Alberta
Alberta government should reform hospital funding to help shorten wait times
From the Fraser Institute
By Mackenzie Moir and Alicia Kardos
Other high-performing countries with universal health care (Australia, Germany, Switzerland) use “activity-based funding.” Under this model, hospitals receive funding based on the amount of care they provide.
Earlier this year, the Alberta Medical Association sounded the alarm on “rolling surgical outages,” patients diverted to other treatment sites, and the potential capping of services at major provincial hospitals. Unfortunately, the delays these problems create aren’t new to Albertans, as patients continue to face lengthy wait times.
According to the latest data, Albertan patients faced a median wait time of 33.5 weeks in 2022 for non-emergency medical treatment, a delay that was nearly six weeks longer than the national average, and three times longer than what patients in the province experienced in 1993 (when national estimates were first published).
When broken down, the wait in Alberta includes the first 16.4 weeks it takes for a patient to see a specialist after referral from their family doctor—then a second wait of 17.2 weeks to receive treatment after seeing that specialist. And these figures don’t account for the wait to see a GP in the first place, which is a significant issue in a rapidly growing province where remain without a family doctor.
Of course, we hear the predicable calls for more money. But in reality, spending more won’t get Albertans out of this problem. In a recent comparison of high-income countries with universal coverage, Canada (in 2021) was already one of the highest spenders on health care (as a share of their economy) while having some of the fewest doctors and hospital beds (after accounting for differences in population age among countries).
And when compared to nine other high-income countries in 2020, Canadians were found to have the longest waits for medical care. Specifically, Canadians were the least likely to report waiting under four months for non-emergency surgery (at 62 per cent) compared to higher-performing countries such as Australia (72 per cent), Switzerland (94 per cent) and Germany (99 per cent).
So what’s the solution?
In a word, reform. For example, Alberta could change the way it funds hospitals. Canada’s predominant approach is to provide hospitals a set amount of money each year, regardless of the level of services provided. This means that the money hospitals receive isn’t tied to the actual number of services they provide. This discourages hospitals from providing more care because each patient represents a drain on their budget rather than an opportunity.
In contrast, many other high-performing countries with universal health care (Australia, Germany, Switzerland) use “activity-based funding.” Under this model, hospitals receive funding based on the amount of care they provide. This creates a powerful incentive for hospitals to treat more patients, because each patient represents an opportunity for the hospital to earn more money.
Quebec decided in last year to fund all of its surgical procedures using this model, and now plans to expand the model to all hospital care by 2027/28. The Smith government has also taken some steps that lay the foundation for these types of reforms. This is good news for Albertans, if reform is actually on the way.
Across Canada, despite the availability of solutions, the status quo of long waits persists. Breaking from the past can be hard, but there may be hope on the horizon for patients in Alberta’s beleaguered and poorly performing health-care system.
Authors:
Alberta
On gender, Alberta is following the science
Despite falling into disrepute in recent years, “follow the science” remains our best shot at getting at the truth of the physical sciences.
But science, if we are to place our trust in it, must be properly defined and understood; it is at its essence an ever-changing process, a relentless pursuit of truth that is never “settled,” and one that is unafraid to discard old hypotheses in the face of new evidence.
And it is in this light—in the unforgiving glare of honest science—that Alberta Premier Danielle Smith’s three new legislative initiatives around gender policy are properly understood, notwithstanding the opprobrium they’ve attracted from critics.
Bill 26, the Health Statutes Amendment Act, proposes to prohibit the prescription of puberty blockers and cross-gender hormones for the treatment of gender dysphoria to youth aged 15 and under. It would allow minors aged 16 and 17 to begin puberty blockers and hormone therapies for gender “reassignment” and “affirmation” purposes only with parental, physician, and psychologist approval. The bill also prohibits health professionals from performing sex reassignment surgeries on minors.
Bill 27, the Education Amendment Act, seeks to enshrine parents’ rights to be notified if their kids change their names/pronouns at school, and it gives parents the right to “opt in” to what sort of gender and sex education their kids are exposed to in school.
And Bill 29, the Fairness and Safety in Sports Act, is designed to protect females in sports by ensuring that women and girls can compete in biological female-only divisions, while supporting the formation of co-ed opportunities to support transgender athletes.
Each of these initiatives is entirely reasonable, given what we know of the science underpinning “gender care,” and of the undeniable advantages that a male physique confers upon biological males competing in sports.
The notion that the trifecta of puberty blockers, cross-gender hormones, and revisionist surgery is a pathway to good health was a hypothesis initially devised by Dutch researchers, who were looking to ease the discomfort of transgender adults struggling with incongruence between their physical appearance and their gender identities. As a hypothesis, it was perhaps reasonable.
But as the UK’s Cass Review exposed in withering detail last spring, its premises were wholly unsupported by evidence, and its implementation has caused grievous harm for youth. As Finnish psychiatrist Riittakerttu Kaltiala, one of the architects of that country’s gender program, put it last year, “Gender affirming care is dangerous. I know, because I helped pioneer it.”
It’s no accident, then, that numerous European jurisdictions have pulled back from the “gender affirming care” pathway for youth, such as Sweden, Finland, Belgium, the Netherlands, and the United Kingdom.
It makes perfect sense that Canadians should be cautious as well, and that parents should be apprised if their children are being exposed to these theories at school and informed if their kids are caught up in their premises.
Yet the Canadian medical establishment has remained curiously intransigent on this issue, continuing to insist that the drug-and-surgery-based gender-affirming care model is rooted in evidence.
Premier Smith was asked by a reporter last month whether decisions on these matters aren’t best left to discussions between doctors and their patients; to which she replied:
“I would say doctors aren’t always right.”
Which is rather an understatement, as anyone familiar with the opioid drug crisis can attest, or as anyone acquainted with the darker corners of medical history knows: the frontal lobotomy saga, the thalidomide catastrophe, and the “recovered memories of sexual abuse” scandal are just a few examples of where doctors didn’t “get it right.”
As physicians, we advocate strongly for self-regulation and for the principle that medical decisions are private matters between physicians and patients. But self-regulation isn’t infallible, and when it fails it can be very much in the interests of the public—and especially of patients—for others to intervene, whether they be journalists, lawyers, or political leaders.
The trans discussion shouldn’t be a partisan issue, although it certainly has become one in Canada. It’s worth noting that Britain’s freshly elected Labour Party chose to carry on with the cautious approach adopted by the preceding administration in light of the Cass Review.
Premier Smith’s new polices are eminently sensible and in line with the stance taken by our European colleagues. None of her initiatives are “anti-trans.” Instead, they are pro-child, pro-women, and pro-athlete, and it’s difficult to see how anyone can quibble with that.
Dr. J. Edward Les, MD, is a pediatrician in Calgary, senior fellow at the Aristotle Foundation for Public Policy, and co-author of Teenagers, Children, and Gender Transition Policy: A Comparison of Transgender Medical Policy for Minors in Canada, the United States, and Europe.
Alberta
Alberta mother accuses health agency of trying to vaccinate son against her wishes
From LifeSiteNews
Alberta Health Services has been accused of attempting to vaccinate a child in school against his parent’s wishes.
On November 6, Alberta Health Services staffers visited Edmonton Hardisty School where they reportedly attempted to vaccinate a grade 6 student despite his parents signing a form stating that they did not wish for him to receive the vaccines.
“It is clear they do not prioritize parental rights, and in not doing so, they traumatize students,” the boy’s mother Kerri Findling told the Counter Signal.
During the school visit, AHS planned to vaccinate sixth graders with the HPV and hepatitis B vaccines. Notably, both HPV and hepatitis B are vaccines given to prevent diseases normally transmitted sexually.
Among the chief concerns about the HPV vaccine has been the high number of adverse reactions reported after taking it, including a case where a 16 year-old Australian girl was made infertile due to the vaccine.
Additionally, in 2008, the U.S. Food and Drug Administration received reports of 28 deaths associated with the HPV vaccine. Among the 6,723 adverse reactions reported that year, 142 were deemed life-threatening and 1,061 were considered serious.
Children whose parents had written “refused” on their forms were supposed to return to the classroom when the rest of the class was called into the vaccination area.
However, in this case, Findling alleged that AHS staffers told her son to proceed to the vaccination area, despite seeing that she had written “refused” on his form.
When the boy asked if he could return to the classroom, as he was certain his parents did not intend for him to receive the shots, the staff reportedly said “no.” However, he chose to return to the classroom anyway.
Shortly after, he was called into the office and taken back to the vaccination area. Findling said that her son then left the school building and braved the sub-zero temperatures to call his parents.
Following his parents’ arrival at the school, AHS claimed the incident was a misunderstanding due to a “new hire,” attesting that the mistake would have been caught before their son was vaccinated.
“If a student leaves the vaccination center without receiving the vaccine, it should be up to the parents to get the vaccine at a different time, if they so desire, not the school to enforce vaccination on behalf of AHS,” Findling declared.
Findling’s story comes just a few months after Alberta Premier Danielle Smith promised a new Bill of Rights affirming “God-given” parental authority over children.
A draft version of a forthcoming Alberta Bill of Rights provided to LifeSiteNews includes a provision beefing up parental rights, declaring the “freedom of parents to make informed decisions concerning the health, education, welfare and upbringing of their children.”
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