Alberta's much ballyhooed 'Third
Way' health reforms have spectacularly crashed and burned.
Ralph Klein had no choice but to abandon his long-promised
market-driven plans for the province's healthcare in
the face of mounting pressure from within the province
coupled with warnings of draconian fiscal punishment
from Prime Minister Stephen Harper and federal health
minister Tony Clement. Mr Clement described Ottawa's
power to withhold health transfer payments as a "blunt
instrument." And this is one stick Mr Klein didn't want
to feel the end of — particularly after the drubbing
the once-unassailable 'King' of Alberta took at the
hands of his party's rank and file in a recent leadership
review.
For University of Alberta political
science professor Steve Patten, PhD, this episode tells
a great deal about how the minority Tories in Ottawa
will govern. "Ideologically, people like Prime Minister
Stephen Harper and Tony Clement are comfortable with
the sort of experiments that Ralph Klein proposed in
the 'Third Way'," he says. "But in practical political
terms the federal Conservatives have to be seen as defenders
of the Canada Health Act if they hope to win a majority.
"The letter the prime minister
wrote to Ralph Klein raised concerns about dual practice
physicians," he adds. "It seems he picked up on a lot
of the good thinking that has come up in the last 10
years of serious research on the Canadian healthcare
system. It appears that both he and Mr Clement are getting
good advice from federal health bureaucrats."
WATCH
YOUR BACK
After his dismal showing in the recent leadership review,
Mr Klein announced that he'll be stepping down as premier
by the end of the year. Jim Dinning and Dr Lyle Oberg,
two fellow Alberta Progressive Conservative party members
and frontrunners in the race to succeed Mr Klein as
premier, openly criticized the 'Third Way' plan in the
run-up to its derailment. The plan didn't strike a chord
with Mr Klein's once-loyal constituents, including many
physicians, either. In practical terms this means that
the more controversial parts of the 'Third Way' —
particularly allowing doctors to work both public and
private systems — won't likely be revisited under
the next premier.
CHERRY
PICKING
But what about the not-so-controversial aspects of Ralph
Klein's plan? For the Alberta Medical Association (AMA),
the timing of Mr Clement's — who was once dubbed
"Two-tier Tony" — political wrecking ball could
scarcely have been worse. The federal minister's comments
came just days before the AMA's big doctor forum on
'Third Way' was to be held in Edmonton. The AMA was
most unhappy about the plan's failure to offer care
guarantees.
The AMA forum went ahead anyway,
but with a new mission: AMA president Dr Tzu-Kuang Lee
urged the Alberta government to salvage the bulk of
the reforms that don't challenge the Canada Health Act.
"Let's not throw the baby out with the bathwater," Dr
Lee said at a press conference on April 29. Dr Lee hopes
the best parts of the 'Third Way' plan will survive.
In particular, he's rooting for investments aimed at
fixing Alberta's doctor shortage, increasing its electronic
health records funding and investing in primary care
health teams.
Dr Patten agrees that the majority
of the 'Third Way' plan's 10 points are very reasonable
and uncontroversial. In fact he deems the first seven
points as very positive. (For more on the nuts and bolts
of the plan see "Ralph
Klein bets the farm on Third Way" in the March 30
issue of National Review of Medicine).
THE
BIG DEAL
Has the news media unfairly raked Ralph Klein over the
coals during the 'Third Way' controversy, especially
considering the fact that private healthcare is much
more on the march in Quebec? Not really, says Dr Patten.
"Quebec Premier Jean Charest did not allow dual practice
physicians — which is in my opinion the most negative
aspect of the 'Third Way' plan."
However Mr Klein has been taunting
the feds with teasers of the plan so long it's unsurprising
that he was so harshly rebuked, even by fellow Tories.
"For years, he vacillated between saying 'I might be
violating the Canada Health Act, it's going to be a
rough ride' and then saying 'We're just going to introduce
modest reforms'," says Dr Patten, who hopes this will
spell the end of free market zealotry of Alberta's health
agenda. "I think politicians who are looking for a Big
Bang fix for healthcare are misguided," he says. "What's
actually needed is real persistence in implementing
the recommendations of existing studies."
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