From the Fraser Institute

By Bacchus Barua and Tegan Hill

Shortly after Danielle Smith was sworn in as premier, she warned Albertans that it would “be a bit bumpy for the next 90 days” on the road to health-care reform. Now, more than two years into her premiership, the province’s health-care system remains in shambles.

According to a new report, this year patients in Alberta faced a median wait of 38.4 weeks between seeing a general practitioner and receiving medically necessary treatment. That’s more than eight weeks longer than the Canadian average (30.0 weeks) and more than triple the 10.5 weeks Albertans waited in 1993 when the Fraser Institute first published nationwide estimates.

In fact, since Premier Smith took office in 2022, wait times have actually increased 15.3 per cent.

To be fair, Premier Smith has made good on her commitment to expand collaboration with the private sector for the delivery of some public surgeries, and focused spending in critical areas such as emergency services and increased staffing. She also divided Alberta Health Services, arguing it currently operates as a monopoly and monopolies don’t face the consequences when delivering poor service.

While the impact of these reforms remain largely unknown, one thing is clear: the province requires immediate and bold health-care reforms based on proven lessons from other countries (e.g. Australia and the Netherlands) and other provinces (e.g. Saskatchewan and Quebec).

These reforms include a rapid expansion of contracts with private clinics to deliver more publicly funded services. The premier should also consider a central referral system to connect patients to physicians with the shortest wait time in their area in public or private clinics (while patients retain the right to wait longer for the physician of their choice). This could be integrated into the province’s Connect Care system for electronic patient records.

Saskatchewan did just this in the early 2010s and moved from the longest wait times in Canada to the second shortest in just four years. (Since then, wait times have crept back up with little to no expansion in the contracts with private clinics, which was so successful in the past. This highlights a key lesson for Alberta—these reforms are only a first step.)

Premier Smith should also change the way hospitals are paid to encourage more care and a more patient-focused approach. Why?

Because Alberta still generally follows an outdated approach to hospital funding where hospitals receive a pre-set budget annually. As a result, patients are seen as “costs” that eat into the hospital budget, and hospitals are not financially incentivized to treat more patients or provide more rapid access to care (in fact, doing so drains the budget more rapidly). By contrast, more successful universal health-care countries around the world pay hospitals for the services they provide. In other words, by making treatment the source of hospital revenue, hospitals provide more care more rapidly to patients and improve the quality of services overall. Quebec is already moving in this direction, with other provinces also experimenting.

The promise of a “new day” for health care in Alberta is increasingly looking like a pipe dream, but there’s still time to meaningfully improve health care for Albertans. To finally provide relief for patients and their families, Premier Smith should increase private-sector collaboration, create a central referral system, and change the way hospitals are funded.

Bacchus Barua

Director, Health Policy Studies, Fraser Institute

Tegan Hill

Director, Alberta Policy, Fraser Institute

From LifeSiteNews

By Alliance Defending Freedom

The American Society of Plastic Surgeons argued that ‘genital surgical interventions’ have not been proven an effective solution to adolescent gender dysphoria, adding that current ‘research’ backing medical intervention is of ‘low quality/low certainty.’

One of the most effective weapons that proponents of radical gender ideology have wielded in support of their cause has been “consensus.”

When pressed to explain how blocking a young boy’s puberty or removing a teenage girl’s healthy breasts provide any medical or mental benefit, they often cite “experts” or refer to a “consensus” of medical organizations and government agencies.

But there’s a problem with that strategy.

Recent research has shown the glaring flaws in the argument that transition drugs and procedures are appropriate or helpful for minors. European countries that had once embraced “gender affirming care” for minors, including the U.K., have begun to reverse these policies.

While American medical organizations and governments have been slow to respond, recent developments indicate that may be changing.

Earlier this year, City Journal reported that the American Society of Plastic Surgeons (ASPS) had not signed on to “any organization’s practice recommendations for the treatment of adolescents with gender dysphoria.”

ASPS added that there is “considerable uncertainty as to the long-term efficacy for the use of chest and genital surgical interventions” and that “the existing evidence base is viewed as low quality/low certainty.”

More recently, the president of that organization, Dr. Steven Williams, told a local media outlet, “I don’t perform gender-affirming care in adolescents, and the reason why is because I don’t think the data supports it.”

“So at my practice, we don’t even entertain that.”

Prominent plastic surgeon Dr. Sheila Nazarian echoed that sentiment. “I think some physicians and some medical associations have been overtaken by a vocal minority and they are politicized,” she said. “This is 100 percent an American political issue. If we look at Europe, very progressive governments have backed off of these procedures in minors because they’re just analyzing the data – as we should with every procedure. Why is it that for this procedure, in this patient population, we just have to shut up?”

In addition, whistleblowers have come forward to reveal the damage being done to children. Evidence now shows that the World Professional Association for Transgender Health (WPATH) has exerted pressure on researchers. In fact, leaked files from WPATH show that some doctors understood many of the concerns about pushing such drugs and procedures on minors – but did so anyway.

A landmark review of the available research on the effect of these drugs and procedures by Dr. Hilary Cass “demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.”

The Cass review, commissioned by the U.K. National Health Service, noted that “[t]he strengths and weaknesses of the evidence base on the care of children and young people are often misrepresented and overstated, both in scientific publications and social debate.”

In short, the “consensus” that our media, doctors, activists, and politicians rely upon is no consensus at all. It’s based not on proven science but on a commitment to ideology.

These cracks in the façade that advocates of gender ideology use as a shield provide hope to those who have long been advocating for the truth – in the courtroom and in the culture:

• The truth that no amount of cross-sex hormones or permanently damaging surgery can change a person’s sex.
• The truth that doctors have a duty to “do no harm,” and that includes being honest with patients about the facts regarding procedures that are mischaracterized as “gender affirming.”

It’s heartening to see prominent doctors from at least one major medical association speak the truth about the harm being done to so many children.

In the wake of Donald Trump’s election, we are hopeful that the new administration will follow through on promises to protect boys and girls from gender ideology.

And the issue of gender transition efforts for children has reached the U.S. Supreme Court too. On December 4, the court heard arguments in United States of America v. Skrmetti, in which the state of Tennessee is defending its law protecting children from these harmful and unnecessary procedures.

But we know that regardless of what happens in Washington, D.C., we will continue to face challenges in statehouses, government agencies, and school districts across the country.

The fight for truth isn’t over yet – but this is a big step toward achieving a lasting victory.

Reprinted with permission from the Alliance Defending Freedom.