Scary Stuff. Truly.

[EMSEDU]

Tories' grand plan for health a little unsettling

Don Braid, Calgary Herald

Published: Tuesday, December 16, 2008

Health Minister Ron Liepert has said candidly he doesn't want to unveil his whole health care plan all at once, in case he "scares the hell out of people."

Now we can see the whole plan, pretty much, in the McKinsey report that was slipped quietly onto a government website on Monday.

This document sets goals that seem impossible to achieve. Yes, it's going to scare the hell out of people.

In a fascinating section, the report says if all its reforms are implemented, the annual operating cost of health care will be reduced by $1.5 billion by 2020.

The population will rise sharply, but somehow Alberta won't need as many health care professionals --5,000 fewer nurses, for example.

This is either magic or a recipe for sharply declining health care.

The cost projection is also at odds with the minister's own words.

Liepert insists at one news conference after another that his measures so far "are not about cost-cutting." He says operating costs will rise next year, although at a slowing rate.

Yet, the report shows cost-cutting --not relative, but absolute--is a major goal of the reforms. Liepert insists the goals are not unrealistic, though.

"A lot of what they've uncovered is what's been wrong with the health-care system all along--it's incredibly inefficient," he says.

He's undoubtedly right in theory, but in the real world it's hard to imagine a system that costs less providing better care for more people.

There can be no doubt the role of rural hospitals is about to change radically. The future state of those hospitals, the report says, will be marked by investments in ambulatory care centres, tele-health, selected rural hospitals and EMS.

Crack the code and the message is: Alberta will have fewer rural acute-care hospitals. Some will be converted into what those of us who don't write bureaucratic reports would call clinics.

The system will rely on ambulances to get sick rural people to city hospitals. The trend that spread across Saskatchewan years ago is coming here.

In fact, some patients in big cities are already being steered to smaller hospitals for elective surgeries.

This may mean communities near Edmonton and Calgary will keep their full-service hospitals. What it means farther out is much less clear, although getting sick in High Prairie might not be a good idea.

This rural reform could prove to be the toughest thing the Stelmach government ever does, because it will inflame passions in the Tories' rural heartland.

If you've wondered why they moved with such blazing speed to uproot the old health regions, here's your answer. No rural regions exist to raise the alarm at hospital closures and conversions.

Meanwhile, the report is full of doomsday predictions about what will happen if the system isn't changed.

By 2020, Alberta will need 32 per cent more acute-care beds, 51 per cent more long-term beds, 39 per cent more doctors and 40 per cent more nurses.

Acute-care beds in Calgary hospitals, 92 per cent full now, will run at 97 per cent occupancy.

The dying David Thompson region (Red Deer area) will rise from 89 per cent to 110 per cent.

Nobody wants the status quo in health care, but this utopian report tries to convince us the government can completely reverse these trends in a growing province with fewer staff and less money.

Frankly, the grand plan sounds impossible-- and that's scary.

Dbraid@theherald.canwest.com

[Quakefire]

Nothing about EMS in there, considering that Calgary has removed their planned EMS budget in case the government tried to pull this is really scary. So if they are slashing costs everywhere, and now get control over all of Alberta EMS, what is going to happen to the operating budgets of those services?