessment

Bankruptcy of for-profit Calgary clinic portends worse, more costly system

By Diana Gibson, Freelance June 3, 2010

In the same month as the Alberta Government launched consultations on a new Alberta Health Act, one of its prodigal private surgery centres, the Health Resources Centre in Calgary, declared bankruptcy. Before consultations have even begun, the Alberta Health Act initiative has been seriously undermined because the Act is all about that style of private for-profit delivery.

The only documents to emerge on the new Act to date are "A Foundation for Alberta's Health System" and the online survey. These documents are drowning in warm sounding rhetoric about patients, families, quality and access. However, hidden within are chilling terms like flexibility of delivery and personal responsibility. Flexibility of delivery is often code for increasing for-profit health care, and individual responsibility means moving away from universality and public responsibility and in some cases penalizing individuals for unhealthy behaviours.

Of greater concern is the behind-the-scenes agenda for the Health Act. That agenda is clear in the submission from Alberta Health Services CEO, Steven Duckett, which states the goal as, "Recognize the role of private and non-governmental organizations in service delivery within the Canada health framework."

Even more telling is the submission from the Calgary Chamber of Commerce, which has been advocating for a long time for this form of legislative change. Specifically it asks for the repeal of the Health Care Protection Act and stripping Alberta Health and Wellness of its role in regulating private surgeries and clinics.

Their submission also advocates for increased direct competition between private for-profit providers and public providers while at the same time allowing private providers to benefit from any economies of scale and other advantages of the public sector through a "levelling of the playing field and co-operation in the distribution of resources."

The HRC bankruptcy reveals the folly of that approach. Albertans and Canadians should be alarmed and should watch the health act initiative closely.

Certainly there are serious challenges to be dealt with on the delivery side of health care. Hospital stays are becoming much shorter, and community or day-surgery alternatives have been growing. That sector is fragmented and mostly outside of the public health system and protections of the Canada Health Act.

Services such as rehabilitation services that were previously offered in hospitals are being offered in communities and homes. Long-term care is being downgraded to assisted living, and the sector is becoming increasingly dominated by for-profit providers.

On the flip side, the province has under-funded hospitals for many years, causing shortages of beds, nurses and physicians and has not adequately funded quality public services for seniors needing long-term care.

The growth of the for-profit involvement in those service areas has come at a cost, Albertans now have the highest out-of-pocket spending on health care in the country.

Not only has this path been costly, but it means lower quality. A number of academic studies have shown that care in for-profit institutions is often lower in quality than in not-for-profit institutions.

Findings include higher death rates in private hospitals and dialysis clinics, more quality deficiencies and less nursing care in nursing homes and less care for the dying in for-profit hospices.

The Alberta government pays a lot of lip service to best evidence. Best evidence shows for-profit providers deliver poorer results at higher cost. It is time to learn from our mistakes and stem the tide. To this end, the Alberta Health Act initiative should not proceed as planned.

Certainly, there are challenges in health care, not only the fragmented delivery system that is increasingly for-profit but also the lack of attention to prevention and the social determinants of health such as poverty and inequality.

The act will not address these problems; the barriers to reform are political not legislative. Without the political will to account for the health impacts of social policies, without the political will to fund adequate public health services, and without the political will to limit the profits of pharmaceutical companies, pharmacies, doctors and private insurers, legislative changes will not significantly improve health care outcomes or sustainability in Alberta.

The public health system is now paying to bail out the HRC and surgeries are at risk.

Alberta can afford better and should invest in making the HRC back into a non-profit hospital and bring it under the public umbrella. Beyond that, the health-act plans should be shelved and the government should get down to the business of delivering health care that is public, universal and affordable.

There is room for a new health act, but it needs to be one that limits for-profit involvement in health care and strengthens the public system which delivers the most cost effective, most accessible and best quality health care.

Diana Gibson is the research director at the Parkland Institute. This opinion piece is based on a new series of reports by the Institute on the proposed Alberta Health Act.
© Copyright (c) The Edmonton Journal

Public health care is sustainable as we want it to be

Toronto Star

June 1, 2010

Medicare as sustainable as we want it to be

By Robert G. Evans

�There are stark and unpalatable choices that we face with respect to health care, but there is no magic solution. We absolutely must have an adult debate about how we deal with this.� That�s what David Dodge, former governor of the Bank of Canada and former deputy finance minister, told the Liberal policy conference last March.

Dodge joined a list of economists and other pundits who predict that public health care will be financially unsustainable in coming years as Canada faces an aging population and escalating costs for scientific advances in care and treatment. But an �adult debate� on the sustainability of public health care must start from who and what drives health care spending.

It�s true that total health care spending in Canada has risen in recent years, taking larger shares of both government revenues and budget allocations. This has led to accusations of �crowding out� other public programs by those favouring further privatization of health care.

The data tell a much more nuanced story. The central fact is that, recession years apart, Medicare spending - hospitals and physicians� services - has fluctuated between 4% and 5% of Gross Domestic Product since 1975. After the introduction of Medicare in the late 1960s these costs stabilized because universal, comprehensive coverage consolidated expenditures in the hands of a single payer. The cost of health services not covered by Medicare has risen from 3% of GDP in 1975 to 7% in 2009.

Today, Canada�s expenditures on health care match those by other OECD countries. The public share of overall health costs in Canada is relatively low for high-income OECD countries, around 70%. Private insurance, primarily for prescription drugs and dentistry, now accounts for 12.7% of Canadian health spending, 14th highest in the world. The OECD outlier is the United States where extensive private finance supports uncontrollable cost escalation (now over 16% of GDP. Getting these costs under control will be the major task facing Obama�s health care reform.

Provincial governments� spending on health care over the past 15 years has taken increasingly larger bites out of their expenditure budgets. But this is a simple consequence of large cuts in non-health programs, not of out- of-control Medicare spending. These cuts in non-health spending are traceable to substantial cuts in personal and corporate income taxes by the federal and most provincial governments, particularly since 1997. Between 1997 and 2004, these tax cuts removed an estimated $170.8 billion from public sector revenues . Total provincial revenues are by now roughly $35 billion per year less, or about half provincial spending on Medicare. Cumulative federal cuts are at least as large.

The provinces� revenue shortfalls were not all self-inflicted. The federal government�s large cuts in financial transfers since the mid-1990s also left big holes in provincial budgets. Subsequent increases have not fully made up the loss.

What are the real motives behind the claims of financial unsustainability? Two, I think. First, under Canada�s universal tax-financed Medicare, higher-income people contribute proportionately more to supporting the health care system, without receiving preferred access or a higher standard of care. Any shift to more private financing would reduce the relative burden on those with higher incomes and offer (real or perceived) better or more timely care for those willing and able to pay.

Second, every dollar of health care expenditures is also a dollar of someone�s income. The Ontario government�s recent change in reimbursement for generic drugs made this clear, the shares of Shoppers� Drug Mart fell 10% overnight. Privatization is a way to avoid cost containment, re-opening greater income opportunities for providers of care (and private insurers) outside public control. Expenditures would accordingly rise, as in the United States, but public budgets might (in the short term) be contained. �Unsustainable� public spending magically becomes sustainable when shifted from taxpayers to patients.

It is time, long past time, for an �adult conversation� about these motivations, and for a clear identification of the winners and losers from eroding or dismantling Medicare.

But it is also time for an adult conversation about the real drivers of cost escalation. Researchers have known for decades that population aging is a real but a minor factor. Its impact will certainly increase, but it will remain secondary to increases in intensity and costliness of care. This is the real issue. Where is the money going, both public and private, and are we getting value? Again the Ontario generic drug initiative makes the point. Rising expenditures are not a Law of Nature; several hundred millions will be cut at a stroke. The real issue is political; those millions are also cut from pharmacy� incomes.

Are there other opportunities? Yes. Medical imaging and laboratory testing are currently the major sources of cost escalation. What are the benefits? No one knows. Ultrasound for low-risk pregnancies is up 50% in ten years. Why? Patterns of medical practice and hospital use vary widely across the country, for no apparent reason. Toronto�s Institute for Clinical evaluative Science, among others, has tracked some of these large unexplained variations, but they are largely ignored. These are what we need to discuss, not �stark choices� about relieving the burdens on and improving the benefits for high-income taxpayers -- and, incidentally, opening new markets for private insurers. Panic-mongering about a �grey tsunami� is simply a distraction.

Canadians consistently show that they support public health care. In May, a national poll by Nanos Research confirmed that 90% of Canadians feel that health care is the most important national issue, and almost 90% support public solutions to problems in the health care system. They are right. Canada�s health care system is as sustainable as we want it to be.

Robert G. Evans is a University Killam Professor in the Department of Economics at the University of British Columbia and a member of that university�s Centre for Health Services and Policy Research. He is an officer of the Order of Canada, and a fellow of the Royal Society of Canada and the Canadian Academy of Health Sciences.

Great new website on Seniors Care in Lethbridge

Click Here!

Parkland Releases Reports on Healthcare Costs

Parkland Report

FRIENDS LAUNCH NEW CAMPAIGN: READ LATEST PRESS RELEASE

Albertans Look for a Better Way

In response to overwhelming popular input from Albertans, Friends of Medicare is launching an aggressive campaign to urge the government to cease and desist from further dismantling our public health structure in this province.

The overwhelming evidence from polling, letters and petitions is that Albertans want their public health care system improved, not dismantled. However, government actions in the past 12 months have consistently served to undermine the effectiveness and proper functioning of the public health system:

Downloading the costs of health care onto seniors and families

Cancellation and postponement of surgeries

Broken promises on building and maintaining urgently required health facilities

Proliferation of private health facilities

Massive operating deficits

Hiring and budget freeze

Delisting of medically necessary services

Confused and dangerous declarations such as "there is no more nursing shortage" and "public health care is no longer sustainable"

"Most Albertans now see the government is choosing the wrong way down a dangerous and destructive path," says David Eggen, Executive Director of Friends of Medicare. "More health cuts inflict real damage to the health and security of the population. Certainly, there has to be a better way." Friends of Medicare's province-wide campaign will seek to galvanize public opinion with mediums such as billboards, publications, internet, social networking and other advertising, along with specific actions to apply pressure on government members.

"We have invested time and energy to build strong community action teams which have been building capacity and applying pressure in all corners of the province," says Eggen. "It has been the work of these action teams where we have seen a lot of activity and even some degree of success." Eggen points to the government retreating from their first senior's pharmaceutical strategy in the face of overwhelming popular outcry, although Plan B is not much better and the pressure is still on to build a universal pharmacare plan.

Success of this campaign will be measured not just by how the government turns back from their dangerous and destructive "wrong way", but by the degree to which they start to choose a "better way". "There are so many examples of best practises from around the world that we could employ," says Eggen. "Albertans can judge the government's sincerity and commitment to true health care reform if they are willing to entertain ideas that actually strengthen and expand our public health system."

The Friends of Medicare campaign is designed to act as a beacon to the many thousands of people who have been experiencing anxiety and concern over the government's cuts to public health. "It gives Albertans hope to know we won't just roll over and let the government pull our public health system out from under us," says Eggen. "Mr. Stelmach would be wise not to underestimate how much Albertans understand the value of their public health system, and how hard they are willing to fight for it."

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Chiropractic cut from coverage

http://www.edmontonjournal.com/Health/Chiropractic+from+coverage/1476082/story.html

Chiropractic cut from coverage

Sex-change surgery also delisted to put a combined $42 million toward seniors' home care, Liepert says

BY JODIE SINNEMA, THE EDMONTON JOURNALAPRIL 8, 2009

Albertans will no longer be able to claim chiropractic care starting this summer, after the government delisted chiropractor services from its provincial health plan.

The cut, which will save approximately $53 million, will mean patients will be out up to $200 each year.

The province also cut coverage for gender reassignment surgery or sex-change operations, a move that will save $700,000, leaving about 20 patients each year on the hook for procedures that cost anywhere between $18,000 and $70,000.

"We want to ensure that we look after the most vulnerable in society and at the same time we have the cost pressures of what we can afford and what we can't afford, and so some tough decisions have to be made," Health Minister Ron Liepert said.

He said he had to find $42 million to boost home-care for seniors, and the cuts to chiropractic care and for sex changes was the solution. "This is not about whether the service is a required service or a desired service. This is about making tough choices in the budget. We can't cover everything."

Chiropractors knew the cut was being discussed, but have no plans to lobby the government to change its decision.

"We're a little disappointed, obviously," said Dr. Clark Mills, president of the Alberta College and Association of Chiropractors. "We're confident Albertans value chiropractic and its benefits."

"I think it is now in the hands of Albertans," Mills said. "If it is something they wanted embedded in health care, they will have to make that case."

Mills said delisting chiropractic service seems to be the trend in Canada, with both B.C. and Ontario making similar decisions in the past. Those provinces saw an initial drop in patients turning to chiropractors, but that turned around quickly. Quebec and the Atlantic provinces offer no coverage.

Mills said he suspects seniors and people with low incomes might cancel appointments. He imagines they might return for care once third-party insurance companies offer more coverage.

NDP Leader Brian Mason said the chiropractic cut may end up costing government more in the long run.

"I think very often that kind of care keeps people out of the health-care system and saves money," Mason said. "I think that's unfortunate."

Alberta Health and Wellness is also pinching money for capital projects, spending $386 million less than last year to upgrade hospitals and continue construction already started. That will force Alberta Health Services to spend $1.5 billion it has sitting in capital reserves, already tied to specific projects.

Even so, the new health superboard is deferring several projects for at least three years, including one to expand the pediatric emergency room at the Stollery Children's Hospital and a long-term care facility in Fort McMurray.

Several other large projects, including the much-anticipated $250-million hospital in Grande Prairie and an $88-million health centre in Sherwood Park, are being reviewed to see if they need to be trimmed back. There is no time frame on when those decisions will be made, but Liepert said he has committed to meeting with MLAs and representatives from the affected communities in the next 30 days to discuss how to proceed.

David Eggen, executive director for Friends of Medicare, said he has a hard time believing that hospitals in Grande Prairie and Medicine Hat will go forward when previous promises never came through. Funding was first promised for the Grande Prairie hospital in the 2007 budget, but the community is still waiting for the money.

"Eventually, you're going to be reducing your quality of health in those centres," Eggen said. "This is a good time to build infrastructure."

No new projects are being funded, leaving the Cross Cancer Institute and the Tom Baker Cancer Centre in Calgary with thousands of new cancer patients each year and a hiring freeze on oncologists.

"That's a serious omission because cancer patients are struggling today on many fronts," Swann said. "It has to be a priority. That's a sine qua non (an essential element) of a good health system that we can care for the most ill, the mothers and babies at one end and cancer patients on the other end. We have to be able to fund those things."

Overall, health maintained its top spot for government spending despite some belt-tightening, taking 42 per cent of the entire budget. Health's operating budget sits at $12.6 billion, an increase of 4.6 per cent from last year. Alberta Health Services will receive $7.7 billion for operations, although the government still doesn't know how deep in deficit the health superboard sits.

Previous estimates put the operating deficit at $700 million.

"Today's announcement underscores the fact that we can't afford to pretend it's going to be business as usual," said Stephen Duckett in a news release, the new president and CEO of the health board.

jsinnema@thejournal.canwest.com

HEALTH HIGHLIGHTS

- The government is increasing funding for physician services by 13.8 per cent or $365 million, triple the increase in last year's budget. Most of this is spent on physician compensation after the newest contract gave doctors a 15-per-cent fee increase over three years.

- People will be paying more for liquor, including an extra $1.30 for a dozen cans or bottle of beer, at least 75 cents for a bottle of wine and $2.85 for a bottle of hard liquor.

Finance Minister Iris Evans said there have been no liquor mark-ups in six or seven years.

"Sin taxes are always the toughest things to take to caucus," Evans said.

- Tobacco taxes are also going up an extra $3 per carton to $40. The tax on loose tobacco is also going up by 11.5 cents to 30 cents per gram.

"It puts us on the higher end of taxation for tobacco," Evans said. "I think it fits with our tobacco strategy and a recognition we had made no change on that over the last couple of years."

New Website!

Friends of Medicare is pleased to announce its new website! We are in the process of adding information and smoothing out any bumps, we are improving as we go! We are fixing anything that is out of place or missing! If you have any questions about content, on the site or not, please don't hesitate to contact us!

Public Responds to - "Liepert's strategic attack on Alberta seniors"

After reading this article in today's Edmonton Journal, I sent an email to Premier Stelmach asking him to respond to the charges levied against these changes. I'll copy my email below.

I also sent a letter to the Editor of the Journal showing support for this article. I hope all of you will take the time to do something similar. (Click on the link below to go directly to the editor of the Journal.)

Butch

Ed Stelmach
Premier of Alberta

cc Ron Liepert, Minister Health & Wellness
cc Fred Horne, MLA, Edmonton/Rutherford
cc David Swann, Liberal Leader
cc Brian Mason, NDP Leader

Dear Mr. Stelmach:

This will acknowledge receipt of your letter replying to my earlier emails concerning the proposed revisions to Health Care policy in Alberta as presently proposed by Minister Liepert.

The reply to my various questions does not seem to address many of the issues I raised and I would like to direct your attention to a letter by Noel Somerville, Chairman of the Seniors Task Force of the advocacy group Public Interest Alberta. which appeared in today's Edmonton Journal. I do not know Mr. Somerville, nor do I belong to this group of people, so please don't think that this letter is in anyway connected with that group.

However, I certainly agree with the points he has made in his well-written letter and I request a direct response from you on the comments he has made.

Again, I must point out that I feel that Mr. Liepert, being the Minister responsible for this disastrous course of action, is biased in his approach and therefore not suitable to reply to any of the comments raised unless it was to say he is scrapping the entire strategy and will start again.

W. C. Whiteman
2419 - 113th St.
Edmonton, Alta.
T6J 4Y7

letters@thejournal.canwest.com
http://www.edmontonjournal.com/opinion/editorial-cartoons/Liepert+strategic+attack+Alberta+seniors/1417297/story.html

Liepert's strategic attack on Alberta seniors
New health initiatives pave way for a Third Wave end run

By Noel Somerville, Freelance

March 23, 2009

Masquerading as a form of tax on the wealthy, Health Minister Ron Liepert's Pharmaceutical Strategy is actually a form of tax on the sick. Masquerading as "choice," his Continuing Care Strategy is really cutting seniors out of medicare when they are frail and sick.
What is the Pharmaceutical Strategy?
The Pharmaceutical Strategy was presented as a plan to give free prescription drugs to poor seniors by reducing the benefit to those who can afford it. But it is really a form of tax on middle-income seniors who are sick or chronically ill, and therefore in high need of prescription drugs. Most seniors are relatively healthy and don't spend anything like five per cent of their income on medications. The only ones who do are those suffering from chronic health conditions. When did it become acceptable public policy to put the heaviest burden on the sickest and frailest members of society?
A second major problem with the pharmaceutical strategy is that, for seniors only, supplementary health care coverage is indexed to income. Most Albertans carry supplementary healthcare insurance and pay a fixed rate for fixed coverage with a fixed deductible. Under the pharmaceutical strategy, what seniors will pay for the drugs they require will be a function of their income. I wonder how MLAs and most public-sector employees, whose premiums are covered, at least in part, from the public purse, would react if their supplementary health insurance kicked in only after they had spent five per cent of the first $150,000 of their remuneration on prescription drugs?
A third major problem is that income disparity is already adjusted through the taxation system. It is a form of double jeopardy to address income differentials again through the health-care system. Several years ago, Alberta adopted a maximum 10-per-cent flat-tax system: Regardless of our income, we would not be taxed more than 10 per cent of our taxable income.
A HIDDEN TAX
Now, however, it seems Minister Liepert thinks it is acceptable to require seniors to also lay out up to five per cent of their gross income as a deductible on their prescription-drug coverage. Even though that money isn't paid to the government, it is a form of tax because it is paid to reduce government expenditures.
A fourth major issue for many seniors is the invasion of privacy implicit in a scheme requiring confidential financial information to be made available to pharmacists, so they know when the deductible has been reached, and to insurance companies, so they know the magnitude of the risk they are assuming. The program will be a nightmare to administer for the government, for the insurance industry and for pharmacists.
There are many other flaws in Mr. Liepert's pharmaceutical strategy:
- It has blindsided seniors who carefully planned for their retirement on the assumption that the long-standing, universal Blue Cross for Seniors plan would be available to them.
- It comes at a time when many seniors have seen the book value of their retirement nest egg shrink by 40 per cent or more.
- It makes mockery of the principle of universality and is so unfair that it is difficult to rationalize as anything other than blatant ageism.
British Columbia has tried a form of income-based deductibles for prescription drugs and, while it was successful in reducing government expenditures on medications, it has not reduced health-care expenditures. Medications are a form of preventive medicine, and when financial barriers prevent people from getting the medications they require, more of them end up in hospital.
None of these shortcomings of the pharmaceutical strategy will be addressed by simply adjusting the income thresholds upwards, as recently suggested by the Minister of Health and Wellness.
CONTINUING CARE STRATEGY
Like the pharmaceutical policy, the Continuing Care Strategy also puts the heaviest burden on seniors who are the sickest and frailest -- those who have been medically assessed as requiring long-term (nursing home) care. They are adversely affected in two ways.
First, they are affected by the strategy's declaration that the number of long-term care beds will be frozen at the current level of 14,500 for several years. Not only does this fly in the face of Premier Stelmach's undertaking during the last provincial election to provide 600 new long-term care (LTC) beds, it makes no sense in light of the fact that Alberta currently has about 1,500 seniors medically assessed as urgently requiring LTC placement. About half of those 1,500 are actually waiting in acute-care hospital beds that Minister Liepert, himself, concedes cost thousands of dollars a day compared to hundreds of dollars a day in a continuing care facility.
As Dr. Felix Soibelman, president of the Edmonton Emergency Physicians' Association, has recently pointed out, the lack of progress in reducing emergency room wait times is due, in part, to the number of seniors who are either on hard foam stretchers in the emergency department or in acute-care hospital beds because they are awaiting placement in long-term care homes.
A second major blow for frail seniors is the strategy's revelation that the government no longer intends to regulate the accommodation charges in LTC facilities in order to open the LTC market to private, for-profit operators. The accommodation charges in LTC facilities are currently the only rates set by government anywhere in the continuing care system.
When seniors are assessed as requiring LTC placement, it means that they have extremely high nursing and personal care needs. Typically, they need help getting out of bed, toileting, bathing, dressing, getting to the dining room and eating when there. They require that care just as urgently as the victim of cardiac arrest may require bypass surgery. Accordingly, it is unconscionable that such individuals should be turned over to the tender mercies of the free market and charged market rates not only for the accommodation but also for the care that they require.
All of this calls into question Premier Stelmach's statement when he took office that "the Third Way is DOA." A key element of the Third Way is the delisting of previously covered services and it looks like Minister Liepert intends to delist much of the continuing care system for all but the most impoverished of Alberta seniors. Frail seniors are in no position to fight government and it is up to the rest of us to protect them.

Noel Somerville is the chairman of the seniors task force of the advocacy group Public Interest Alberta

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Public Responds to - "Liepert's strategic attack on Alberta seniors"