There was cross-Canada interest before the mid-January release of a report from the Don Mazankowski-led Premier's Advisory Council on Health in Alberta, but the document turned out to be less a radical right turn and more a boxed set of old health-reform favourites.
Mazankowski reported in the fall that “the council has continually been challenged to ‘be bold’ in our recommendations and I think our report will live up to the challenge.” His final document, which faced relatively little criticism, appears to have done just that.
“There is no reason why we can't open up the system, seize new opportunities and take advantage of new approaches,” it says. “But to do that we need to be prepared to debate the real pros and cons and not just rehash the rhetoric of old arguments.”
Its 44 proposals include developing smart cards to track health care use, introducing medical savings accounts and delisting services. On Jan. 22, Premier Ralph Klein accepted all the recommendations, which he said will be implemented within 3 to 5 years.
“We believe our recommendations are consistent with the spirit and intent of the Canada Health Act,” states the report. “If actions are not taken to make changes in critical areas and sustain the health system, it is highly likely that pressures will mount to look for new options outside the limitations of the act.”
When details of some council recommendations were leaked last fall, critics accused Mazankowski of downloading costs to patients by delisting services and raising premiums (currently $408 per year for individuals living in Alberta and $816 for families). Mazankowski, a former deputy prime minister, refused to respond to the leaks.
Roy Romanow, who is preparing his own national report on health care, told CMAJ he reserved judgement pending the implementation of recommendations, but he did question the report's underlying thesis.
“My preliminary reading tends to be that the report is premised on a fundamental assumption that publicly funded health care — at least in Alberta — is no longer sustainable. I don't share that assumption.”
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