A Pretty Good Job???

I don’t know about you but I’m getting a little tired of being told that health care costs are out of control and that somehow it’s my fault because I run to ER at the first sign of the sniffles.  The provincial budget for health care is $15 billion.  That equates to 42% of the provincial budget—15 years ago the entire provincial budget was $15 billion and health care accounted for only 26% of it.  So what happened?   Here’s a punch list of poor decisions and bizarre missteps described by a number of MLAs during the debates on the new Alberta Health Act.

A good place to start is the vaporization of hospitals and health care professionals.

  • 3 Calgary hospitals (which equates to 1,500 beds and 10,000 support staff) disappeared when the General was blown up, the Holy Cross was sold—for $5 million right after the completion of $32 million in upgrades—and the Grace was converted to the HRC which was also closed down when the government terminated its contract.
  • By 2010 the number of acute care beds had dropped to 7,800, down from 13,300 in 1989.  The health minister has promised to add back 360 beds, but can’t confirm whether they will come with trained staff.
  • In 2008 the Premier promised to hire more nurses but in 2009 the AHS laid off 448 nurses at a cost of $24 million in severance, then in 2010 it announced a plan to hire 500 new nurses—net result, we’re still short staffed.
  • In 2010 Alberta medical schools cut 31 spaces due to a lack of government funding; institutions responsible for upgrading foreign accredited doctors cut the number of seats from 60 to 40.
  • The proportion of alternate level of care (ALC) beds in acute care hospitals rose from 3.6% in 2002 to 5.5% in 2008.  That number is still climbing and making even fewer acute care beds available to ER patients.
  • Alberta hospital occupancy rates now run at 100 to 110%.  The optimal occupancy rate is 85%.  Anything higher creates inefficiency and no surge capacity.
  • Preventive care has been cut by 50%.

And if this isn’t bad enough, the government tripped over itself time and time again when it rolled the 9 health regions into the Superboard.

  • Pensions for 119 health service managers were enhanced at a cost of $45 Million.  One happy recipient of this largess was Jack Davis, the ex-CEO of the Calgary Health Region.  He walked away with a lifetime pension of $270,000/year.
  • Severance for the ex-CEOs of the 9 health regions resulted in payouts in excess of $6 Million.
  • Bureaucracy  and inefficiency increased when the AHS created seven organizational layers where once there had been four.  An example:  no vacancies could be filled without Dr. Duckett’s approval notwithstanding the fact that the AHS has 87 people functioning at the VP, Senior VP, or Executive VP levels.
  • Dr. Duckett was fired after 18 months and left with a severance package of approximately $700,000.
  • Minister Zwozdesky interfered with the autonomy of the AHS Board to such a degree that four board members resigned.
  • The Auditor General announced that the AHS had misallocated nearly $1 billion and was building facilities with no funding agreements in place.

So who’s responsible for the skyrocketing health care budget?  Clearly not sniffly patients.  Unfortunately Minister Zwozdesky doesn’t appear to realize this.  On Nov 30 in the middle of the debate on the new Alberta Health Act, the Minister said: “…it’s very clear that the [AHS] is accountable to the minister for the delivery and operation of the public health system.  And that’s what they’re trying to do:  operate the public health system.  They get their money—guess from whom?—from the taxpayers.  Guess who has to sign off on that budget?  I do.   I’m accountable for it, and so are they for delivering and operating within those parameters, and they’re doing a pretty good job of it.”  Well, Minister Zwozdesky, in any other context, the man accountable for the budget would be trying to figure out what went wrong rather than patting himself on the back for doing a “pretty good job”, especially when the person providing the funding is the taxpayer.

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