A week ago, in an exclusive interview with the far-right Western Standard, Alberta premier Jason Kenney signaled his aim to privatize the province’s health care by handing out public funds to for-profit companies. The aim of these moves, Kenney announced, was to transfer as many procedures as possible from “union-run hospitals.”
The Premier openly boasted of leveraging the stresses that the pandemic has put on Alberta’s health care system in order to impose his privatization agenda.
Because of all of the COVID controversy, a lot of the bold conservative reforms of this government have not been recognized. For example, we passed a law through the Legislature to massively expand privately owned and operated surgical hospitals to help us get faster and more efficient health care for Albertans.
In the same interview, Kenney vowed his that his government’s “surgical reform initiative will more than double the number of surgeries that Alberta performs in private surgical facilities.”
Kenney resorted to the hackneyed neoliberal dogma that the free market is better than any state-run alternative to justify these measures. Privately run clinics, the premier boasted, will “be operating a heck of a lot more efficiently” than their publicly run counterparts.
One possible obstacle to Kenney’s plans is Canada’s public health care system, which guarantees free health care for all of the country’s citizens. The Canada Health Act, passed in 1984, stipulates that the North American nation’s federal and provincial governments must ensure “continued access to quality health care without financial or other barriers.” Kenney was keen to stress that his reforms would not run afoul of this piece of legislation. Under the changes, surgeries “will be publicly insured, but they won’t [take place in] union-run hospitals.”
The political motives underlying the premier’s plans are clear: to attack organized labor and the professional associations that work to ensure that Canada’s health care system is free at the point of use.
It may seem strange that Alberta’s premier chose to make these announcements in the Western Standard, given the fractious history between Kenney and the publication. In June 2021, the news outlet falsely reported that Kenney and his cabinet staff had violated lockdown rules, meeting at an Edmonton restaurant for meals during the pandemic. However, despite forcing the Standard to apologize, Kenney and the paper remain on good terms.
Derek Fildebrandt, a former legislator with Kenney’s United Conservative Party (UCP), relaunched the Western Standard after it shut down its print publication in 2007. These close ties are one possible explanation for the amicable relationship between Kenney and the right-wing paper.
In 2017, Fildebrandt, who describes his politics as “traditional conservatism with a kick in the ass of libertarianism,” was booted from the UCP caucus following a string of misdemeanors. The ex-legislator was caught renting out his taxpayer-funded apartment in Edmonton on Airbnb, improperly expensing meals, and fleeing the scene of a car accident.
The piecemeal privatization of Alberta’s health care system has been a long-term goal of Kenney, who cut his political teeth with the Canadian Taxpayers Federation. The federation sees tax cuts and privatization as the solution to all social ills.
In 2019, when the UCP won the provincial election in a landslide, Kenney said that he wanted to introduce some “commonsense competition” to the health care system, citing eye-care procedures that were already contracted out to private providers. “With the most expensive health system in Canada, I believe we can find some savings to do things more efficiently without affecting frontline services,” he said.
Data from the Canadian Institute for Health Information shows that, as recently as December 2019, Alberta spent $7,658 per person on health care. This is slightly higher than the national average of $7,068, but it is still only the fourth-most costly health care system in the country. There is little reason to think that these numbers are likely to rise significantly any time soon. Alberta’s health care costs before the pandemic were increasing at a rate of 0.3 percent — the smallest rate for any province and far less than the nationwide rate of 2.9 percent per annum.
Once in office, Kenney commissioned a report from accounting firm Ernst & Young to look into ways to spend less money on health care. Unsurprisingly, given the neoliberal bent of the firm, the report found that cuts were the only way forward. Alberta could save $2 billion by cutting benefits for nurses, reducing the pay of some doctors, outsourcing more health and support services to the private sector, and closing some rural hospitals.
The government ruled out shutting hospitals but left many of the report’s recommendations on the table. Tyler Shandro, the health minister at the time, said that all savings from the cuts would be reinvested in health care. By which he of course meant subsidizing for-profit companies.
These reforms, anathema to a majority of Canadians, appear to be popular with the UCP’s membership. In 2019 at their annual conference, members voted against a motion that would ensure all health care changes that the party proposes conform to the Canada Health Act. As the Toronto Star reported at the time, there was almost nobody on the floor willing to speak in favor of the resolution.
In July 2020, Shandro introduced the Health Statutes Amendment Act, or Bill 30, claiming that the legislation would “provide more voice and choice to Albertans and physicians” by increasing the number of surgeries contracted out to the province’s forty-three private clinics. Shandro billed the announcement as a way of reducing wait times in the public system for procedures such as cataract removals and hip and knee replacements.
The legislation allows for-profit companies to directly charge the Alberta government for publicly funded health services. It also enables physicians to take private sector contracts, smuggling the profit motive into Canadian health care provision. Ominously, Shandro added in a news release that the bill would “enable future innovation.”
Bill 30 also allows doctors “to enter into alternative relationship plans for compensation.” These alternatives must be understood in the context of Shandro’s unprecedented move to rip up the province’s agreement with the Alberta Medical Association and impose a new fee arrangement. The UCP’s fee arrangement, announced in February 2020, led to a mass exodus of physicians at precisely the moment when they were most needed.
In a statement from July of last year, the United Nurses of Alberta (UNA) said that, instead of looking for ways to subsidize private surgical companies, the government should focus on increasing the capacity of the “existing fair and efficient public health care system.” The union also expressed skepticism about the claim that privatization will lead to shorter wait times.
Independent columnist David Climenhaga likened the notion that privatizing health care would lead to shorter wait times to “treating iron-poor blood by attaching blood-sucking leeches to patients’ arms and legs.”
Previous experiments with private health care delivery have yielded less-than-stellar results. A private clinic in Calgary that was contracted to do hip and knee surgeries, the Health Resources Centre, went broke in 2010. While the clinic attempted to figure out how to integrate its patients back into the public system, it left the public on the hook to its creditors
Rebecca Graff-McRae of the Parkland Institute, a progressive think tank based at the University of Alberta in Edmonton, says Bill 30 “provides crucial pieces in the puzzle of the UCP privatization agenda.” Graff-McRae explains further that “what Bill 30 represents, at its foundation, is an unprecedented transfer of power from physicians to corporate investors, and Albertans may pay the price in reduced access to primary care.”
The view that privatization can enhance patient care and decrease wait times has little basis in reality. It serves as a smoke screen for the broader agenda that the UCP has pursued so vigorously since coming to power: pushing Alberta’s health care into the private sector.