Letter to Halvar Jonson
I had originally sent a letter to the Premier, Treasurer and Health Minister regarding the foolishness of their flat tax plan (to be implemented next year) and its effect on health spending. The Health Minister responded with some half-truths and misinformation about Bill 11, which I briefly mentioned in my original. I will be scaning the original letter soon. This is the original email I sent:
From: mike [at] SPAMmike-warren.com To: premier@gov.ab.ca CC: learning.minister@gov.ab.ca, ahinform@health.gov.ab.ca, sday@assembly.ab.ca Subject: Recent Budget/Health and Education Funding Date: Mon, 28 Feb 2000 17:08:31 -0700 (MST)
Dear Mr. Klein,
In your recently announced budget plans, you speak in glowing terms about your ``increases'' to health and education funding. In fact, these supposed ``increases'' only take the funding of these important areas to 90% of 1993 levels, which obviously doesn't account for inflation or the increasing use of health services as the Albertan population ages or the increases in Alberta's population since then.
Further, your move to an eleven percent flat tax (as opposed to the current system which is a percentage of Federal rates) is touted as a great way to save all Albertans money. It really means that the wealthiest residents of Alberta -- who can most afford a few extra dollars of tax -- save far, far more money than middle and lower class Albertans.
This tax cut comes after your recent insistence that the ``status quo [of health care] is not an option'', implying that your proposal to contract out to private surgical facilities is the answer. No, the status quo is not an option, but neither is funneling public money to a private surgical institution in the form of profits. Perhaps the ``innovative idea'' for health care funding you are searching for is as simple as an increase in public money. Despite its problems, our health system is still far cheaper and provides much more coverage than the mostly-private system of the United States.
---
I will have Halvar Jonson's reply scaned in shortly. My response to his letter follows:
From: mike [at] SPAMmike-warren.com To: ahinform@health.gov.ab.ca CC: calgary_varsity@assembly.ab.ca, premier@gov.ab.ca, nmacbeth@assembly.ab.ca Subject: Re: Your Letter Date: Tue, 2 May 2000 12:06:06 -0600 (MDT)
Honourable Mr. Jonson,
Thank you for your letter regarding my email to Mr. Klein. The thrust of my email was questioning the sanity of the proposed flat tax for next year vis a vis a large drop in spending; you are not responsible for this area, but perhaps you could ask Mr. Klein why he thinks Albertans want a tax cut versus re-investment in health and education.
You mention in your letter that Alberta spends $17 million a day on health care; this is useless without comparing it to other provinces. According to the last CIHI report, Alberta spends some of the fewest dollars *per capita* on health care. I respectfully suggest that no matter what the raw dollar amount is, it needs to come from somewhere. Currently, only the US has a higher percentage of private health care spending than Canada (of G7 nations, according to CIHI).
You mention that Bill 11 ``offers our regional health authorities one more option'' in providing service. The problems with allowing the health authorities to contract to private providers are many:
. Bill 11 has nothing forcing Health Authorities to only contract out surgeries if they are cheaper than doing them in public hospitals. Cataract surgeries are a good example, since they cost far more now to pay private clinics than they did in the public system
. There are many, many conflict of interest possibilities without the above requirement. Further, the Health minister has sole approval powers over determining contracts; shouldn't actual doctors have a role in this? Here I am thinking of the Alberta Medical Association. Naturally, they, too, would have potential ties to private providers, but as more people are involved in the decision, the possibility is lessened.
. Health funding has seen only meager increases, yet Klein makes wild claims that more surgeries will be performed under Bill 11 and waiting lists will shrink. This isn't possible without more money being spent on health care; Bill 11 will use ``enhanced services'' to get this extra spending from individuals (unless they can't afford them, in which case you get worse service). I do think that in some cases, user fees would be a good way to offer the latest medical technology while understanding that it is very expensive and can't always be provided solely with public money; Bill 11 is not a good way to introduce limited user fees, however.
You further state in your letter that, ``the services that are currently covered through our Alberta Health Care Insurance Plan will continue to be covered''. This isn't the case. Please point out the Bill 11 clause which guarantees services won't be de-insured, or that some aspects of current services won't become ``enhanced service''. Even more disturbing, the Health Minister decides what are required services, with no requirement to consult or heed the College of Physicians and Surgeons.
Stating that ``Bill 11 totally bans private hospitals'' is a misnomer; Bill 11 defines ``hospital'' wrongly by assuming that a hospital necessarily needs emergency services. There are a number of people who disagree with this definition, including Allen Rock. Semantics aside, the surgical facilities allowed under Bill 11 are very hospital-like, and statements such as yours are misleading; my dictionary defines hospital as, ``an institution providing medical and surgical treatment and nursing care for ill or injured people'', which certainly sounds like a Bill 11 ``surgical facility'' to me. If Bill 11 really banned what the Oxford English Dictionary defines as a private hospital, then that would be excellent.
You mention that the College of Physicians and Surgeons first determine the safety of proposed private ``surgical facilities''. This is definitely a good thing, but where is the College when the Minister is deciding which services are essential and what constitutes an ``enhanced service''?
You say that the Minister's decision will be in the best interests of the public and the health system; why are cataract surgeries not being performed in the more cost-effective public system rather than in a more expensive contract arrangement with various private eye clinics?
Your last paragraph, correctly stating ``there has been considerable misinformation and misunderstanding'' about Bill 11 is true; both sides of the debate have done their share of misleading. I find it insulting that you imply with this paragraph that I am uninformed and have not read Bill 11.
Sincerely yours,
Mike Warren, Concerned citizen