And then there was one

By now, you've probably heard about the Alberta government's decision to amalgamate the province's nine regional health authorities into one mega-super-board. As I'm not a health policy expert (per se), I find my reaction - like most of the reaction I've seen - is pretty mixed. So rather than providing you with either a resounding denouncement or endorsement of the plan, here are a few thoughts:

• I know this is being billed as an 'overwhelming' change, at least by Liepert. But I for one fail to see how this is going to revolutionize health delivery in Alberta. Liepert argues that amalgamation will significantly reduce administrative costs, but they only account for 3.5% of the health budget. This likely means that Liepert and former Deep Sixer Ed Stelmach still have other possibly more privatizationey (yes, that's a word) changes in mind. Indeed, the amalgamation is being referred to as only phase one of the plans and Charlotte Robb, the woman appointed the new CEO of the superboard until yesterday was president of a for-profit medical services company (DynaLife).

• Did anyone hear any solid rational for this change? I know Liepert says that it's going to reduce costs, but why? Did anyone see any evidence, studies of the success of previous amalgamations under Klein, international comparisons of best practices? Just wondering. I thought that neocons liked decentralization because it allowed them to take apart large unwieldy bureaucracies like super-mega-health boards. Moreover, it seems like the move yesterday came really fast. It was only the day before yesterday that Stelmach was promising that the Liepert would announce details within the next month, but then BANG! all of a sudden we have this major change effective immediately.  It would be nice to know that this change was based in well grounded policy research rather than fly-by-the-seat-of -your-pants  ideological(?) beliefs. I'm not so sure we have that in this case.

• I'm generally a believer in the notion that it's important to keep power closest to the people affected by it, so I for one would have liked to see the province have made a more genuine effort to give local elected health region boards a chance to work. However, Klein scrapped that idea almost as quickly as he implemented it, realizing that adding another layer of elected official into Alberta's political milieu might make for public criticism or open and honest discussion of problems in the system. It is unfortunate but largely unsurprising that the RHAs didn't function well in their previous form, given that board members were somewhat unaccountable and generally appointed on the basis of their closeness to the PC party.

• It's been suggested by a few people as well, that this latest quick move has also come out of a desire to quash dissent from board members and CEOs, and that the comments made by Calgary Health CEO Jack Davis during the last election were simply too much for Stelmach to handle.

And there you have it, the AGRDT-healthcare-revolution-analysis-post. Unfortunately, the other two-thirds of the main contributors to this blog are traveling today for May-long (must be nice), so this is probably all the analysis you're going to get from us on this issue for the time-being. For other views on the issue, you can check out Daveberta, today's Edmonton Journal editorial, Don Bell's take,  and Rick Bell's "analysis". In addition, today's Edmonton Journal has several stories on the subject, linked to from their front page.