Tuesday, July 12, 2005

Alberta Health Reform - "Action 1"

As promised, I thought I'd do some commentary on the new health care proposal released by the Albertan government today. As a preamble, I'm not from Alberta - so my commentary is based upon an Ontarian's point of view. Also, I've refrained from reading stories on this and listening to the news. I think I saw the National Post headline said "more health care for the wealthy".

I assume that the governments and medical professional administering the health care services has a willingness to help their citizens and patients respectively and that there are no evil machinations.

I am also making commentary on a section by section basis, so you're not allowed to say, "But Section XX contradicts what you're saying."

Anyway, here goes.
Action 1: Put an Overall Health Policy in Place
Alberta is following through on the direction set in the Mazankowski report and we’re determined to finish the job. To do that, and do it well, we need an overall health policy that focuses on wellness and personal responsibility, defines what services are included in the publicly-funded health system, guides our decisions and sets clear priorities.
Go Alberta. :-)
October 2005 - Announce a new Health Policy Framework
I have no idea what that means, but it's coming this October.
January 2006 - Announce a new Health Services Plan to be developed by health boards across the province. The new services plan will identify what health services Albertans can expect to receive, how quickly, and where.
I kind of like this in theory. It stands to reason that people know what's covered and where the treatment is available.

On the "how quickly" part, I've thought about if it's possible that a contract could be developed between the government, doctors, and patients to define what are medically realistic wait times.

I understand that each procedure and patient is different, but I think there are possibly general guidelines that likely could be followed when determining how long a wait time is reasonable. Let me throw something out there.
  • If the public system can deliver within the medically defined acceptable time period for the procedure, then the patient must elect for public care.
  • If the public system cannot deliver within the medically defined reasonable time period, then the patient may elect for private carewith the portion covered by public health care covered by tax funds.
  • If the public system does not deliver the required/optional medical treatment, then the patient can elect for private care.
  • If the private system has a new or experimental procedure not approved for use by the public system, then the patient may elect for private care.
Administration and licensing of private facilities will be with the provincial ministry of health.

Now, how do we define "reasonable" time period? I don't think every procedure needs to be handled immediately, but general guidelines could be developed that covers criticality and quality of life. This is aside from life-threatening cases which should be handled immediately.

I don't feel comfortable entirely with the notion of letting people choose private health care outside of this system. That's based more on my not knowing the intimate details of either side.
In 2006 - Develop a new Public Health Strategic Plan focusing on what needs to be done to protect the overall health of Albertans.
Okay. Alberta wants to develop a strategy to help people avoid using the health care system. That's seems reasonable. Short of specifics, though.
In 2006 - Develop and implement a Provincial Research Strategy to ensure research guides clinical and administrative practice. Promote Alberta's health sector as a significant provincial economic driver.
I think this would tie into the strategy for the where, when, and how. Continued monitoring of new research and new innovations to redefine policy.

Interesting that they'd put in that the health sector as a significant provincial economic driver. I'm not sure what that means either. Are we talking health practise innovation, or pharmaceutical innovation, or ... I don't know.


Update (July 13, 2005 - 9:10 am): In my list above, I mentioned where the public and the private systems could be used. I have added one more for discussion.
  • If the private system has a new or experimental procedure not approved for use by the public system, then the patient may elect for private care.

3 comments:

MH said...

'I don't feel comfortable entirely with the notion of letting people choose private health care outside of this system.'

That's a loaded statement that certainly requires a little justification. Maybe some vague concern about limited availablity of medical professionals in the country?

Jim said...

It has to be taken with the next sentence.

"That's based more on my not knowing the intimate details of either side."

My uncomfortability comes from not knowing what would happen if people were allowed to choose and what would happen to the health care market for those unable to choose. I'm not as literate in the policies of both sides as I'd like to be.

I would argue that our shortage of medical professionals in this country is due in part (not wholly) to the public health care system.

I'd think if we could wave a wand and grow more doctors or grant licenses to more foreign-trained doctors, we would have. That latter point might be a big assumption.

I'd also think if we could compensate doctors to keep them here (not just higher pay, but shorter hours), that would help too.

Dirk Hintze said...

Stop blogging right now!