A storm brewing on the health care horizon?

The Edmonton Journal's Archie Maclean has an interesting preview of (Alberta's new Health minister) Ron Liepert's plans for the upcoming legislative session. If you're at all skeptical about the role of the private sector in the delivery of public services, this article is pretty disconcerting.

His appointment of cabinet muscleman Ron Liepert to the health portfolio is an indication that he is intent on spending some of his political capital to make the changes happen.

Liepert says the timing and political will were never quite right to make the necessary reforms. It's different now.

"We've got a new caucus, we have a premier with a pretty darn strong mandate and if we start making these changes very soon in the term, we have four years to get it done," Liepert said in an interview. "And I don't think we're left with any choice. We need to make some significant changes to how we deliver health care in Alberta."

Liepert says the template for his changes is the government debt-busting reforms that went on in 1990s.

"Albertans bought into it," Liepert says. "They acknowledged that there would be some pain. They were prepared to share in some of that pain and I would hope that we are now at the same kind of juncture when it comes to health care."

To summarize: Stelmach thinks it's time to make huge changes to health care, and judging by his appointment of Ron 'I won't take no for an answer' Liepert to the portfolio, he anticipates the changes aren't going to be very popular (see this earlier AGRDT post for more on that). Liepert even goes so far as to say that his plans for health care are going to be modeled on the major cuts Albertans saw under Klein during the 1990s, "as Albertans bought into it" then, so they should now too, right?

Well that's the big question isn't it? On the one hand, Albertans (and Canadians) for that matter have heard time and time again that there health care system is broken and unsustainable and needs to be fixed. In that way, they're primed for big changes as long as they're framed in the language of inevitability. On the other hand, the economic climate in Alberta today is a lot different than it was in the 1990s. It seems unlikely that Albertans are going to sit back and watch the price of caring for their parents and grandparents skyrocket as services are delisted and privatization becomes more common, while the government continues to post record-breaking surpluses. One cannot underestimate the power of the $22.7 billion boogeyman Klein inherited when he took office, but perhaps a more relevant lesson for Liepert and his reforms is the disaster that was the 'Third Way', which Klein tried to introduce as his final legacy project.

Ultimately, the political success of Liepert's reforms are going to be based on two things: the specific tools he uses to reduce costs and the strength of Alberta's economy. If Liepert chooses to cut costs mainly through the use of P3s and a reform of the health region administrative system, it may not be enough to get Albertans really worked up. However, if he starts going after more controversial reforms like de-listing services or adding in a user-pays fee structure he's going to have a lot more public resistance on his hands. One thing working in everyone's favor is the necessity that Alberta increase the number of doctors, nurses and other health care professionals working in the province. This objective will stem a repeat of the more controversial features of the 1990s budget cuts and could lead to less vocal opposition from health care workers.   The other factor, the strength of Alberta's economy, plays into the equation because it impacts how successfully Liepert will be able to sell the need for reform. If the US does enter it's seemingly inevitable recession, Alberta's oil sector (a.k.a. its entire economy) could be looking at a major slump. While this development may be bad news for the government as a whole, it will help Liepert make his case more effectively.

In any case, it will be interesting to see if Liepert is as ideological and heavy-handed on the health file as he was in education. Reading this story in which Liepert muses about the halcyon days of Alberta circa 1992, I'm not optimistic.   

Comments

[Simon Kiss]

I suspect we'll get a pattern like Bill 11 here. The government will believe it has a massive for massive change; ponder some significant privatization measures; the unions, opposition parties, public interest groups, social movements, the federal government and the Edmonton Journal and the CBC will mobilize, point out the ridiculous logic behind any reforms, the government will realize that its legislative majority does not correspond to a majority of public opinion, they will water down their reforms to something very minor, go on and win the next election on a turnout of 40% of voters. Whoever will be the Liberal leader will lose their seat and the NDP will win 2.
You heard it here first.

[Feynman & Coulter's Love Child]

The problem with the "Third Way" was that it had too much to do with the "First Way" (government control of public healthcare) and too much to do with the "Second Way" (government control of private healthcare) and when the dust had settled you ended up with another government healthcare system. Who in Alberta was asking for that???