MINISTER'S ADVISORY COMMITTEE ON HEALTH

Survey Introduction

Laying the foundation for legislative reform

A message from the Minister's Advisory Committee on Health

Alberta's health system is governed by a complex web of legislation, regulation and contractual agreements. Some of our legislation dates back to the early 1900s and has become a barrier to improved care and innovation. (The legislation was a deliberate barrier protecting against privatization!)

That's why the Minister's Advisory Committee on Health is examining what an effective and responsive legislative framework could look like in today's – and tomorrow's – context.
Alberta's health system needs to better consider a patient-centred approach that places wellness, good health and the prevention of avoidable illness and injury in the forefront.

We need support for a broader array of health providers and health care settings. We have new care facilities, new health providers, new technologies, and new ways of providing care – Alberta needs renewed legislation that keeps pace. (New Health Care Providers are US style insurance companies on the march into Alberta and Canada)

Legislation can be a tool for transforming our health system. So how can we reshape our legislation in order to put the focus on wellness? How can it help us put patients' needs first? How can we capture the best that innovation can offer? And how do we do that while respecting and complying with the Canada Health Act and our desire for a publicly-funded, patient-centered system? (They have told us they intend to change the Canada Health Act so it conforms with their ideas of private medicine practice and coverage!)

Survey guide
• Please read the following guide before completing the online survey.
The need to update health legislation in Alberta (And in Canada!)

The Minister's Advisory Committee on Health met on two occasions to discuss what principles and themes a new health legislative framework should address. As a starting point, we would like to offer the following thoughts and ask for your input.

Albertans value a strong public health system. They want to know that they can access health services when they need them, regardless of income. They want a health system that delivers services in better ways and uses technology to improve outcomes. However, today's system has legislative and regulatory barriers that limit choice and prevent change. (Again, shylocks using verbiage to do away with the Canadian standard for health in a public system!)

For example:

• A funding structure that pays for prescription drugs in a nursing home but not in an assisted living or home setting;
• Barriers to enabling health providers to use all their training and competencies, for example, in primary care settings; (stopped now by funding and soon to allow hospitals to take on US patients in our hospitals!)
•
• Models that firstly fund and focus on care in hospitals and secondly at home or in the community; and (Take a lien of your home before treatment is offered)

• A fee structure that makes a routine prescription renewal a medical event rather than something done by a pharmacist. (Have you ever put up with the half hour lectures and arguments by a pharmacist to get even a physician prescription filled?)

This arises because historically, health legislation – and the system – has been organized primarily according to specific facilities or settings (e.g. hospitals, nursing homes, etc.) or providers (e.g. physicians) and focused more on the treatment of disease and injury than on wellness and prevention. (The structure of the legislation has been set up to stop publicly funded and built institutions from being used by private coverage to treat their patients-as in the case of looking for US insurance business for their Cardiac and other converges; Canada hospitals are public funded and cheaper than the comparable US hospital. Canada would be a savings for US insurance)

Today, we see health in a broader social context, more in line with the determinants of health as laid out by the World Health Organization, namely, that the things that make people healthy or not include their income and social status, education, physical environment, social support networks, genetics, access and use of health services, and their gender.1

Health legislation for the future must support this broader perspective and key transformations underway in health and health care. It should also encourage innovation and allow for the adoption of new technology and practices as they emerge. It needs to help us address the challenges before us. (As in MRI units built across the province and no staff hired to run them while keeping up waiting lists to foster dissent in the population!)


Challenges to the health system
Our health system needs to be structured to meet the challenges that lay ahead. These include:
• An aging population – Today's boomers will be tomorrow's seniors and will bring profound and enduring economic, social and political implications. The first baby boomers will reach age 65 in 2011. By 2031, it is projected that one in five Albertans, or 20 per cent of the population, will be seniors. This aging population will bring greater and greater demands on the health system.
(Seniors have proven to be in better general health than the average 40 year olds in the US and Canada)

• Population growth and diversity – As of June 2009, Alberta continues to have the highest year-over-year growth rate in Canada as a result of its high birth rate and continued interprovincial and international migration2. Alberta's aboriginal communities are also growing and experience higher than average rates of certain chronic diseases, particularly diabetes, renal disease, heart disease and mental illness. Furthermore, these communities experience access barriers to the health system due to cultural, social and financial factors. (All problems brought on by the unteathered and unplanned expansion of the tar sands)

• Health spending – Alberta has consistently spent more than the Canadian average on per capita and annual growth in health spending3, yet only has average outcomes in areas such as wait times and health service quality4.

Therefore, it is unclear if we are getting value for our spending in Alberta's health system. (There has never been an itemized accounting of health care expenses in this province! At the same time hospitals have been blown up. Built and not used and huge salaries paid and even larger settlements given to changing regimes. Multi Billions squandered by this Government is not health care it is mis management)

• Impact of chronic disease and injury – The incidence of chronic diseases, such as cardiovascular disease, cancer, respiratory illness, mental health disorders and diabetes, are rising and account for 60 per cent of the health system's medical costs5. In Canada, the current cost of illness, disabilities and death due to chronic disease is $80 billion annually(Figures consider time lost at work etc not direct costs to health care)

6. Injuries are the leading cause of death for Albertans aged 1–44. Managing chronic disease and injury prevention is not solely a health system issue and requires collaboration across governments and all sectors of society. (Studies have shown much of the chronic ailments stem from sedentary life styles; lack of exercise)

• Dependency on facility based care – The majority of Alberta's hospitals and long-term care centres are operating above capacity and are not always the appropriate setting for the patients for which they are caring. However, the system is unable to readily transition patients out of these facilities and into community based care alternatives where appropriate because there is limited capacity available. (Ongoing short funding has caused bed closing which in turn lowers the capacity of the hospitals. Quirky numbers being used)

• Increased utilization of health technologies – Technologies are developed to solve a problem and improve quality of life. They are an indispensable component of the health system in prevention, diagnosis and treatment of disease and disability.

They also have the potential to be effective in avoiding health system costs, but only if used appropriately. Policies for the selection and management of new technologies must be based on scientific evidence and best practice; otherwise, health technologies can quickly become a significant cost driver while not necessarily providing for better health outcomes. (Here we go folks; they will take your house before you get a new treatment!)

• Supply and diversity of our health workforce – Health is labour intensive; in fact, Alberta Health Services spends over 70 per cent of its budget on staff salaries.(Again there is no accounting of spending-Massive severance packages come under salaries)

By the year 2020, it is projected that Alberta's health system will not have enough nurses or family physicians to meet the needs of the population. While strategies are needed to increase supply in these areas, consideration of the expanded role of other health providers is required. (An introduction into nurses union busting)

Over the past two decades, Alberta has seen a significant increase in the diversity of health professionals, such as respiratory therapists, nurse practitioners, paramedics and mental health workers. These highly educated professionals potentially could take on a larger role in the provision and coordination of health services through expanded scopes of practice. (Alberta has forced a system of reference onto Physicians. The physician refers you to a specialist and gets extra coin as does the specialist. The specialist refers patients back to the physician again for more bucks)

• Insufficient emphasis on public health – Public health is the collection of programs, services, policies and regulations that together focus on keeping the whole of the population healthy. Currently, more emphasis is placed on improving the health care or healing system rather than focusing on activities that keep us from becoming sick or getting sicker. (We do not need a private system to exercise more and eat better!)

• Limited health literacy – Health literacy is the ability to access, understand, evaluate and communicate information as a way to promote, maintain and improve health in a variety of settings. It is an essential step in managing and advocating for one's health. Research indicates that persons with limited health literacy skills are more likely to skip preventative measures, making them more susceptible to illness, higher rates of hospitalization and ultimately, higher health care costs. Strategies such as engaging health providers to assist in educating patients and early health emphasis in schools have increased health literacy. This results in improved maintenance of one's health, lower rates of hospitalization and ultimately, lower health care costs.


A discussion about principles for renewed health legislation

As Alberta's health system evolves and adopts new ways of delivering care and models that put patients and their families at the centre of their care, what principles need to be embedded or maintained in order to ensure that we protect and sustain what matters most in our health system?

In its Terms of Reference, the Committee was given two principles as a starting point for its deliberations –

1. The public health system will serve the interests of all Albertans regardless of their ability to pay; and (Ability to pay key here- if you make more than 20,000 per year you have enough to pay your own in health care- enter private insurance)

2. Access to publicly funded health care services will be fair and effective. (This means limited, fair in the Conservative world means your income is 20,000 or below!)

Another way of describing those principles is patient-centered, publicly-funded and accessible. Albertans along with other Canadians value the national framework of health services available on the basis of need, not ability to pay, linking provincial health systems with the principles in the Canada Health Act. What about quality and safety as principles? A focus on wellness? (Again the deceit :Talk Canada Health Act as it is now then, change the Canada Health Act! If there was any honesty they would tell us what exactly they want to change in the Canada Health Act and, what they want to delist in services! Ability to pay means in the final form they take a lien on your home if you do not have private insurance. Just look to the US system they are trying to emulate!)

As a starting point, we need to ask ourselves what might the guiding principles for a new legislative framework be? Do the principles below provide a starting point? What other principles need to be embedded in a new legislative framework? What would you change or add?

Examples of principles
1. Publicly funded and consistent with the Canada Health Act, including the principles of public administration, comprehensiveness, universality, portability and accessibility.

o The principles of the Canada Health Act embody many of the values that Albertans and Canadians expect from the health system. While the Canada Health Act focuses on what are termed "medically necessary" services – primarily hospitals and physician fees – Alberta’s publicly funded health system covers a much broader range of health services and the principles within the Canada Health Act have come to mean more than when originally drafted. (Here we go again, they are talking of the Canada Health Act as it is now and their intention is to change it to fit their privatize programs)

2. Committed to quality, including acceptability, accessibility, appropriateness, effectiveness, efficiency and safety.

3. The Health Quality Council of Alberta has developed a quality matrix outlining the dimension of quality in health. They include the six dimensions of quality included in the proposed quality principle. Sustainability is embedded in these dimensions; a quality system is a sustainable system. (This is what we have now with no changes)

4. Focused on wellness and public health.

o It can be said that what we have now is a disease system and that our approach needs to be fundamentally rethought so that public policy and priority is given to initiatives that will support healthy and resilient people, families and communities. (This is what we have now!)

5. Patient-centered across a full and integrated continuum of health services, from health to end of life. (If you don't have the cash earlier than you might think!)

o Focusing on what works for people and their care journey improves access and outcomes. A full continuum of care looks at health needs throughout a person’s life, including prenatal through to continuing care and palliative care (We have this now under the public system; when it goes private you have only what you can put up the cash for!)

6. Protective of infirm and vulnerable Albertans.
o A critical measure of the health system is how it cares for the most ill and vulnerable. (This crew is a breath away from compulsory euthanasia!)

7. Accessible to all Albertans regardless of ability to pay.

8. Albertans believe that need, not ability to pay, is a fundamental part of the social network in Canada. (This is what we have now, they are going to change it!)

9. Decision-making based on the best evidence available that enables the right care, in the right place, at the right time and by the right provider.

o Use of up-to-date evidence to determine what health services are delivered, how they are delivered, and where and by whom, will help lead to better health outcomes for Albertans and better use of the time and skills of providers and other health resources. (Nancy Bethowsky format; chewing gum for the mind!)


A discussion about themes for renewed health legislation
In its discussions around what key transformations should be enabled by new legislation, the Minister's Advisory Committee on Health discussed the importance of a system focused on wellness, one that helps build resilience in Albertans, families and communities, and one that puts patients and their families at the centre of their care.

The following themes outline broad policy areas that could support a patient-centred health system for the future. Do these themes reflect the changes that you think should happen? Would you change any of them? We want to know what themes you would propose – and why.

Optimizing the competencies and capacity of all health service providers (As in changing the Canada Health Act)

Stelmach rejects royalty-loss warning

The US Interior Department's inspector general found exactly the same thing Mr. Dunn found!

Stelmach's views are strictly there to discredit Mr. Dunn while propping up a dysfunctional system.

SUBJECT TO MANIPULATION the US view on payment in kind.

Salazar said the program "has been a blemish on the department" and has "created problems and ethical lapses" among those who managed it.

At a recent House committee hearing, Salazar said, "It's time for us to end the royalty-in-kind program." About half of the oil and gas royalties come through the in-kind program, and Salazar said that would be phased out over a period of time to make an orderly transition.

The credibility of MMS offices responsible for the royalty-in-kind program was undermined last year when the Interior Department's inspector general found evidence that at least 13 employees were involved in unethical behavior such as rigging contracts, working part-time as private oil consultants and having sexual relationships with - and accepting golf and ski trips and dinners from - oil company employees.

The inspector general's report cited a "culture of substance abuse and promiscuity" involving a small group of individuals "wholly lacking in acceptance of or adherence to government ethical standards."
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A STRAIGHT QUOTE FROM ANDREW NIKIFORUK

The United States has the U.S Government Accounting Office (GAO) along with the U.S Congressional Research Authority. Both groups make valuable information and policy analysis available to the public. The GAO, for example, reported on Alberta's low royalty rates in a 2007 global comparison of oil royalties months BEFORE Alberta's royalty review panel and Alberta's Auditor General came out with similar findings.


That's what Alberta needs now.

Alberta Health Care is a National Problem!

Alberta announced they would open the Canada Health Act to make changes allowing them to further privatize medicine in this province!

This is a Federal Jurisdiction. The Feds would have to get the Provinces on board before they would attempt this.

Not one of the Provinces raised an alarm nor did any of the other political parties!

We have pretty much a wall to wall Conservative government in Canada at this time. BC has a government that claims to be Liberal but is every bit as right wing as is the Alberta Tories.

This means all the Provinces are in agreement as are all the political parties!

It follows then we have only the choice to make provincially and nationally who we want dealing our health care and our NAFTA.

I include NAFTA in this article because trucks are moving loads of water in bulk to the US now and it is against Canadian law.

What was Ralph Klein Hiding?

Days before he left office, Ralph Klein made changes to Alberta's Freedom of Information and Protection of Privacy Act that put a five-year blackout on ministerial briefing documents and other records that show how he mismanaged the Province for more than a dozen years. Klein also put into place a cloak of findings of internal audits for 15 years in order to keep from Albertans a full accounting of how he spent our money.

If Ed Stelmach really believes in more transparency in the Alberta government, he should change the FOIPPA back to the way it was before Klein buried the records. What are you hiding from us Ralph?

Alberta should not complain about Abscan and the Liberals! The biggest problems are ongoing here in Alberta!

Jack Layton: Political opportunists

Jack Layton is going to sell out Canadians and the Public Health Service in order to protect his personal increase in pensions due him from the House of Commons.

Even NDs should have cause to look at what they have, in my opinion, for an arrogant self centered egotist.

Agreement with A conservative- who would have guesed?

Mr. Ken Chapman has commented on a post in the Calgary Herold where I said Alberta Royalty started out as the lowest in the world and then went down from there.

Ken Chapman
September 11, 2009 - 1:50

cyberclark - royalties are rents not taxes. Very different things and all are legitimate charges
citiznes are entitled to as owners of the resources.
Jobs last as long as the companies decide - not us as citizens and
resource owners. Income taxes requires an income and that is not
happening as much these days and commodity prices are volatile so
the owner's revenues are lower.

That is Albertans sharing the risks but we don't seem to get the
full benefits of the rewards we are entitled to in good times.
According to the Auditor General Alberta Energy doesn't have
the manpower or other capacity to calculate the oilsands royalties,
never mind collect them. As for conventional rates,
I get the sense the companies phone it in whenever they feel
like paying. The whole thing is sloppy and citizens are getting screwed.

To make it worse, the PC government just denied the Auditor General the
extra budget this year to finish off his investigation on royalites
to see if Albertans were getting our legal entitlement. The OWNERS
are not amused.

Proposed Power lines costs go sky high!

Power line costs are expected to go as high as 200.00 per month for individual homes. 1.3 million homes in Alberta times 200.00 per month - you play with the zeros.

Power lines are heavily financed. Any number of generation plants and power lines fell by the way side in the US when the interest rates went sky high under Nixon. It seems like a long time ago but the deals put in at that time are still being paid for!

If the costs of today's numbers are based on today's rates of 1/4% we are well and truly in deep trouble. Think of it! If the bank rates go up to 5% which they most certainly will at some point, the interest charged on those power lines will be 100 times higher than they are now.

I think it is fair for Albertans to ask for some figures on the "estimates".

Canada Health Act- What it does.

I'm getting questions about why the Canada Health Act is important. Here is a short version.

The Act enables the regulations.

Act does not allow hospitals to take on US insurance patients. This, is exactly why the Conservatives built the Mazankowski Alberta Heart Institute and this is why it was empty for so long.

US Insurance companies have long viewed Canada as being a cheaper place to send their patients mostly because taxpayers pay for building the hospitals and in one way or another, cover the staffing.

The Act states which services are covered in Health Care in Canada. The Conservatives have a long list of services to be delisted from health care but, they need the act opened and changed to do this!

And finally the whole thing stinks! I have used the statement "Our public health care system is about to be changed to private by political chicanery!" because I am very sure the other premiers in Canada were on side with this change. Alberta has done a job on them too!

It remains that if Harper is booted out of office, the process comes to an end. However with Layton playing coy on an election, that is to support or not support Harper, I would think he is on side with this program too.

Alberta Oil Exports to Increase!

Another 800.000 BBL per day pipelines is going to build. ENMAX has a second 800,000 bbl per day going into Chicago; should be ready in November.

In addition the pair to Alberta Clipper another 900,000 BBL per day is under construction to the Gulf States.

That is 2.5 million BBL per day that has yet to be filled.

Where is the oil coming from? When is it coming? Who is building what and when?

Meanwhile; the cheapest oil royalty rates in the US are still higher than what Alberta is charging!

We really cannot afford Conservatives in this province! Our resource is non renewable and is going below costs!

Alberta Healthcare -Ready to kill Canadian Public Health

The Alberta Conservatives are desperately looking for a scenario that will allow them to turn the Canada Health Act into a guideline rather than a law.

Certainly they have the support of Stephen Harper in this; health care has been the Conservative holy grail of privatization for many years.

Harper supports the opening of the Canada Health Act. When this is done anything can be changed. Their program is not about de-listing services; it is about doing away with the Canada Health Act which will effect every province and the country as a whole.

Alberta trying to change Canada Health Act to De-List Services

Alberta Conservatives have declared their intention to change the Canada Health Act in order to de-list health services.

Meanwhile they have legislation in place to allow US Health Care Companies to sell insurance in Alberta.

Mr. Duckett was hired from Queensland Australia where he was instrumental in bringing the US health coverage companies into Australia. This was called "building partnerships".

The word from Australia is do not let them in; your state coverage is greatly reduced and you cannot get rid of them!

The Canada Health Act must be changed by the Federal Government. If the Conservatives are sitting at the time (between October and December of this year) the Canada Health Act will be changed dramatically by the Conservatives.

The Liberals have made it clear they have no intention of changing the Canada Health Act and have defended it over time. If the Liberals can unseat the Conservatives it will be the end of the Alberta plan.

Now is the time as never before for Alberta to vote Liberal in the next Federal Election!

Alberta Electricity-4.1 billion in indirect taxation

A study commissioned by the Province of British Columbia on the merits of privatization has been put forward.

This study tells us how much we have paid in indirect taxation to Edmonton and Calgary. The number is a staggering 4.1 billions dollars.

That is 3/4 of an annual budget collected on electricity alone as a utility bill rather than the indirect tax that it is! Alberta's low tax regime is still another lie!

Certainly there must be some Conservatives out there shaking their heads and, there must be a bunch of people out there who thought it was not worth while to vote, rethinking their decision?

Alberta Insider Trading Opportunities

Alberta pays power line construction at 15% cost plus.

Alberta power line construction is pegged at 16 billion dollars.

15% of 16 billion is 2.4 billion dollars

There were no public bids; There were no public announcements. Yet, members of the legislature knew that 2 companies were going to get the contracts ahead of any public disclosure.

I find it very difficult to believe some members did not rush out and buy stocks in the two companies before the announcement was made public. By not making the windfall profits to these companies public knowledge they further prevented the general investors from being invited to the table.

That is serious coin going to insiders!

This same scenario is prevalent in all this Governments' transactions. When bids are asked for the winners are seldom published. The unsuccessful bidders are never published nor are their bids. The latter with 1 exception when last challenged on this site.

Alberta Electricity-Indirect Taxation at its best.

Stelmach tells us there will be no sales tax on his watch. He is proud to say Alberta has the lowest taxes in Canada. He fails to say they ramp up utility charges so the cities can get revenue from that source, rather than the Government. When this is considered, I would think Alberta's tax rate is higher than most states.

The headlines today read to the effect companies are leaving Alberta because of high energy prices. Companies have been leaving Alberta ever since they privatized the electricity! Goaded with "Oil or nothing policy" because of their constant failures in creating business they actually opted for energy and nothing else.

Now, we have nothing. The Conservative Government is broke; a complete and abysmal failure! In hindsight I would call it criminal. Time and again I have said it is difficult to distinguish this Government from Organized Crime.

In 2007 I wrote a couple of electrical articles. They seem to have been right on the money!
Search the blog for "Electrical" you will find a small volume of warnings.

The indirect taxation by municipalities by ramping up electrical and water bills is not a new thing. Devon recently raised water prices 25%, because they could. Cities across Canada and the US got into this about 8 years ago. However, no one has taken it to the extreme that Alberta has!

Every dollar the cities take out of utilities as profit is a dollar the province does not have to put back into the city programs. That in turn is 1 dollar more they can reduce the royalty rates.

Add to this shell game the real price of new power lines for export of electricity and you have some big bills coming your way but, that is not all of the story.

The Conservatives have denied the export marker forever. We are all blind and stupid in their minds.

The whole thrust of the power thing has been for power export to the US and this Government has ever admitted this. They continue to flounder under mismanagement.
The US as of 3 years ago stated they needed 70,000 MW of new power generation by 2020. By comparison Alberta is 12,000 MW. Any power built in the US is that much less power to be imported from Canada. It is a sweet export market!

In today's news the US power generation build has slowed down because of the recession. That said, there is still 43,000 MW of generation under construction now.
Ontario and Quebec are ramping up generation to meet this market. There are about 2 dozen power export companies in Canada working this market.
Looking at how quickly the new production is coming on line I would guess that Alberta has missed this market; still another loss for Albertans

Down the hall, Saskatchewan is opting to build one or two nuclear plants of which the Province ( Saskatoon’s Cameco Corp.) will own 30% or more. This is one of the best investments made of any of the provinces.

For those of you who voted Conservative or did not vote at all; you deserve this. The rest of us do not deserve the beating.

Alberta Upgraders - Game over!

The state-owned energy companies in Mexico and Venezuela are falling behind in oil production. Consequently, they are supplying progressively less crude to major refineries in the Southern United States. Refineries in Texas, Oklahoma and Louisiana are becoming more and more depending on supplies from Alberta's Oil Sands. This may not be quite the bonanza that it seems however due to a quirk of segmentation in oil production.

Bitumen has historically been about 30% cheaper than crude oil. In the past, this has provided an incentive to upgrade Bitumen where it is found. But due to the decline in supply from Mexico and Venezuela, the prices gap has narrowed considerably. The return on bitumen is approaching the price of crude oil.

Bitumen has historically been about 30% cheaper than crude oil. In the past, this has provided an incentive to upgrade bitumen where it is found. But due to declines in supply from Mexico and Venezuela, the price gap has narrowed considerably. The return on bitumen is approaching the price of crude oil. This lowers the profit on upgrading it.

Therefore, some major producers in Alberta are opting to ship bitumen to existing upgraders in the US south and postpone their own plans. This is a big disappointment for construction and energy sector workers for the provincial government. Many of the higher-end jobs are in refining. This is also where most "value added" occurs.

Alberta History 3- The camp grounds and parks.

Up until this crew came into office, Alberta's camp grounds were all public. They were quite probably the very best in Canada!

Millions of Federal monies and more millions of Provincial monies had been put into the camp grounds to install showers, build various buildings, build piers and various other first class improvements.

A large portion of the money from the Federal Government was put into the camp grounds just prior to their being sold.

As usual the Government opened the doors for bids for the camp grounds. As is their lack of business practice, the camp grounds, totally improved, were sold for pennies on the dollar of value.

As usual there were never any names published as to who bought the camp grounds and for how much. Nor were there any figures published on the bids that were put in that didn't get selected.

To put it in one line; "All the camp grounds in Alberta were sold to Torrie insiders at a fraction of their worth"

This scenario is a standard business operation for this crew even today!

In Alberta there is no sense putting in bids on anything as the parties who are going to get the property or chattel are already selected and know what price to bid.

For those of you who think Conservatives are the only way to vote should give your heads a shake. You are not on their buddy list.