According to Danielle Smith, AHS isn’t “truly accountable” and it’s been a “management problem” for quite some time. So she’s going to blow it up.
This week some brave soul leaked a 36-page slide deck asking cabinet to approve a “package of reforms to refocus the health care system to achieve better outcomes for Albertans” and to signal this decision to the public.
Cabinet, bless their pathetic little hearts, approved it.
The slide deck
Instead of fixing AHS’s “management problem” and increasing its accountability, Smith is going to replace AHS with four new organizations: acute care, primary care, continuing care, and mental health & addictions.
These organizations will report to the Integration Council (made up of two cabinet ministers, various deputy ministers and assistant deputy ministers, other leaders and yet to be named sub-committees and councils), plus a Procurement & System Optimization Secretariat, plus 13 Advisory (not decision making) Councils and an expanded Health Quality Control Council.
That’s a lot of councils, secretariates, sub-committees, cabinet ministers, deputy cabinet ministers and assorted “leaders” to manage a service that was once managed by AHS and its board.
According to the slide deck additional changes to Public Health, EMS, and Lab and Diagnostic Imagining will be coming down the pike as well.
No one is disputing that AHS could do a better job, however, speaking as someone who’s been through more than her fair share of corporate reorganizations in the private sector, this reorg promises to be a disaster.
Why? Because it doesn’t track the reorg recommendations made by top tier management consultants like McKinsey who say in order to be successful a reorg must follow a few basic rules.
Rule One: Know why you’re reorganizing
Everything Smith has said to justify this reorganization—refocusing on patient-centered care, improving health outcomes, empowering health care workers—has been said before. The only new element is her complaint that AHS is a “management problem.”
No management consultant worth his big paycheque would recommend a massive reorganization to fix a “management problem.” Why throw the baby out with the bathwater? Just fix your management problem.
Rule Two: Understand the existing organization before you create a new one
Smith did not conduct any meaningful consultation with doctors, nurses, front line workers, or the public with respect to AHS’s existing delivery model. Consequently we can only assume the deficiencies listed in the slide deck are based one someone’s impressions, biases, or beliefs.
McKinsey warns against basing a new structure on one’s untested hypothesis and intuitions, noting that “In our experience, companies make better choices when they carefully weigh the redesign criteria, challenge biases, and minimize the influence of political agendas.”
Influence of political agendas, need we say more?
Rule Three: Establish short- term and long-term metrics
This one is pretty obvious. You need metrics so you’ll know where you are and whether the organizational changes you are making are taking you in the right direction. If someone thought metrics would be a good idea, they failed to include them in the slide deck.
Rule Four: Identify and mitigate risks
The slide deck identifies the following risks: (1) fragmented health care deliver, (2) system disruption, (3) system failure, (4) delays in implementation, (5) public perception, and (6) carve-out risks.
Hold on. System failure?
If this was a presentation to the executive team in the private sector the CEO would stop right there. He’d demand an assessment of the risk. Is it 10%, 50%, 90%? He’d want to know what the Integration Council (which is identified as the body responsible for mitigating this risk) is doing to prepare for it. What mechanisms are in place to warn the Council that the system is on the verge of collapse? What plans has the Council made to response quickly when the alarm bells go off?
The slide deck says this group of bureaucrats will spend their time sitting around identifying efficiencies and eliminating barriers. That simply doesn’t cut it.
(Frankly, the CEO would have little confidence in the government’s ability to mitigate the risk of system failure given its abysmal handling of the transfer of public lab service to DynaLife.)
Moving on.
The risk of public perception will be addressed by a “full scale stakeholder and communication program.” More lectures in telephone town halls I presume.
The carve-out risks will be managed by a “dedicated transformation office, supported by merger and acquisition experts who will lead separation efforts and ensure compliance to all legal and policy requirements.”
Pardon?
Our private sector CEO would stop right there. He’d ask for more information about the “carve-out” risk because it sounds like the government is getting ready to sell off parts of our public healthcare system. That’s a topic that deserves its own comprehensive slide deck.
Bottom line
The slide deck raises more questions than answers. The most important question is: Does anyone really know what’s going on.
This is a huge reorganization project and yet in the Legislature Smith downplayed it saying “we are making incremental change.” Doctors, nurses, and others working on the front line need not worry because the changes will proceed “slowly over time.”
Nope, that’s not what the slide deck says.
Then there’s the kicker. When Rachel Notley questioned Smith’s decision to appoint Lyle Oberg, a proponent of privatized health care and a partner in Canada’s first private, for-profit hospital, as the chair of the AHS board, Smith replied “There will be no privatization.”
I’m sorry but the carve-out risk description in the slide deck begs to differ. I’ll just park that promise in the drawer next to the “nobody is touching anyone’s pensions” promise.
Danielle Smith says she’s going to improve health care by replacing the centralized AHS with a politically controlled centralized bureaucracy. Four Edmonton hospitals are at 150% capacity and the slide deck indicates that she’s not spending another dime on hiring and retaining more doctors, nurses, and front line staff.
In what universe does this make any sense?
Susan on the Soapbox 
Do not expect sense from a UCP government in AB…they play to the thé rural and oil & gas votes in order to stay in power and everyone else be damned. What physician or other health care professional would choose to work here under this new plan.
That’s right Diane. No one in their right mind goes to work for an organization when it’s in the middle of a corporate reogranization. There’s too great a risk that after the dust settles you job will be gone. But then again, if Smith’s goal is to break the system, and sell the best bits to the highest bidder, then this makes perfect sense.
EXACTLY
I’d like to know what happened to the Minister of Red Tape Reduction.
Sorry, reynoldreimer, “red tape” is rules intended to keep private companies from cutting corners for higher profits.
When you mess up a Crown corporation, that’s called either “streamlining” or “right-sizing.” Depends on whether the layoffs are the end, or the start, of the process.
Thanks for the elucidation. What do we call it if the crown corp becomes privatized?
In this case, “disaster.”
I just laughed at your last comment Mike because that is exactly what happens.
Once the private takes over and get used to the ways of the government suddenly everything doubles and triples and becomes accepted just like our awful deregulation of electricity and our disgraceful Insurance situation.
We are being gouged by business greed but that somehow is ok because it is not the decrepit public service which has been demolished to pieces. We use to have one of the most efficient public services in the West, but it was intentionally destroyed to allow the efficient private enterprise to take over and do whatever they want.
A well regulated society is fundamental for capitalism to work otherwise it becomes as rot as the communist systems still in existence at least by name. No one is able to call China a communist country with a straight face.
Talk to Dale Nally, MLA at Morinville.StAlbert@assembly.ab.ca
Payments under the table
Nancy, he’s in Texas on a 4 day trip. The first 3 days he’ll meet with cryptocurrency and block chair people and the foruth day he’s meeting with aerospace manufacturers. How’s that for money well spent? (I”m being sarcastic). Here’s the link: https://www.alberta.ca/release.cfm?xID=892704E81F63A-B5B7-2CEA-3CE186DA236BDE1B
Mike and reynold: great points. I agree 100%. Thanks.
Susan: Thanks for sharing another great blog. It’s quite clear what the UCP’s intentions are. They absolutely want private for profit healthcare in Alberta, and are going to find any way they can to achieve that goal. This is also what Ralph Klein had in mind. Weaken the public healthcare system so much, from senseless cuts, so that it has to be privatized. Danielle Smith is getting former Alberta PC MLAs who played a role in what Ralph Klein was doing to help her do this. I’ll play some more fitting music. This is Stevie Wonder doing a live version of his own composition, You Haven’t Done Nothin’. It is from 2009. Stevie Wonder is also in my music collection.
Dwayne: fantastic pick.
Stevie Wonder nailed it.
“And we are sick and tired of hearing your song
Tellin’ how you are gonna change right from wrong
‘Cause if you really want to hear our views
You haven’t done nothin'”
No Kidding!!!!
I can’t help but wonder how many weeks of brainstorming and message control went into that slide deck. The dumbest aspect of this is, it wasn’t intended for the gullible public. It was intended for Danielle Smith and Rob Anderson. In Qberduh, emotional decisions lead to feeble justifications. This way lies Trumpism and America’s 51st state.
The disorganization chart Smith has released is actually worse than I thought. I expected four (initially, allegedly) non-profit companies with four chairmen, four boards of directors, four CEOs, four sets of vice presidents, and assorted admin assistants, executive assistants, assistant executive assistants and assorted hangers-on, bowers-and-scrapers, sycophants and toadies.
Maybe the hangers-on etc. will find space around the trough at the Integration Council, the Procurement & System Optimization Secretariat, and the Advisory Councils (why 13? Bad luck, that. Better make it 14). The Quality Council will have to be drastically expanded. They’ll provide all the empirical data of impending screw-ups for Smith and the various CEOs etc. to ignore.
The ideal of organizing a large corporation is to make it pyramidal: lots of workers doing saleable work at the bottom, with ever-narrower levels of management rising to the top. There’s one CEO, the metaphorical tip of the pyramid, who’s responsible (hah!!) for everything below him.
This disorganization sounds more like an inverted pyramid. Rather, it’s four pencils balanced on their sharpened tips (the health care workers we, the public, see). On top is a 2-by-4 balanced on end—but in between are Tetris blocks more-or-less stacked on the eraser ends of the pencils. This is a corporate structure deliberately designed to fail.
Mike J Danysh: The UCP are obviously not having a smaller government. So many panels, and studies are made for their friends, who get paid so much for them. These have a set agenda. Multiple redundant positions, that have a high paying salary, from $100,000 to almost $300,000, for their other friends. Staff count for UCP MLAs has increased, and it has for Danielle Smith, with 34 staff members. The cabinet count for the UCP has dropped, after they lost seats in the last provincial election, but it is still a record level for Alberta at 33, with associate ministers. The AHS restructuring is adding to that. When Danielle Smith was the Wildrose leader, she was criticizing Alison Redford for the size of her cabinet, which wasn’t even this large as the one the UCP has now. If I recall correctly, Rachel Notley’s cabinet had only 12 ministers. It’s definitely a dictatorship that the UCP has.
Yeah, and why am I not surprised? Smith is a relic of the pork-barrel politics of the Old Tories, only worse. Smith had to reward all those TBA apparatchiks who pushed Kenney out.
Now I see they’re changing the rules on gratuities for MLAs. Not content with empire-building and bloated bureaucracies, they’re awarding themselves bigger gifts. Yay.
PS: Notley started with 12 ministers, but the workload was extreme. After six months, she appointed six more; total 18 cabinet ministers. Some things can be cut too much.
Mike, apparently they’ve been working on this for many months, maybe even a year. And this, THIS, is what they came up with.
As you point out four silos with their own Boards, CEOs, VPs and assorted hangers on (loved how you described them) would have been bad, but this is infinitely worse. For one thing the two cabinet ministers have no operational experience. Instead of making decisions they’ll be referring issues back down the line to people who have no idea how this is all supposed to fit together. Meanwhile Albertans will get sicker, their doctors, nurses, and healthcare workers will become even more demoralized and eventually the whole thing will implode.
We’ll see just how popular Smith et al are then. .
Hi Susan. I’d ignored the part about the ministers being ultimately in charge. TBH, I just didn’t want to think about that. I’m not sure that cabinet ministers would NOT make decisions in ignorance. Remember the Dunning-Kruger effect, and try to imagine Adriana LaGrange (shudder) and Danielle Smith (shudder!!!) making health policy decisions on the fly.
I wonder if they’ve chosen the new CEOs and chairmen for their new and improved health-care companies yet. The head-hunting must have started some time ago. The question is, can they hire anyone with experience in health administration? How many candidates said “No thanks”? This demolition job will take months to get started, and they better have the new “leadership teams” (hah!!) already lined up.
Given how consistently rural Albertans vote against their own best interests, I don’t see this making Smith unpopular unless someone who’s widely known and well-liked gets sick and dies horribly. That might be shocking enough to overcome both apathy (“we can’t make the guv’mint change it, anyway”) and religion-inspired learned helplessness (“we can’t change God’s will”). I don’t see anything less than a personal tragedy, which Smith’s fanboys can relate to emotionally, having any effect on her popularity.
(Note to Con trolls: No, of COURSE I don’t want somebody to die. But be honest. Will you change your mind about Smith’s destruction of AHS for anything less?)
Kudos and many thanks to the brave whistleblower who leaked this! As a former employee of the AB govt., I know how a dedicated civil service has tried to protect Albertans from the govt. they elect (think oil, gas and electricity deregulation). Too bad Albertans and the NDP cannot do anything to stop the train wreck. They fumbled that opportunity last May. Here’s hoping for more whistleblowers and a miracle that sees Albertans “wake up and smell the coffee”, as Ann Landers used to advise.
LAS thanks for that insight re: what it’s like to work as a public servant with this government.
You gave me a chuckle with the reference to Ann Landers, when I was younger (and she was still alive) I used to read her all the time. 🙂
Question: did another anonymous team at LifeWorks do this so-called analysis? Or was Rob Anderson leading a brainstorming session in the Premier’s Office?
Actually, to put in this many layers of built-in failure points, the “plan,” so-called, must have been developed over a long time. You can’t make this many mistakes in only a couple of months.
From Ms. Soapbox’s review, I’d say the plan was the exact opposite of anything a competent management consultant would recommend. Here’s a conspiracy-theory review of what Smith, Anderson et al were really doing.
Rule One: Know why you’re reorganizing
Hey, Danielle already knows that! She’s mad at AHS, Deena Hinshaw and Verna Yiu for telling Smith to get the jab and wear a mask in public. They trampled Smith’s right to be pointlessly selfish and stupidly ignorant. How DARE they expect Smith to be a responsible adult?!?
Even worse, Smith is the chosen spokecreature of the ignorant right—because she’s one of them. That’s how she won the leadership of the UCP, now TBA, Party.
Rule Two: Understand the existing organization before you create a new one
Why? All Smith needs is a plan. She’s not smart enough to make this plan herself, so that begs the question: who wrote this garbage? We might find some clues in the list of lobbyists who’ve been infesting the Legislature since Smith became leader of the UCP. Anyone want to bet the list is a who’s-who of long-known privatization shills?
Rule Three: Establish short- term and long-term metrics
Short-term metrics? Oh, please. That’s like counting the bricks as the wrecking ball bashes them loose. Why bother when the whole thing’s gonna be knocked flat? As for long-term goals, that’s easy. Sell it off at fire-sale prices and brag about how much you’ve reduced guv’mint spending. Win-win, right?
Rule Four: Identify and mitigate risks
The first three are only system-related “risks” if they don’t happen fast or badly enough. Fragmented delivery: feature, not risk. System disruption: enabling feature, not risk. System failure: this is the whole point! Break AHS like a mirror dropped on a flagstone floor, say it’s impossible to fix—and sell the pieces!
The true risks can be summed up in a single sentence: “Dammit, they’re onto us.” Public outrage might delay the plan and scare off potential buyers. (Remember when Jason Kenney tried to sell provincial campgrounds? The plan failed because—wait for it—nobody wanted to buy them!) We might mitigate some of the damage if we all shout loud enough. I hope.
Conclusion: We’re screwed
So that’s it. As a survivor of multiple reorgs in a Crown corporation (Alberta Research Council and its descendants), I can say with confidence this is the most blatantly bad abortion of a reorg that I’ve ever heard of.
Rube Goldberg would be proud.
Mike J Danysh: I have to agree with your comments. Danielle Smith isn’t smart enough to do this all by herself. Maybe Preston Manning has given her advice on this? Come to think of it, he isn’t that smart either. His covid report still isn’t made public, and at this point in time, I’m skeptical that it ever will be. He is the recipient of $253,000 from Danielle Smith to provide that report. In addition, he happens to support the carbon tax, which the UCP are claiming to be against, but they increased the carbon tax Alberta has, greatly. Furthermore, his behind the scenes advice to get Danielle Smith and around 8 of her Wildrose MLAs to cross the floor to become part of the Alberta PCs, led by Jim Prentice, made her get a whopping defeat in 2015. When you give someone the wrong advise, you are given a big reward. That’s as backwards as it gets. What Danielle Smith and the UCP are doing is running a dictatorship. They are pushing things that they never campaigned on, that wouldn’t pass the electorate, if they were part of the provincial election agenda. What I believe may come from this is the CPC will meet their demise, because Canadians will not agree with the things Danielle Smith is pushing for Alberta. They would oppose Pierre Poilievre grabbing these ideas and implementing them on a national level.
Dwayne, I wonder what goes through Smith’s mind. First she fired the AHS Board and appointed Dr John Cowell to fix AHS in 3 months. The fact she even thought this was possible tells you a lot about her judgment, it’s not like AHS is her husband’s restaurant. Then she decided tinkering with AHS wouldn’t get the job done so now she’s going to rip it apart and rebuilt it from the ground up.
No rational business person would swing from a few little tweaks to burn it down and start again in less than 6 months. What’s going on in her head?
Thank you Michael: I certainly agree with your comments as well. The UCP seem to be an ecumenical descendant of the “know nothing” party in the 1850s US. Instead of seeing Catholics and Jews under every bed plotting to take away their freedom, they now see modernity, environmentalists, and scientists as the enemy of their freedom to be ignorant and destructive.
We had a cohort of “know nothings” on the prairies during the collapse of capitalism in the 1920s and 30s as well.
https://en.wikipedia.org/wiki/Know_Nothing
Yes, I came across that Wikipedia entry myself, more or less by accident. The parallels are disturbing.
I’d say it’s even worse today. The historical “know-nothings” were supposed to reply to hostile questions with “I know nothing of this.” Now, it’s a badge of honour among extreme-right yahoos to be ignorant.
Alberta has more than its share of such.
They’re driving the bus towards the Grand Canyon and are getting angry at the people pointing it out to them.
Thanks Kelly, I laughed out loud at your comment.
But it’s gallows humour. Smith and the UCP/ TBA/ Free Alberta Fantasists are mad at us–because we’re paying attention.
Could not agree more Mike
We are paying attention alright.
She has to realize that half this province does not support her and we are paying very close attention.
Carlos, the entire country is paying attention. First the “Tell the Feds” campaign re: electricity emissions regs, then the APP campaign, and now this. Today’s Globe and yesterdays Toronto Star carried stories about it. The headline in the Globe asked whether this restructuring was simply an act of revenge. (Which it is.)
You are absolutely right Susan.
All of this is a distraction to slowly change to their dream paradise of private enterprise full control of the citizens and stablish an irreversible far right mythological space.
People can call me whatever they want but I have past experience which unfortunately many Canadians do not. We need to take all of this very seriously and battle them back as much as we can because we are fast getting into a cull de sac and believe me Parker knows exactly what he wants. Unfortunately we are just naïve fish in the toxic river.
I am expecting the worse from this UCP cabal. This is not a political party. This is a cult and they know how to navigate the waters so well that even the NDP is fast loosing touch with it.
Rachel Notley is great but again she is not doing what she should. The NDP needs to find ways to stop or arrest their so far no obstacles road to their freedom.
Pay attention or we will all be victims. I know people laugh at comparisons with Hitler times in the 1930s but pay attention because times are different but just look at the US.
They are running a serious and factual risk of loosing their democracy. This is not a joke. If Trump wins next time he has been very clear as to what he is going to do. One of the scariest ones is to have the FBI going after the democrats. Do you doubt he will? I do not. What is even more horrifying is that half the Americans want that. The same applies in Alberta and if we sleep we loose.
The times when Parker was not even on the horizon because all he said was just lunacy is over. He is winning and he will do what he wants. He already has full control over the cult. It almost sounds like the cult in Guiana or whatever it was where they all got convinced to commit suicide.
Daniellezebub has had a hate on for AHS since before the 2012 provincial general election. The Wildrose Party she then led had a platform that advocated the breakup of AHS a scant three years after it was formed — https://www.poltext.org/sites/poltext.org/files/plateformesV2/Alberta/AB_PL_2012_WA.pdf — see page 78 of the PDF file.
Those of us working in the system lived through multiple reorganizations in the 1990s and 2000s, leading up to the formation of Alberta Health Services in 2009 (announced in 2008). Every time this happens, those of us working at the point of care would continue doing the day-to-day work of caring for our patients. But when it comes to trying to make the system better, every restructuring leads to a prolonged period of decisional paralysis, as middle & upper management & executive-level leadership figure out their portfolios, their budgets, & their priorities. This happened with the initial round of regionalization in the mid-90s, then again as the then 17 Regional Health Authorities realized that their first org charts were ineffectual.
Then again in — was it 2003? — when the Regional Health Authorities were merged into nine, at the same time abolishing elected RHA Board seats. Then again in 2008-09, as AHS was built from scratch, a new Board appointed and a CEO hired — the unlamented Dr Stephen Duckett (he of the “can’t you see I’m eating my cookie” fiasco). A few years after his departure, the AHS Board got into hot water with the government over senior executive compensation, and the entire Board was dismissed by the Minister, putting the lie to any claims of “arms’-length governance” at the province’s largest public agency.
We didn’t really see stability at AHS until the election of the NDP government in 2015. Health Minister Sarah Hoffman reconstituted the Board of AHS, and the Board hired Dr Verna Yiu to be CEO. Things ran along relatively smoothly until the pandemic hit in March 2020. Then, the wheels didn’t just fall off – they were unbolted and tossed aside by Tyler Shandro and Jason Kenney.
So now, they once again want to break it up, and this time they are in government and can do it. We will still do our jobs, but woe betide anyone who thinks they have an idea to make things work better for patients: nobody with the power to implement such ideas will know what their job will be a year from now and will be too busy polishing up their cvs to take any action.
Jerrymacgp, you and your colleagues went through far more hell than we did at ARC. I’m sorry to say it ain’t over yet. Smith’s new Goldbergocracy will suck up so much money there’ll be none left for patient care—especially after the inevitable budget cuts. My sincere sympathies.
Earlier this year I read a political-science book called “Blue Storm: The Rise and Fall of Jason Kenney.” (Duane Bratt, Richard Sutherland and David Taras, eds. University of Calgary Press, 2023.) It’s a collection of essays by familiar names like Duane Bratt, Jared Wesley, Gillian Steward, Melanee Thomas and Graham Thomson. There are two sections, comprising six essays, on “Health care, education and public sector policies” and “Covid in Alberta and Ontario.” None of the six authors are complimentary of Kenney, as you can well imagine.
Colour-contrasting footnote: In 2019, Bratt et al had published a similar volume titled “Orange Chinook.” It was about—you guessed it—Rachel Notley’s astonishing election victory and subsequent government. It’s interesting to note that “Orange Chinook” contained NO essays on health care in Alberta. The editors thought none were needed.
jerrymacgp: thanks for this excellent review of all the machinations our healthcare workers have had to endure. I knew someone who had a huge aquarium full of saltwater fish. They were beautiful and very aggressive if a new fish was introduced to the tank. So before a new fish was put into the tank this guy would move all the ornaments. The bubbling diver was shifted to the other side of the tank, the treasure chest was relocated under the fake ferns and all of the fish were so busy looking for their favourite hangout spot that they didn’t notice that a new fish has joined them.
Sometimes I wonder whether Smith is busy rearranging the ornaments in the tank so we won’t notice that she’s dead serious about her Free Alberta strategy.
Mike J Danysh Thanks for this excellent discussion of the Rules and the Blue Storm and Orange Chinook books, your comment about the discussion or lack thereof of healthcare was interesting. Made me wonder whether it’s the real canary in the coal mine.
Remember back in 2005 when Ralph Klein introduced The Third Way (the slide deck was leaked to the Opposition, this time the Liberals, in a plain brown envelop). The Third Way was going to yield tremendous benefits by introducing competition (private healthcare funded with public dollars), responsibility (patients shoulder part of the cost) and freedom (to choose private healthcare if you can afford it). The public went nuts and Klein was forced to back off a bit.
Perhaps we can do it again.
The Wildrose Party had similar plans in their 2012 election platform, with noise about “competition” among hospitals and “more choice” for “clients”. The utterly wrong-headed idea of “market forces” in health care lives on.
I should have referenced jerrymacgp’s link in his comment, above. That’s where I learned that Danielle Smith’s old right-wing screwball party hated the AHS as much then as she does now. Apologies for not making that clear earlier.
Silos, snouts in troughs — this is the handiwork of the United Farmers of TBAlberta.
Albertan: Yep, nailed it!
Susan: Here is my second song pick. This is a George Harrison composition, from The Beatles, While My Guitar Gently Weeps. Eric Clapton is a guest guitarist on this track. It was released in 1968. I did see Eric Clapton live in 2007, and he is in my music collection.
The late Canadian blind blues guitarist Jeff Healey did a highly creditable cover of this song — it’s so good, in fact, that I’d be hard-pressed to decide which version I like better, his or the Beatles’ original.
Then there’s the live tribute performance at the 2004 Rock & Roll Hall of Fame induction ceremony, with such musical luminaries as Tom Petty, Jeff Lynne and Steve Winwood, along with George Harrison’s son Dhani and Prince. Prince’s blazing guitar outro was a surprise to me: never a fan of his music, I had no idea he was such a skilled axeman.
jerrymacgp: By a strange coincidence I came across the Prince clip a few days ago under a heading “that time Prince forgot he was a human being for three minutes.” or something like that. Amazing.
Dwayne, great choice. So many telling lines in this song including: “I don’t know how someone controlled you/They bought and sold you ” Isn’t that the story of Alberta.
I didn’t know (or maybe I forgot) about Eric Clapton appreaing on this track.
Thanks.
Susan: Here is my final song pick. Given what’s going on in the world, I thought I’d share this song by The Doors, The Unknown Soldier. It was released in 1968.
Dwayne: as you said, Very apt given what’s going on in the world.
You know as I listen to these songs I can’t help but wonder whether “modern” songs are as insightful and hard hitting as they were way back then. I really can’t say because my radio is tuned to classical more than anything. What do you think?
Susan: I do like classical music a lot, and my favorite classical composer is the Hungarian composer, Brahms. Certain newer artists and bands are raising awareness of important issues, but not as much as before.
Dwayne, that’s a good point about the newer artists/bands.
PS I like Brahms, Debussy, Chopin, all the old classics. There’s an opera song, Lakme: The Flower Duet that gives me chills every time I hear it. Here’s the link https://www.youtube.com/watch?v=MfcXCobbRzE
Well, it looks like a straight out privatization scheme, masked as a re-organization of health care…which is the intention all along. It’s an old carny trick…which cup is the pea under?? Sad that a lot of Albertans fall for this slight of hand.
Paul I think that’s a very real possibility. This reorg goes against all the research that says healthcare must be integrated in order to treat the whole patient; instead they’ve carved up AHS into four functional silos which makes them easier to sell off to the private sector.
Good column Susan! As another commentator said it was like deck chairs on the “Titanic “ I think we have added more chairs and another band. They are firmly committed to make things worse.
David, thanks. I know you’ve been involved in some huge reorgs in your day as well. As we all know, they’re difficult even when they’re well planned out, that’s not the case here, this one is going to be a disaster.
Well if you think about it, is it not what they want? They will cause a disaster and then SALVATION the private choice. These people love resurrections and the second coming and all that jazz. It is in their DNA
Yes, Carlos, it’s a tried and true method we’ve seen unfold many times in the good ol’ U. S. of A as well.
I think I can identify the universe for you Susan…it’s the little self contained galaxy of the ultra conservative faithful.
It took me awhile after coming to Alberta to realize that a lot of the silences in conversations, and the dismissive tones if anything untowardly progressive was mentioned……came from the conservatives universe. In this universe, everyone has the answers already and they are self enforcing.
That’s why they could throw out an evidence based, expert consulted curriculum the Notley government had spent a of time updating, and substitute a better one put together by a few old conservative men. No need to consult teachers, that might cost money and lead to unnecessary complexity. Old men in high places have the answers at their fingertips and know how to ‘cut through red tape’, while creating do nothing boards of gatekeepers grateful for their substantial salaries to the Conns in Power,
Conservatives have been stacking boards for decades….and this latest brainwave was likely already waiting in outline at least at the Manning Centre for the UCP win. Unfortunately, Albertans delivered……..as they have as long as I’ve lived in this one size utopia. She has four years to gut our provincial health care system and lead the way for Canadian entre proners………out of universal medical care and into the waiting arms of the American private medical establishment.
The number of new cushy positions, created by this slide deck of ‘reform by board room appointment’ is substantial. This party may talk red tape cutting, but what they do in power is something quite different. Useless Board Room Stacking we might call it.
I’m open to a better name, but its way past time we named it. When the NDP were in power we learned to our dismay how many of our agricultural marketing boards were bleeding money to big whigs who didn’t farm, but were making more money than most farmers……chizling off a bit of every side of bacon and bushel of wheat farmers sold.
We’re about to see the same top heavy do nothing gatekeeping scheme implemented in our health care system. Very soon we just won’t be able to afford it, and will have to sell off at bargain basement discounts….to the gawdawful PRIVATE PROVIDERS.
The “plan” appears to be a ripoff of Mike Harris’ Ontario Hydro plan; create a bunch of new private corporations to “fill” the spot of the provincial system you’re getting rid of, and claim that the corporations will run more “efficiently” because they’re private. Then, in a few years when people are paying more money for worse service, shrug and say you have no idea what the issue is.
Kelly, I think you’ve nailed it with this comment. Why anyone thinks the private sector which is focused on the profit margin more than anything else will do a better job is beyond me. Have these politicians never worked in the private sector or are they just too willing to sells their souls in return for staying in power.
Ingamarie: So many good points here,. I really liked “Useless Board Room Stacking.” Seems to me we have too many old men who just missed the mark. People like Jim Dinning who appears to be suffering from “I coulda been a contender” syndrome. They competed for the highest political office in the province, missed it, and now in their dotage are lending their credibility (what little is left of it) to Danielle Smith’s hairball schemes in return for a seat on the Board. Sad…and dangerous.
Opportunistic is also the politicians game
Most of us only see the tip of the Board Room Stacking iceberg……….but if we watch closely as Smith ‘restructures’ our health care system, we’ll see lots of appointees….to these new boards. We can check out their background, their level of expertise, and the ‘honorarium’ they are collecting.
It’s called “following the money’ I believe.
Ingamarie…I was looking at the Fair Deal report the other day, it was lead by none other than Preston Manning, who as we all know led the covid/public health inquiry and god knows how many other inquiries for Smith and Kenney. To paraphrase something someone told me the other day, these old guys don’t retire, they decompose.
Standard Conservatives. You see the same shit from Pierre, and saw it from Erin and Andrew before him. They’re REALLY good at pointing fingers but they never have any actual solutions to fix anything… Well, okay, they have one solution, “cut taxes”, which ALWAYS exacerbates whatever problems are occurring. Then they can propose cutting the social safety net as a “solution”…
Exactly Kelly
Cutting taxes to get votes and then cutting back social programs to balance the budget.
Because most of them have no empathy, it really does not natter to see the misery on the streets. Just send the police and put them in jail. If the jails are full then easy peasy, release them and they will reoffend and go back in. They rarely are the victims so it is a great solution.
It has been the theory for the last 3 decades and despite not having worked at all they are so darn brainwashed by their own slogans and just continue doing the same. It is what Einstein called idiots.
People of faith my friend….people if faith. Just because it doesn’t work the first time….or the tenth….is no reason to criticize the good intentions of the followers of the Lord.
And going easy on the sinner is no solution and certainly doesn’t keep our excellent penal system running. e
If the poor did not exist, how could the servants of the Lord practice their charitable acts???
I read this really nice article on DailyKos about how Evangelical Christian conservatives tend to think: https://www.dailykos.com/stories/2023/11/12/2205331/-Inside-the-Mind-of-one-Evangelical-Republican-Voter
In their view, the social safety net is evil because it’s helping people solve problems from God himself and when God throws problems at people, they’re supposed to solve them alone. Anything that would require the involvement of more than one person is outside of the purview of humans and so any human attempt to help is trying to overthrow God’s authority and is thus pride.
Kelly, thanks for the link. Fascinating, nihilistic, and downright incomprehensible.
Ingamarie that made me laugh.
It reminded me of different times when I was a young kid and the rich ladies in town would get together in CHURCH of course and would run this one lunch for the poor kids so that they had a chance to avoid being like their parents and had a better future. The only problem is that their parents were all working people, employees of the same ladies businesses.
Very Christian gesture!!
Carlos, that story nails it in a nutshell. Thanks.
Yes. And many of us are the tax whiners and cheats that fall for the bait.
Imagining that for profit providers are going to do it cheaper leads to the abandonment of our elders who died in their own excrement during covid….not to mention to the exploitation of men and women of colour…..who had to work at more than one long term care centre…..because the creeps who ran these privatized gulags keep them at part time…..so said creeps don’t have to pay benefits.
The worship of Money has only one outcome: a feudal reboot with a few very wealthy aristocrats and a vast majority of working poor.
But hey!!!! LOW TAXES SEEM WORTH IT…in Alberta anyway.
Hi Kelly, thanks for the link. The twists and turns of the religious-right mind are disturbing.
One fun follow-up from the comments I’d like to share is “social-emotional learning” or SEL. One commenter said it’s “a godsend for autistic kids, kids with behavioural problems, and really any kids who could use some extra help learning how to get along with each other.”
https://en.wikipedia.org/wiki/Social%E2%80%93emotional_learning
Sure seems to me we could use this in Alberta’s grade-school curriculum—and as a remedial course in adult learning, too. Of course, Republicans hate it.
Slide is an apt name for this. Our health care system is on the slide out of free healthcare no matter what Danielle (DeSantis, Trump) Smith says!
A reply to Kelly Miller re standard Conservatives:
Hi Kelly. Alberta, Saskatchewan and Ontario have become more Americanized ever since the rise of Stephen Harper’s Conservative Party of Canada. Alberta’s always been more Yankeefied than other provinces, because of an early-1900’s policy by the Federal government of enticing American farmers to the prairies. Something about too many eastern European peasants coming here.
Albertans have been “tax-averse” (quoting Trever Tombe, among others) for decades. We must be the whiniest bunch in Canada when it comes to paying taxes. The “no more taxes!” chorus is loudest among businessmen—no surprise there—but boy oh boy do they demand free guv’mint money when times get tough. Gotta save them businesses! Gotta protect them jobs! Gotta increase them stock options! (“Oooo, did I say that out loud? Everybody just ignore that.”)
Ralph Klein was the first Canadian politician to prove you could slash government services—and get re-elected for it. At that, Ralph was 10 years behind the times. Ronald Reagan did it in the ‘80s. Every Canadian Con since has tried to out-do his predecessors. Stephen Harper was the first federal politician who was blatantly Republican. His only majority government was too much for Canadians to stomach—which is why we got Justin Trudeau instead. (Not that Justin’s been much of a prize; he’s about equally pro-business and Establishment as Harper was, just less mean about it.)
The Republican party has oozed into Canadian politics the way slime oozes into a paper towel. Before Trump, the Republicans/ Tea Party were controlled by American billionaires—the Koch brothers and their many fellow-travellers. Those rich guys spent 50 years gradually pushing their anti-government BS on Americans—and it’s worked. Trump is an extreme example (remember “drain the swamp”?) but he’s also the extreme end-point of the anti-tax, anti-law propaganda.
Now it’s in Canada, too. Danielle Smith, Scott Moe and Doug Ford—to say nothing of Poilievre!—don’t believe in “government.” They break things. They build nothing but chaos. Ford’s Greenbelt scandal was old-fashioned pork-barrel politicking. Scott Moe was mostly a mini-me to Jason Kenney, but his latest “parental rights” noise may become something worse. Danielle Smith…well, she’s full-on Trumpie Qanon crazy.
Smith may not consciously intend to, but she’s put us on a path to negate Canada’s greatest strengths. Confederation was built on cooperation. Since the late 1940s, Canadians built a nation that promoted the welfare of everyone (well, theoretically. It’s not ideal, there’s a lot of work to do, but—till recently—we’ve been trying). Danielle Smith swallowed American libertarian BS whole. David Parker’s a rage-farming empire-building “strong-man” wannabe. Barry Cooper’s “Free Alberta” fantasy makes him a legend in his own mind. (I wonder if Cooper wants to be crowned king?) Among them, they’re gonna wreck this province. It’s up to us to make enough noise to at least slow them down.
I’m actually from Ontario, and you’re right about Doug Ford; one of the major reasons he got re-elected is that he showed the areas between the big cities in the corridor that if they voted for him, he’d take shots at Toronto and Ottawa for them, and they have ENTHUSIASTICALLY jumped in with both feet for that. And it’s a Trumpist move; tel the suburban and rural voters that the urban areas are the source of every problem ever.
Us-vs.-them politics is an old, old game. Jason Kenney played it a little too well and “us” decided Kenney was actually “them”–and kicked him out. Doug Ford is better at it (he hasn’t lost his job yet).
Danielle Smith is playing a variation of the game. Her politics is “us alone count.” For Smith, “them” are beneath her notice, unless “them” become a threat.
“System failure can be difficult to overcome.”
–the 2005-ish PeopleSoft implementation manual
difficult to overcome, but far too easy to initiate….
Morbeau: succinct and very accurate. Thanks.
Forgive me for being ignorant….healthcare in Alberta was always supposed to be arms length from the Government…having cabinet ministers and deputy ministers running the show sickens me. Healthcare is not a business. It is a right of every Albertan to have it when we need it. It should operate on a zero based budget. Instead it will be fat cats who know nothing about what they are doing running the show. Talk about micromanaging…
It would behoove the minister of unhealth to read the myriad of healthcare studies that have been done by consultants over the years…the problems are the same, nothing has changed, except the unhinged clown party is more unhinged and the pretend premier’s tinfoil crown is affecting her brain. And does she think privatization is a good idea? Well we will lose our transfer payments from the feds. It may not matter to the Queen of Alberta but it sure matters to me.
‘And does she think privatization is a good idea? Well we will lose our transfer payments from the feds. It may not matter to the Queen of Alberta but it sure matters to me.’
Loved your comment – It matters to me to.
Hi Sharon. Generally, Crown corporations are supposed to be separate from the current Government (regardless of party). However, they’re always subject to review and supervision by the relevant Minister. The Minister isn’t supposed to give orders directly to the CEO, but he can give instructions to the board of directors. In exceptional cases, the Minister can intervene in the governance (maybe even operations) of the Crown corporation.
My experience with the Alberta Research Council may be relevant. A very unpopular CEO in the early 2000’s had a watchdog sicced on him by the Minister (names withheld because I don’t want to be sued). However, 10 years later an incompetent CEO who wasted millions of dollars on an unproven “corporate structure” didn’t even get a smack on the wrist.
The worst aspect of Danielle Smith’s destructive plan is the amount of control she’s apparently granted herself (oh, and Adriana LaGrange, too). Bad as the implications of this four-way split are, the idea of Smith being able to give orders to the AHS remnant organizations is frightening. This is the woman who got mad when Dr. Deena Hinshaw told everyone to wear masks and get the Covid vaccine. Now she’s taking her revenge on the entire health care system. Even without Smith meddling directly, this will be a disaster.
One thing for absolute sure Ms Wright.
No damn doctor in Alberta is going to be taking a dressed chicken, a box
of brown eggs, and, a quart of High River Hooch in lieu of dollars for
his/her services!!!
Dem days [daze] are lonnnnng gone.
Sincerely.
Gord -Peterboro ON
As if we needed any more warnings, and remembering that Kenney’s and Smith’s governments both signed contracts with private surgeries, this news from Ontario:
https://www.cbc.ca/news/canada/toronto/ontario-doug-ford-private-clinic-surgeries-fees-hospitals-1.7026926
And a reminder of just how bad Smith is at governing, courtesy of Ms. Soapbox:
“The latest contract with Canadian Surgery Solutions was signed on Jan 1, 2023. It has a 6 year term, requires a minimum number of surgeries per year and has the most onerous termination clauses I have ever seen.”
Tell your acquaintances who think Smith will save us that they’ll be paying for health care NOW, and they’ll be paying LATER, too.
Lovely column and your points are spot on. This seemingly central provincial Conservative off-the-spectrum bete noir cycle of health care administrative model experimentation and health care administrator pay scales has been going on since the early 90s. Smith herself has been hammering away on this since 2000 in columns she wrote in the Calgary Herald.
Believe someone when they tell you who they are the first time!
None of this buggering around will make a whit of difference on waiting times, patient care outcomes, nurse/doctor workloads/morale, staffing shortages in facilities around the province, elder care etc.
It will “prove” that public delivery of services “doesn’t work” and more and more procedures will be de-listed and moved to private service delivery providers (all PC insider buddies – natch!).
Oh yeah, there is a Fed-bashing element coming here too – the base has to gets its outrage trough filled on this issue – so look for a fight to picked. *sigh*
Keep the eyes on the prize folks, take deep calming breaths, organize – 6 seats in 4 four years. 6 seats!
Lots of excellent comments, those who read your blog Susan already know the answers to ‘why’ Smith & crew are reorganizing health care. Starting of course with rewarding UCP faithful with lucrative positions at public expense on the many new committees/boards. Plus when ‘carve out’ or ‘privatization by any other name’ is being done, wonder just who will get the pick of the health care goodie crop in lucrative ‘contracts’? Any bets that said bidders will be UCP approved supporters/cronies?
One thing I must say. Health care is not ‘free’. It is funded by our tax dollars. Further, in order to get more than basic health care one needs to purchase additional coverage. Take the basic Seniors health care benefit in Alberta. It covers some 2,000 drugs – many of which must receive pre-approval or that cost won’t be covered – a ground only ambulance ride to a hospital/primary medical assistance centre/clinic BUT not to any other facility like a nursing home/long term care. Air ambulance is NOT covered. Also, no vision care or dental care unless one qualifies for low income assistance in same, which must be applied for & proof of income provided. A single senior whose income is more than $31,675 doesn’t qualify for any assistance; a couple whose household income exceeds $63,350 ditto. Benefits are reduced once your base income exceeds $29,631 for a single senior; double that for a couple. One surprise is that the basic Senior’s health care benefit does cover some chiropractic care. Up to $200 per annum at $25 per treatment to the maximum allowed.
Like other commenters I expect this latest health care reorg to be a complete disaster from the public point of view. About the only silver lining is that when the UCP succeeds in privatizing health care there is at least a chance that health care workers will receive higher compensation than they do now in the public system. Unpaid overtime would presumably cease to occur. Certainly that was reported to be the case during Covid, where hospitals in Canada were hiring additional staff from private firms due to medical staff shortfalls in the public system which cost considerably more than what they paid their regular staff. Not a few medical staff who had made the switch to a private firm mentioned that being able to control their working hours as well as higher compensation was why they’d left the public system.
It has been exposed that Doug Ford in Ontario is paying the for profit surgical units 2 to 3 times what he pays the public system for the same procedures. Does anyone out there know what Smith is paying the for profit surgical units compared to the public????
This looks like a job for…Charles Rusnell!
Manning’s report was released today
https://open.alberta.ca/publications/public-health-emergencies-governance-review-panel-final-report
https://nitter.net/cspotweet/status/1724850935283986713#m
For a while, during the election, Smith had a a number of people believing she wasn’t going to do anything too disruptive to health care. Like Kenney before her, she tried to sound reassuring during the election and saved the disruptive and vindictive change for shortly after.
Kenney had his war, initially focused on doctors, but there was a lot of hostility to other health care workers too. Now Smith seems to be at war, focused currently on AHS, but no doubt there will be a lot of collateral damage to the rest of the health care system.
It seems to be the conservative cycle – sound reassuring during election and then go out and break or damage the health care system after. It has been repeated many times in Alberta, even by other conservative governments before the UCP. At this point, I’m not sure why a number of voters still fall for it.
Dave, this is a very interesting question. Indeed, why do so many voters continue to vote conservative given that their politicians are more likely than not to hide their real agendas. Erin O’Toole hid his more moderate leaning when he was running for the leadership of the CPC and they got rid of him. Smith has lied about no one touching our pensions and I’m pretty sure her promise that the AHS breakup is not a prelude to more privatization and yet here we are.