What’s wrong with Ralph Klein’s 
plan for reform?

Faulty Assumptions – Almost all the recommendations in the Mazankowski report are based on three faulty assumptions: first that health costs are out of control; second that patients are abusing the system and need to be "disciplined"; and third that privatization would save money and improve efficiency. However, there is simply no evidence to support any of these beliefs.

Shifting Costs – The Mazankowski commission talks about the need to increase efficiency in the public system. But the recommendations aren’t really about controlling costs – they’re about shifting costs from the public system onto individuals. So, the Alberta government may succeed in reducing the amount of tax dollars spent on health. But individuals will pay much more – in the form of increased premiums, supplementary private insurance and charges for de-listed services. This is a classic case of "robbing Peter to pay Paul."

Penalizing the Sick – The real victims of the Mazankowski plan for reform will be those Albertans unfortunate enough to get sick or injured. Under the commission’s schemes for Medical Saving Accounts or Variable Health Premiums, people with serious health conditions would quickly exhaust their accounts and be forced to dig deep into their own pockets. This is exactly the kind of scenario that Medicare was supposed to eliminate.

Discouraging Necessary Treatment – Another big drawback of Medical Savings Accounts is that they give people a financial incentive to delay seeking medical attention. People will put off seeing a doctor until their conditions worsen. When they finally do seek medical care, treatment will be more complicated and more expensive than if they had gone earlier. Significantly, the people who will face the biggest barriers will be the same people who need medical attention most – the poor and the elderly. The Mazankowski plan will punish these people – and favour the young, the healthy and the wealthy.

Increased Costs for Business – In Alberta, many employers cover the cost of Medicare premiums for their employees. So, if the government doubles premium rates, they will also be adding a substantial cost to businesses in Alberta. This problem will be compounded if health services are de-listed: employers will then have to start forking over cash to cover the cost of private, supplementary insurance for their workers. Taken together, these changes will add up to a huge erosion of the so-called "Alberta Advantage" for businesses in the province.

Violating the Canada Health Act – Both the Mazankowski Commission and the Alberta government have been careful to avoid the phrase "user fees" – which they know are prohibited under the section of the Canada Health Act guaranteeing access to necessary health services. But the "variable premiums" and surcharges for costly procedures that are being proposed are user fees in all but name. This is a clear violation of the Canada Health Act.