Alberta doesn’t need Ottawa’s thumbs-up on healthcare reforms, says think tank

by Leo Almazora06 Feb 2019

While many provinces seek to improve healthcare outcomes for their residents, compliance with the Canada Health Act has proven to be a major obstacle to their efforts. But according to a new policy paper from the Fraser Institute, one province may be able to act without running afoul of federal legislation.

“Alberta is a relatively high-spender on health care with often middling to poor results to show for it, but fortunately the province can enact a number of policies to improve the system for Albertans,” said Bacchus Barua, associate director of health policy studies at the Fraser Institute, who co-wrote the study Health Care Reform Options for Alberta.

According to the institute, Alberta currently occupies the second-to-top spot in per-person healthcare spending in Canada. However, it ranks near the middle or bottom when it comes to the availability of health-care resource: out of the 10 provinces, it placed fifth for number of doctors, seventh for number of nurses, fifth for MRI units, and eighth for CT scanners. The median healthcare wait time of 26.1 weeks reported for Albertans last year was also the sixth worst among the provinces.

The study’s authors found that the province can use third-party private clinics to deliver healthcare services within the public system, which would dramatically expand capacity and spur competition. The measure, which they said is not prohibited by the Canada Health Act, would likely cut wait times for patients in the province.

Another possibility, they said, is to take a cue from Saskatchewan and create a central province-wide registry of specialist referrals. By pooling the referrals made by primary care physicians, it will be possible to prioritize and directly connect patients to specialists with the shortest wait times.

They also noted that the Canada Health Act doesn’t explicitly prohibit the creation of a private parallel system where patients could pay entirely out of pocket, or obtain private insurance for the full cost of services. However, provincial legislation in Alberta severely impedes that possibility; removing those restrictions, the authors said, could potentially alleviate pressure on the public system and give patients an alternative within the province’s borders.

The study also looked at other potential reforms such as patient cost-sharing, which is common among other successful universal healthcare systems like Switzerland, the Netherlands, and Australia, but prohibited by Canadian federal legislation.

“Contrary to general perceptions, there are meaningful health-care reforms the Alberta government can pursue on its own, that don’t require Ottawa’s approval and would benefit Albertans,” said Jason Clemens, the Fraser Institute’s executive vice-president and study co-author


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