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Private delivery of public health: an idea that's dumber than a sack of hammers!

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As long ago as the Ralph Klein regime, cynical conservative politicians from Alberta who wanted to privatize our public health care system have talked up the notion that private corporations do a bang-up job delivering "publicly funded" health care.

Indeed, when the "publicly funded" mantra starts coming out of the mouth of an Alberta politician nowadays it's a certain sign a pro-privatization pitch is next on the agenda. In the Albertan context at least, the phrase has come to be code for "provided for a profit."

The long-term objective, of course, is to get rid of the whole crazy idea of fair and cost-effective public health care provided at public expense and replace it with a system that makes a few people (i.e., them) very, very rich and to hell with the rest of us. But, since Rome wasn't wrecked in a day, the acolytes of the market fundamentalist cargo cult are always willing to chip away at things a piece at a time.

So, back in 1996, when King Ralph reigned in the Legislature and all was right with the world, the brain-trust that ran the Calgary Health Region decided to close down the Salvation Army Grace Hospital -- which hitherto had specialized in women's health programs -- and allow a private, for-profit surgical corporation to set up shop in the formerly tax-subsidized facility. (These are the same brainiacs now collecting multi-million-dollar pensions at taxpayer expense, but never mind.)

Operating (as it were) under the name Health Resource Centre, the company provided hip, knee and ankle surgeries to paying customers -- mainly the health region. Calgary hospitals that couldn't be sold off to private surgical groups in this era, of course, were blown up to make way for expensive condos.

Fast-forward to 2010, and the facility was doing about 1,000 publicly funded surgeries a year. The Calgary Health Region was no more, Premier Ed Stelmach's government having eliminated health regions for political reasons and put their highly paid execs out to pasture on luxurious golf courses throughout Canada’s national parks. But Alberta Health Services, the huge province-wide health region that replaced the CHR, depended on HRC pretty heavily to get it through Calgary's annual allotment of broken hips, knees and ankles.

Mind you, there was no saving to taxpayers doing publicly funded health this way. In 2004, hip and knee surgeries done by HRC cost an average 10 per cent more than the same surgeries done in public facilities -- $8,690 each, compared with $7,900.

Meanwhile however, despite all this money being paid, apparently not all was well behind the scenes at HRC. On April 30 this year, Alberta Health Services announced that it had asked the courts to appoint a receiver to oversee the affairs of the company during bankruptcy proceedings against its corporate owner, Networc Health Inc.

It's unusual for a public agency to try to impose a receiver on a private-sector bankruptcy proceeding, but the situation appeared to be desperate. Thanks to its reliance on the benefits of private delivery of publicly funded health care, the province had put itself in a position where it might not be able to deliver an essential surgical service.

The courts said OK, sort of, and gave the health board a week of its receivership request -- that is, until yesterday. The week of receivership alone cost Alberta taxpayers a quarter of a million dollars.

When the health board went back to court yesterday, the judge said they could continue the arrangement -- and the surgeries it allows -- until Jan. 15, 2011. The bill for taxpayers of this extension? Nearly $3 million extra -- $1.3 million for a bank charge, $600,000 in receivership costs and rent of $114,000 per months to keep the insolvent private hospital afloat. This, of course, is on top of the cost of the surgeries, which will continue as before, not to mention the cost of building new surgical facilities to take over the work.

Now, what's wrong with this picture is pretty obvious and doesn't really need to be belaboured. Private delivery of publicly funded health is more expensive (you've got to cover those profit margins), less efficient, completely opaque and unaccountable to the people paying the bills, and subject to bankruptcies and all the other usual business tomfoolery. In other words, it was a stupid idea from the get-go.

If we Albertans had an ounce of sense, we'd never, ever do anything like this again.

But don't expect that to stop Alberta Health Services, the governing Conservatives, and at least one of the other opposition parties with seats in the provincial Legislature to go right on touting the private delivery of publicly funded health care as if it were the greatest thing since marmalade on sliced toast.

Talk about your Alberta Advantage!

This post also appears on David Climenhaga's blog, Alberta Diary.

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