Alberta is bracing for the impact of COVID-19. Is our health care system ready for the challenge?

By Alyssa Pretty, Communications Officer at Friends of Medicare. March 18, 2020.

For decades, Canada has benefited from a single-payer medicare system, which is there for us based on need, not ability to pay. While there is certainly room for improvement – the inclusion of dental, optometry, and pharmacare to the medicare umbrella, for a start – people across the country can rest easy knowing that they can rely on our health care system to care for them when they need it, without worrying about how they are going to pay. However, in the face of a global pandemic, the quality and preparedness of our health care system becomes even more crucial. Globally, we are staring down an outbreak of yet unclear proportions. As COVID-19 wreaks havoc on China, Italy, and Iran, we here in Alberta are bracing for impact. Is our health care system ready for the challenge?

As of now, the best advice given to address COVID-19 is simple: maintain proper hygiene, avoid crowds, work from home whenever possible, self-isolate if you are at high risk or showing symptoms. But containing the illness relies not only on individuals’ actions, but on the preparedness of our health system to both administer tests, and to treat the ill. In the case of Italy, their system has proved wildly underprepared, and doctors are having to make impossible decisions about how to limit access to intensive care.

Alberta, like much of Canada, has suffered from decades of health care cuts and the misallocation of resources from consecutive governments, and has experienced a subsequent steady degradation of our health care infrastructure. Year after year we have seen austerity budgets, and endured government policy that systematically devalues the public sector and the social services it provides. Our province is just a year into a new government’s term, and already we are seeing drastic changes to the shape and structure of our public health care. Surgeries and seniors care are being rapidly privatized; the government unilaterally tore up it’s long standing master agreement with Alberta’s doctors; we are seeing closures of public programs left and right; and we’re anticipating the loss of more than 5,000 front-line health care positions across the province.

More so than just health care, cuts are being made across the public sector, which will undoubtedly have a ripple effect throughout Albertans’ ability to stay healthy. When custodial and support staff are cut from schools, parents can no longer be confident that their children’s classrooms are clean and safe. When unemployment is up, income support is cut, and people don't have access to paid sick leave, they don't have the financial security to self-isolate for 14 days, as is recommended. When affordable housing and social services are cut, people are forced to live more precariously, making them more vulnerable to health issues, and limiting their access to health care. These cuts have real impacts on Albertans, which later show up as downstream costs and pressures on our public health care system.

The government continues to push for “efficiency” in our health care system and other public services, striving for optimal operating capacity and a balanced budget. While on paper this may seem very sensible and appealing to our politicians and decision-makers, unfortunately the health needs of a population are not as static as they look on a budget line. Whether it be a foreseeable shift in demographic health needs, like in the case of Alberta’s steadily aging population, or an unexpected outbreak of a virus, like COVID-19, our health system needs to be able to provide quality, timely care to everyone who needs it. And the only way to get there – to an effective system rather than just an efficient one – is to listen to the people who know best: our health professionals and front-line health care workers. Instead, amidst this pandemic, the government has blatantly ignored calls from Alberta's doctors to change billing codes to support their ability to provide telehealth services, and just this week we learned that they would be cancelling the contracts of Alberta's radiologists.

Decisions unilaterally imposed on Alberta’s health care system by our government (or those feebly justified by government-appointed reviews with narrow mandates and biased panels), have culminated in a health system that is already overwhelmed and underserviced, especially in areas like long-term care, diagnostic services, rural care, and emergency care. And should COVID-19 have as great an effect on Alberta as it has had elsewhere, there will not be enough care capacity to go around when we need it most.

Over the weekend, Premier Jason Kenney announced that he would be allocating an $500 million to Alberta's health care budget to address the COVID-19 pandemic. This additional funding still leaves Alberta $200 million short of the minimum $700 million necessary just to meet inflation and population growth in 2020. And given the damage that has already been done in the form of funding cuts, staff cuts, and program closures, it is no more than a band-aid over an ongoing and growing problem – even before we take into account the costs associated with COVID-19. An announcement late last week from Health Minister Tyler Shandro, that he would be putting a hold on cuts to front-line health care workers during the coronavirus outbreak, was similarly lackluster. We can expect that once this pandemic is over, we will see the government double-down on their funding and staffing cuts, and the overall erosion of our public system. Let’s collectively cross our fingers that the next health care crisis doesn’t happen for a while.

We can, as always, count on our dedicated front-line health care workers and allied health professionals to do all they can to get us through this difficult time. But it is important to acknowledge that they are doing so knowing that as soon as this is over they will be right back in a position facing staffing cuts, pay cuts, contract cancellations, and ultimately being asked to do more with less. Given what we have seen in other countries around the world, we can expect that Alberta is in for its share of this massive global challenge in addressing, treating, and containing the spread of this virus. We know that the only way to flatten the curve and minimize the impact of COVID-19 is for our governments to act quickly and decisively to bolster our public health care system, and to do everything they can to support our integral health care workers in providing care, and to support Albertans in self-isolating. However, given the rapid and drastic changes that we are seeing being made to undermine and erode our public health care system, Albertans should not be confident that their government is prepared for it.