Richard Johnston, president of the Alberta Medical Association, penned a thoughtful letter to end 2014, reflecting on the challenges and difficulties he expects to see in the new year … but people got hung up on three words.
Health care premiums.
Here’s what Alberta’s top advocate for doctors wrote: “A sustainable, predictable source of revenue is required, whether that be a re-introduction of health care premiums or some other means.”
As you might recall, until 2008, Albertans were charged a supplementary fee in the form of a health care premium.
At the time of its abolition, the charge cost families $1,056 per year, paid in $44 instalments every other week. Single people paid $528 annually — half what families were charged.
The fee was often covered by employers.
The premium provided the Alberta government about $1 billion per year to help pay for health care services.
Although that’s a lot of money in absolute terms, the premium never came close to covering the full cost of our universal health care system.
In the current fiscal year, for instance, Alberta is expected to spend a staggering $18.3 billion on public health care.
I can think of a few reasons why health care premiums are a bad idea.
They are regressive: The less money you make, the larger proportion of your income health care premiums represent.
They would be ill-timed: With the economy cooling off due to falling world oil prices, now isn’t the best time to saddle Albertans and/or their employers with something that is essentially a new tax.
They may be unnecessary: Collecting a new fee and pouring the money into a system that isn’t operating at maximum efficiency is by its very nature a waste.
But let’s give the good doctor the benefit of the doubt here.
It doesn’t appear Johnston is actively advocating for the re-introduction of health care premiums: It was just one idea among many more to fix public health care.
In his open letter, Johnston opens all sorts of doors as he encourages doctors, patients and the government — everyone, really — to look for ways to improve the system.
“There is an opportunity to look anew at how care is identified, organized and delivered,” he wrote.
Johnston calls on the government to be clear about what public health care should cover and what Albertans should expect to get from the system.
He attributes much of what currently ails public health care to poor planning, partly caused by unpredictable funding. (The government’s recent decision to postpone the much-needed and already long-delayed upgrade for Calgary’s Tom Baker Cancer Centre only proves his point, even though it was part of a larger move to re-examine the government’s financial priorities.)
He also wants politicians to stop sticking their noses where they don’t belong.
“To be blunt, they need to get out of the delivery of care and play their part in depoliticizing the system as much as possible,” Johnston said.
He singled out former premier Alison Redford’s plan to establish family care clinics, calling the whole idea “ill-conceived out of political expediency.”
These are all points we must ponder and address together.
It really is something that can’t be ignored: With public health care making up almost half of all Alberta government expenditures, it is truly a beast to be wrangled as the province grapples with falling revenues.