Alberta: Get Rich or Die Trying

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.

What Capitol Hill Senators and Congresspeople woke up to yesterday morning

Read about it here and here.

In the news

Lots of interesting stuff going on today. Here is a roundup of links:

Photo: Globe and Mail

The Globe and Mail has a good article detailing the 'in and out' scheme the Conservative Party of Canada allegedly used during the last election to finance national campaign advertising and exceed their allowable spending under the Elections Act by over $1 million dollars (and has resulted in yesterday's RCMP and EC raid of their headquarters). According to the Ottawa Citizen, this is the first time in Canadian history that a political party headquarters has been searched by the RCMP. I always new PM Harper would be a path breaker.

UPDATE: CBC's Politics with Don Newman is reporting that the RCMP are executing a criminal search warrant, granted by a Toronto criminal court at the request of Elections Canada. In fact, the ongoing search may have nothing to do with the 'in and out' scheme investigation and this may just be an attempt on the CPC to mask the real reason the cops are there.

Alberta Health and Wellness minister, Ron Liepert, has laid out his plan for the next year. The press release is seemingly benign. Some highlights include expansion of addiction and mental health services and a renewed strategy for regional health planning by June 15th. As they say though, the devil is in the details (and also the forthcoming provincial budget). I'd expect some healthcare-related controversy when Alberta Health's 'long term sustainability' plan is released in 9 months, if not sooner. Especially given Liepert's stated support for the Manzankowski and the 2006 Health Policy Framework reports and his general lust for 1990s-style, slash and burn budget cuts.

The Edmonton Journal's Todd Babiak has changed his tune (somewhat) on Edmonton's bid for the National Portrait Gallery. His column yesterday paints quite the rosy picture of a revitalized downtown arts and culture district. I like to think his newfound optimism is the direct result of  reading this blog...

Maude Barlow and the Council of Canadians warns that if Canada doesn't revist NAFTA, Canadian governments can expect litigation by foreign oil companies if ever a water shortage were to halt oil and gas production.

Health Canada looks ready to ban bisphenol A. This endocrine disruptor mimics the effect of estrogen and has been linked to breast and prostate cancer. The bad news is that bisphenol A is in many clear plastic bottles (water bottles, water cooler jugs, clear/tinted nalgene bottles) and it is also used to line tin cans. The good news is that it can be avoided somewhat. See Green Edmonton for advice on that.

Finally, this gem. Apparently Vancouver transit cops have been tasering fare-cheaters. Even the non-violent ones. SHADY.

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.   

Bye bye, Guy!

This post is a spin off of ch's broader 'new' cabinet commentary because Guy Boutilier's exit out of cabinet is so fantastic, it deserves a post all its own.  Why was Boutilier the only MLA tossed from cabinet? Was it because his Fort McMurray-Wood Buffalo riding had one of the lowest voter turnouts and as such, Stelmach thought he was expendable? I'm inclined to think it might have been something else. I think Boutilier's incompetence finally caught up with him and that's why he got the boot. Take for example:

• The time he interfered with a quasi-judicial AEUB hearing, by testifying in his capacity as MLA. Not only was this an exception to the rules, but it was completely inappropriate given that he was also Minister of Environment at the time. When asked whether Alberta Environment should set caps and target on growth and expansion, here's what he said:

A. "I'm here as the MLA today. And I'm saying to you, Mr. Chair, through the Chair as the MLA that I understand that those questions, I assume, you have asked to the actual technical people within Alberta Environment and the over thousand people that work for me within that department."
Q. When you appear here as the MLA, do you just turn off  an area of your brain where you were the Minister of Environment?
A. "Yes, I do."

• Or how about the time Alberta Environment pulled out all the stops and hosted the first (and last) Youth Environment Summit at the Delta in Kananaskis in October 2006. After a weekend long photo op, where climate change was the big pink elephant in the middle of the conference room, the minister held a Q and A session. When one delegate rose to ask Boutilier why he had chosen not to attend "Alberta Days" in Washington, DC three months earlier even though talks between the Alberta-US government on tar sands expansion were ongoing. He replied that his wife told him that they had to go on vacation or he would have to sleep on the couch, and he prefers to sleep with his wife. Realizing what he had just said, he attempted to fix it by muttering: and I support condom use! His EA ran up to the stage after that with a can of Coke and half-heartedly suggested that the Minister was suffering from low blood sugar. I know! I wouldn't believe it either, if I hadn't seen it with my own eyes! Ask anyone in that room that day, no one will forget that mishap. (I wish I could offer a transcript or recording as evidence but  Alberta Environment never did forward the tape including those comments on to members of the press...wonder why??).

Those are two of the more memorable Boutilier mishaps. Together they show that even a Harvard degree in Public Administration can't guarantee competence. Feel free to add your own Boutilierisms in comments.

For more thoughts on Alberta's new cabinet, check out our 'Official AGRDT Alberta's New Cabinet Post', and the views of some other clever Alberta bloggers over at Daveberta, Calgary Grit, Straight Outta Edmonton, and Ken Chapman.

Alberta's new cabinet

Cabinet making is always a favorite topic for political watchers because it involves the balancing of a multitude of considerations and generally serves to define a leader's overall tone for her government. More than that though, the personal nature of some of the considerations involved (i.e. loyalty, perceived competence, competition to leader, etc.) means that the outcomes are also completely open to interpretation. Few people can actually speak authoritatively on the subject, but that doesn't mean many won't try. So in light of that, welcome to the Official AGRDT 'Alberta's new cabinet' post!

Today's cabinet looks a lot like the one before it with a few notable exceptions. There's more ministers (cabinet grows from 18 to 23), there's more urban representation (Calgary has six seats and Edmonton three, which compares to the three seats combined they had last time around) and there's more women (five new women - Mary Anne Jablonski, Cindy Ady, Heather Klimchuk, Alison Redford, and Yvonne Fritz - join the existing two female ministers - Janice Tarchuk and Iris Evans). The only other major changes include the creation of several "parliamentary assistant" positions and the switcharoo of Dave Hancock (now Education) and Ron Liepert (now Health).  The mainstream media has a good run-down of the remaining changes to portfolio composition, etc. so I suggest you take a look at these.

I have quite a few thoughts on the new cabinet, so for your reading ease, I'll organize them into seven themes:

1. Best Move: A cabinet that looks more like Alberta

It drives me absolutely crazy when people instantly dismiss the argument that a Cabinet should look like the population it represents. Some people seem to think that second you suggest that not enough women or visible minorites have been appointed to cabinet, you must immediately ascribe to the idea that men can't represent women and white people can't represent non-white people. Not only is this notion problematic because it assumes there is a single women's or racialized minority interest, but it also obscures the actual basis for the desire for a representative cabinet.

Cabinet should be diverse because when a Cabinet is not diverse, (i.e. there are no or a disproportionate amount of "qualified" women, visible minorities, and other minority groups) then somewhere down the line there is a systemic barrier to those groups' full participation at all levels of Alberta's politics. As a person who thinks it's important that all members of Alberta's society have the opportunity to participate in it's politics, the absence of a loosely proportionate amount of women or minority groups is quite disconcerting.

That said, I have to give Stelmach props for recognizing the talent and qualifications of the five new women he appointed to Cabinet. Now if only, there was more than one non-white person around to demonstrate that there aren't systemic barriers to the people of color who make up eighteen percent of Alberta's population.

2. Worst Move: Groeneveld needs to be put out to pasture

This one probably reflects the soft spot I have in my heart for agricultural policy, but...for anyone out there who tries to make the diluted argument that cabinets are picked on the basis of qualifications, I have two words for you: George Groeneveld. His retention of the Alberta Agriculture portfolio has to be one of Stelmach's worst moves. I know Mr. Groeneveld has substantial experience in agriculture and with Alberta's Wheat Pool, but this man is far past his prime. If you don't believe me: watch question period. He spends more time searching through papers on his desk for his PAB written answers and his glasses then he does responding to the question. It's actually sort of painful to watch.

This sad situation contrasts sharply with other jurisdictions, like the EU, Oregon, and even Ontario, which are trying new reforms and innovative approaches to the production and marketing of food in their jurisdiction. Here in Alberta, the biggest news to come out of Agriculture last year was the Auditor General's revelation that up to $34 million a year was going to ineligible recipients of Alberta's farm fuel subsidy program, as the program or it's recipients had not been reviewed in ten years despite the government's own regulations that required a review every three years.

Honourable mention: Janis Tarchuk's retention of the Children and Youth Services portfolio. While I give her credit for being congenial to her opposition critics (this is a rare quality in Tory cabinet ministers, Hancock and (to an extent) Evans are the only others that come to mind), she has no clue what is going on in her department. Her inability to speak authoritatively about solutions to the appalling state of Alberta's foster care program and more generally, it's social infrastructure, or even to explain how her department didn't spend almost $31 million of its budget in 2006-07 and $25.9 million of federal child care money it received this summer in spite of massive child care space shortages, are prime  examples of why Tarchuk should have been showed the door

3. Evans to Finance and Enterprise (I know, I think the new portfolio name is strange, too)

Although I disagree with her politics, views, and value systems, I think Iris Evans is an excellent MLA and cabinet minister. Her work ethic is notorious, and she does seem to care a lot about the work she does. I think it will be interesting to see what she can accomplish in the Finance and Enterprise Portfolio, here's hoping she can hold her own against this guy.

4.  Rob Renner will continue to not accomplish anything in the environment portfolio

Maybe Stelmach should have placed Pierre Alvarez or one of the heads of Suncor or Enbridge in this portfolio instead. At least then something would move forward in this file. See here and here for more of my thoughts on this.

5. Hancock-Liepert Shuffle

This has the potential to quickly become Stelmach's worst move, if Liepert's behavior in Health is anything like his performance in Education. Liepert's attitude towards the ATA during their negotiations last year was divisive, dishonest, and down-right child-like. I don't think I've ever seen a grown man act like such a bully. Alberta would be looking at a province-wide teacher's strike right now, had it been up to him. If this is the approach Liepert is planning on adopting towards nurses and other health care professionals, expect him to cause more problems then he solves. Adding insult to injury is the fact that Dave Hancock is by far the most capable minister and given more time, would have likely come up with some innovative solutions to Alberta's health care challenges.

So what was Stelmach thinking? Liepert is seen by Tories as a hard-line fiscal conservative, not afraid to make deep cuts. Moreover, many Tories have openly complained about Alberta's "bloated" health care budget, and indeed, "increasing access to quality health care and improving the efficiency and effectiveness of health care service delivery" is outlined today as one of the new government's five priorities.  I wouldn't be surprised if Stelmach was looking to use some  neoliberal measures to address Alberta's health care systems, and he sees Liepert as the henchman to do it. Will he go so far as to push for privatization? In the spectre of the disaster that was Bill 11, only time will tell. However, considering Stelmach was a member of the unfortunate episode in Alberta's history known as Deep Six, I can't say I would be surprised in the least if he took steps in this direction (for more on Stelmach's neo-conservatism check out Jeremy Klasuz's excellent article on, 'Ed Stelmach: the Forgotten Years.') 

6. Ted "I hate gay people, and I don't really trust women, either" Morton maintains SRD

Just a reminder that this creep is still lurking around.

7. On parliamentary assistants...

Stelmach deserves some credit here for introducing the Westminister tradition of parliamentary secretaries to Alberta. While only time will tell how effective they are, they will hopefully solve one constant problem in Question Period. Namely, that under current practices when a minister is away, another minister is expected to answer questions on their behalf. This exercise is always a complete disaster, as no one knows who is supposed to be standing in for who, and the stand-in is never prepared. These exchanges always end with a vague promise to "pass the question along" and a minister's absence can work as a tactic for Tories looking to avoid confrontation (and media attention) over controversy in a specific portfolio.

Make sure you stay tuned tomorrow for a AGRDT Guy Boutilier send-off!

Stelmach set to announce "new" cabinet today... (UPDATE)

UPDATE #2: The cabinet has been announced. Here's the deets.

UPDATE: The Journal has more info on potential cabinet picks. According to the updated story, Iris Evans is moving to Finance, and will be one of seven women in cabinet this time around (compared to only two out of eighteen last time). Word also has it that Ron Stevens will retain his deputy premiership, but also pick up the Intergovernmental Relations portfolio. The full cabinet will be announced at 2 pm today, and AGRDT should have oh-so-insightful analysis for you at some point following that.

...and it looks to be just as disappointing as the last. Some highlights from the Edmonton Journal story:

Premier Ed Stelmach will reveal today a largely status-quo cabinet that gives Edmonton only two full-fledged ministers and shuffles veteran Dave Hancock out of health and into a lesser portfolio, The Journal has learned.

Several government sources said Tuesday the modest cabinet makeover is highlighted by a job swap between Hancock and Calgary's Ron Liepert...

...Stelmach is said to have made few major changes to his existing cabinet, based partially on the belief that its solid performance helped the Conservatives steamroll to a 72-seat majority in the election.

Stelmach's cabinet choices will be closely watched for regional and demographic balance. His original 18-member cabinet in December 2006 was roundly criticized for being far too rural, male and all-white...

The premier has pledged more regional balance in a bigger cabinet this time, but several of the small-town Stelmach loyalists who got nods last time -- including Danyluk, Luke Ouellette and Lloyd Snelgrove -- won't be swept aside to make way for city-dwellers.

...Some fiscally conservative Tories were delighted by word of Liepert's new appointment. They see him as a hardliner who may propose aggressive reforms to curb the rapid rise in health-care costs.

The Journal story comes in direct contrast with the headline from today's Edmonton Sun story, Big Change Expected in Stelmach Cabinet, which suggests (among other things) that Ted "I hate gay people" Morton will be moving to Energy and new-comer Teresa Woo-Paw will also claim a seat.

Check back later for a more thorough analysis once the full slate is announced.