Remember the movie The Full Monty. It’s the story of 2 unemployed steelworkers from Sheffield. They’re desperate for cash when they stumble upon a Chippendales type strip show and realize in an ill conceived flash of genius that they’ve found the solution to their cash flow problems—a male strip act. All they need to do is recruit 4 more desperate men and they’re all set. But there’s a snag. The ladies won’t pay a penny to see this pathetic group of middle aged losers perform until Gaz, the ring leader, blurts out that their performance will feature “the full monty” (they’ll be as naked as the proverbial jaybird). The tantalizing arc of the movie, both for the ladies and for the audience, is whether the men will actually go through with it.
How is The Full Monty relevant to healthcare—or anything else for that matter? Well, aside from getting your attention, The Full Monty is a clear example of the principle of full disclosure and why when you commit to doing something, you’d better deliver or suffer a serious credibility blow.
On Feb 14, 2011, I joined the legions of citizens trying to pry a shred of information out of the government. I FOIPed the Dept of Health and Wellness requesting all records relating to the private insurance options that were described in the leaked government policy presentation entitled Alberta’s Health Legislation: Moving Forward. On Mar 31, I received a letter politely informing me that a search had failed to retrieve any records relating to the subject. Furthermore, the leaked presentation was a draft document and “AHW did not look at any private insurance options and no work was conducted regarding possible options. This was a question being asked at the draft stage and the policy shift of considering private insurance options was excluded from the final document.”
Given my cynical nature I wanted to compare the draft document with the final document to confirm that the private health insurance options had indeed fallen off the table. On May 8 I FOIPed again. This time I requested a copy of the “final document” referred to in the Mar 31 letter.
On June 2 I received a reply—“Unfortunately, access to all the information that you requested is refused under section 4(1)(q)…under the FOIP Act” because the final document “was created on behalf of the Minister of Health to be presented to the Alberta government caucus” and therefore was exempt from disclosure.
Now this is where it gets interesting (really it does—do I have to bring back the Sheffield lads?) At this point the question we should be asking not what was in the final document. We already have a rough idea of the answer. It was the process to overhaul Alberta’s healthcare legislation by enacting the new Health Act and setting a time line to roll up 5 other pieces of healthcare legislation. The real question is why should the public be denied access to background information which forms the foundation of government policy?
To answer that question let’s go back to first principles. The FOIP Act gives Albertans access to all governmental records, with some limited exceptions. These exceptions fall into 2 categories: those where disclosure would result in harm to privacy, safety, law enforcement and intergovernmental relations (whether this last exception has merit is being tested right now with the Wikileaks) and those where the request would result in premature disclosure of the confidential deliberations of the Executive Council or its committees on “recommendations, policy considerations, draft legislation,” etc. But this exception bears a time stamp—the protection from disclosure expires once the decision has been made public.
Apply these principles to my FOIP request. The presentation contained background information which was presented by the Health Minister to the Alberta caucus. A decision was made to pass the new Alberta Health Act. This decision was made public. The Premier and Minister Zwozdesky have repeatedly assured Albertans that they have no intention, now or in the future, of adopting privatized insurance options. Surely the justification for refusing disclosure is stale dated. And yet the government response is “no disclosure, go away”.
So Mr Zwozdesky, it’s time to get up on the stage, turn up the footlights and deliver. Albertans may not cheer with wild enthusiasm but at least they’ll have the full picture.
While we’re waiting for Mr Zwozdesky’s response here’s a glimpse of The Full Monty for your viewing pleasure.