When it comes to changes to Alberta’s health care system, Albertans should know that some groups either misunderstand or seem to be purposely trying to mislead the public regarding some reforms that are being introduced. Either way, their actions are disappointing.
For example, a recent report by the Canadian Centre for Policy Alternatives suggests the Alberta government is making changes that “open the door to U.S. health care”.
This is completely false. It’s well-known the U.S. does not have a universal public insurance system that covers all citizens. The Alberta government, however, has announced they are going to keep the province’s public system, but make it easier for physicians to provide private care without sacrificing their public role.
The change represents a more balanced approach that will bring the system closer to European countries like Sweden and France (among others). These reforms are designed to protect and improve the public system while simultaneously offering patients a much-needed alternative to the confines of Medicare. It hardly makes sense to force Albertans, failed by the public system, to cross the border for private treatment when those dollars could be spent in Alberta, supporting Alberta jobs and companies that pay tax in Alberta.
Simply put, “dual practice” allows physicians to “toggle” between public and private practice. Sensationalized media reports would have you believe that this reform will incentivize physicians to leave the public system, whereas it actually helps ensure physicians interested in private practice can choose to remain part of the public system.
Here’s a little-known fact. Physicians in the province (and across most of Canada) have technically always been able to opt-out of the public system. However, to do so, they had to give up their public role entirely. Naturally, few physicians historically chose this option. But that’s changing. Provinces like Quebec that force physicians to choose between the two are now seeing an increase in physicians opting-out entirely as frustrations with the public system continue to mount.
What we can agree on is that strong guardrails are needed to ensure a robust public system that is complemented (rather than corrupted) by a private pressure valve. But Alberta’s government already understands this. Bill 11 includes language that empowers the Minister of Health to dictate the circumstances and conditions under which dual practice is permitted, including restricting the types of services offered.
This is entirely in line with other universal healthcare systems like Germany and France. According to analysts Krystle Wittevrongel and Conrad Eder, dual practice physicians in Germany must work 25 hours in the public system before providing private care. Meanwhile, in France, they must commit to five “half-days” in public practice, and private activity is capped at 20% of physicians’ public activity.
Instead of criticizing the introduction of dual practice, those who consider themselves so-called friends of Medicare should welcome this change and direct their effort towards advising governments on appropriate guardrails to ensure both public and private systems flourish and serve patients.
Polls suggest Canadians support what the Alberta government is trying to do. Almost 60 percent of Canadians say we should keep our public health care system, but allow patients to use their own money, or their extended health insurance, to pay for surgery at local private clinics if they cannot get timely care in the public system.
When it comes to health care, Premier Smith’s recent reforms will actually bring Canada closer to European systems and likely, shorter European wait times.
This blog post was written by SecondStreet.org Research Director, Bacchus Barua.
