Alberta
Critically Important Planning Documents for All Albertans 18 and Over
Critically Important Planning Documents for All Albertans 18 and Over
So now that we are doing our best to “flatten the curve” and all have some extra time on our hands, please take a break from stressing about the news or de-stressing with funny posts on social media to pay attention to another kind of critically important planning.
There are three very important advanced care planning documents that all Albertans over 18 years of age (and especially those of us with children) should have completed in order to be fully prepared for emergencies, like the current COVID-19 pandemic or much more common (but often, unexpected) events such as sudden illness or car accidents:
1) a Personal Directive – that states who would speak for you in making decisions about medical and personal care, if you become unable to speak for yourself (unconscious, unable to communicate). This person is called your “agent”,
2) an Enduring Power of Attorney – that states who would take care of your financial matters if you become unable/incapable of doing this yourself; and
3) a Will – that says how you want your estate to be handled after you die.
The Personal Directive has taken the place of what used to be called a “living will”. Information about what it is, the kinds of instructions to write, why you should write one and how to prepare a Personal Directive (as well as the other documents listed here) are available on the Government of Alberta website: http://www.alberta.ca . You can also download the Personal Directive form from that website. You do not need the help of a lawyer to fill it in. You can register your Personal Directive online but, most importantly, give a copy to the Agent you named in the document and keep a copy in with other important documents in your home. You can also give a copy to your Family Physician to keep with your medical record.
It is recommended that you consult a lawyer to create the Enduring Power of Attorney and Will documents. The Government of Alberta website includes instructions about how to get this kind of legal help. If you die without a Will, the Government will do the work to settle your estate but they will also take the cost of this service out of the inheritance that you have worked hard to leave to your loved ones.
Another excellent website that can help as you go through the process of thinking about and sharing your wishes for future health and personal care is: http://www.advancedcareplanning.ca. The slogan for their 2020 Speak Up Canada campaign is “A Life Well Lived is a Life Well Planned”. In this time of uncertainty, ensuring that you have done all you can to be sure that your loved ones have the best tools to help you in case of emergency can give us all some peace of mind.
Dr Maureen McCall, MD, MPH, CCFP Palliative Care Physician, Red Deer
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From the Fraser Institute
On Monday, the Smith government announced that beginning next year it will change the way it funds surgeries in Alberta. This is a big step towards unlocking the ability of Alberta’s health-care system to provide more, better and faster services for the same or possibly fewer dollars.
To understand the significance of this change, you must understand the consequences of the current (and outdated) approach.
Currently, the Alberta government pays a lump sum of money to hospitals each year. Consequently, hospitals perceive patients as a drain on their budgets. From the hospital’s perspective, there’s little financial incentive to serve more patients, operate more efficiently and provide superior quality services.
Consider what would happen if your local grocery store received a giant bag of money each year to feed people. The number of items would quickly decline to whatever was most convenient for the store to provide. (Have a favourite cereal? Too bad.) Store hours would become less convenient for customers, alongside a general decline in overall service. This type of grocery store, like an Alberta hospital, is actually financially better off (that is, it saves money) if you go elsewhere.
The Smith government plans to flip this entire system on its head, to the benefit of patients and taxpayers. Instead of handing out bags of money each year to providers, the new system—known as “activity-based funding”—will pay health-care providers for each patient they treat, based on the patient’s particular condition and important factors that may add complexity or cost to their care.
This turns patients from a drain on budgets into a source of additional revenue. The result, as has been demonstrated in other universal health-care systems worldwide, is more services delivered using existing health-care infrastructure, lower wait times, improved quality of care, improved access to medical technologies, and less waste.
In other words, Albertans will receive far better value from their health-care system, which is currently among the most expensive in the world. And relief can’t come soon enough—for example, last year in Alberta the median wait time for orthopedic surgeries including hip and knee replacements was 66.8 weeks.
The naysayers argue this approach will undermine the province’s universal system and hurt patients. But by allowing a spectrum of providers to compete for the delivery of quality care, Alberta will follow the lead of other more successful universal health-care systems in countries such as Australia, Germany, the Netherlands and Switzerland and create greater accountability for hospitals and other health-care providers. Taxpayers will get a much better picture of what they’re paying for and how much they pay.
Again, Alberta is not exploring an untested policy. Almost every other developed country with universal health care uses some form of “activity-based funding” for hospital and surgical care. And remember, we already spend more on health care than our counterparts in nearly all of these countries yet endure longer wait times and poorer access to services generally, in part because of how we pay for surgical care.
While the devil is always in the details, and while it’s still possible for the Alberta government to get this wrong, Monday’s announcement is a big step in the right direction. A funding model that puts patients first will get Albertans more of the high-quality health care they already pay for in a timelier fashion. And provide to other provinces an example of bold health-care reform.
Nadeem Esmail
Senior Fellow, Fraser Institute
From the Montreal Economic Institute
Alberta’s move to fund acute care services through activity-based funding follows best practices internationally, points out an MEI researcher following an announcement made by Premier Danielle Smith earlier today.
“For too long, the way hospitals were funded in Alberta incentivized treating fewer patients, contributing to our long wait times,” explains Krystle Wittevrongel, director of research at the MEI. “International experience has shown that, with the proper funding models in place, health systems become more efficient to the benefit of patients.”
Currently, Alberta’s hospitals are financed under a system called “global budgeting.” This involves allocating a pre-set amount of funding to pay for a specific number of services based on previous years’ budgets.
Under the government’s newly proposed funding system, hospitals receive a fixed payment for each treatment delivered.
An Economic Note published by the MEI last year showed that Quebec’s gradual adoption of activity-based funding led to higher productivity and lower costs in the province’s health system.
Notably, the province observed that the per-procedure cost of MRIs fell by four per cent as the number of procedures performed increased by 22 per cent.
In the radiology and oncology sector, it observed productivity increases of 26 per cent while procedure costs decreased by seven per cent.
“Being able to perform more surgeries, at lower costs, and within shorter timelines is exactly what Alberta’s patients need, and Premier Smith understands that,” continued Mrs. Wittevrongel. “Today’s announcement is a good first step, and we look forward to seeing a successful roll-out once appropriate funding levels per procedure are set.”
The governments expects to roll-out this new funding model for select procedures starting in 2026.
* * *
The MEI is an independent public policy think tank with offices in Montreal, Ottawa, and Calgary. Through its publications, media appearances, and advisory services to policymakers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship.
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