AMA: set standards, not user fees

Rich Cairney

Alberta's health minister wants the province to apply user fees now instead of waiting for reports from Roy Romanow's Commission on the Future of Health Care in Canada and Michael Kirby's Senate panel, but the head of the Alberta Medical Association (AMA) says what's really needed are health care standards.

Health Minister Gary Mar says Alberta needs to find new ways to fund health care and suggested a move to user fees or medical savings accounts. The issue has arisen, at least in part, because of the huge drop in oil prices following Sept. 11 — Alberta's financial situation is tied directly to oil industry revenue. On Oct. 18, the government announced spending cuts of $1.26 billion. AMA President Robert Hollinshead agrees that the health care system is in desperate need of new revenue sources, but says these sources need to be structured to ensure consistent funding and access to care. “Canadians should insist upon predictability, and to do that standards should be defined. We need to define a standard for how long it takes to see a doctor if you've got progressive, disabling angina. Right now it's a free-for-all.”

When standards are set, he added, funding levels must be maintained to prevent rationing. “Every time there is a downturn in the oil patch in our province, the government's knee-jerk response is to cut funding to health care,” said Hollinshead. “If you close beds and operating rooms, you just make people wait even longer. Waiting lists are ridiculously long to see specialists in some disciplines.”

His desire to set standards appeals to Christine Burdett, chair of Friends of Medicare, a lobby group that spearheaded campaigns against private-sector surgical services in Alberta a year ago. The group is dead set against user fees. “The government keeps bringing this up, and it's one area we've been successful in fighting against,” she says. Burdett says financial efficiencies will be found in the way the system is operated, not funded. “Nothing Gary Mar is talking about has anything to do with making health care more cost-effective.”