Have Alberta's PC leadership candidates ever been to Europe?

Here we go again. Progressive Conservative leadership candidate Gary Mar suggests opening up Alberta’s health care sector—the one quasi-monopolized by government—to some private options. Sensibly, Mar does so in the context of continued universality. The result? Fellow leadership contenders and the usual suspects launch a disinformation blitzkrieg.

Alison Redford expresses “surprise” and argues the real issue is equality: “I don't believe Albertans want us to have a system that can create preferential treatment.” She means the wealthy might find ways to get treated faster than the rest of us.

Doug Horner chimes in against more private options because “we've got lots to do in our publicly funded system.

Then there were the usual rent-a-quote clips. The Alberta Union of Provincial Employees asserts “our public health care system works.” Bev Dick, the vice-president of the Alberta union that represents nurses, argues Mar was wrong to view health care as a “commodity”.

So much distracting flack and so little space to correct myths but we’ll try.

Health care is a commodity and always will be. When the nurses’ union negotiates with government, they sell their services at a profit. No nurse will say—“Hey, cover just my past tuition expenses and we’re good.”

Also, the nurses’ union uses supply-and-demand reasoning in their bargaining. Union negotiators tell government the demand for nurses is high (as it is). They then point out if wages and benefits are not competitive, the supply of nurses can and will go elsewhere.

Then there is the other myth, that Canada’s health care system “works.” Only in the sense that a 40-year old car works without air conditioning, cruise control and uses too much gas.  

Internationally, according to the latest OECD figures, Canada’s health care system was the sixth most expensive health insurance system out of 33 countries. Moreover, we ranked between seventh and 21st in most indicators that measure the availability of medical resources and services.

In 2010 in Alberta specifically, patients waited about five-and-a-half months from the time they obtained a referral from a general physician to the time they received elective treatment from a specialist. That’s more than double than the (just over) two-month wait time in 1994.

Regrettably, substandard access to medical services and high health care costs will only get worse as Canada’s population ages.

This is where another anti-Mar myth and misconception must be addressed: Redford’s “equality” argument and Horner’s let’s-just-fix-the-public-system-first tack.

Fact is, the wealthy already get preferential treatment. Canada’s millionaires fly to the United States if they want to skip our queues. So that’s a non-issue under any reform.

The critical query is: how can the rest of us get improved access, more doctors in the system, preserve universality and not go broke privately or via the tax-funded public system (i.e., by running deficits to finance health care).

Answer: Not by “concentrating” more on the public system. That system has all the classic signs of a monopoly—because it mostly is: missing supply and demand price signals, politicization, and capture by special interests—think health care unions that claim they’re immune to “profit”.

The only real solution: copy European countries that provide universal coverage but rarely ration access to medically necessary care and thus do not make patients wait unnecessarily long, two characteristics that regrettably characterize Canadian, government-run, government-insured health care.

A number of European countries share Canadians’ social goal of universality. But they also use cost-sharing mechanisms such as user-fees. They also mandate health insurance in a well-regulated competitive market to prevent (private or public) monopolies in service delivery from developing.

Consider Switzerland, Germany, and the Netherlands. All three countries have a health insurance mandate. There, by law, everyone must purchase a basic insurance package in a competitive private insurance market in addition to co-payments at the point of service. Those who cannot afford the insurance or user fees are given taxpayer-funded subsidies. That way, they can choose and purchase their own standard insurance package in an open market.

Consequently, insurers negotiate with providers on price and quality, and must compete for patients. At the same time, patients can shop around for the insurance plan that best meets their personal medical needs. Best of all, people in Switzerland, Germany and the Netherlands have universal coverage with virtually no wait times.

All of this is apparently unknown to Alberta’s PC leadership candidates, save Gary Mar. What a pity. Perhaps the other PC candidates, the ones too provincial in their outlook, should travel to Europe. Health Canada approvals for new medicines slower than in Europe and U.S.|article|142|||||||||||||||186|||1366851600|1|1|en|

CALGARY, AB—It takes Health Canada nearly a year to grant marketing approval to prescription drugs while new medicines are often approved faster in Europe and the United States, according to a new report from the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.

Federal Delays in Approving New Medicines calculates that Health Canada took a median of 355 days to issue a Notice of Compliance certifying new patented medicines as safe and effective in 2011.

These new drugs have already passed extensive clinical trials in accordance with international safety standards, and are reviewed by European and American agencies for safety and efficacy. But Health Canada holds them in bureaucratic limbo, often for more than a year,” said Nadeem Esmail, Fraser Institute director of health policy studies and co-author of the report.

“This raises important questions about whether the drug evaluation system in this country is beneficial or detrimental to Canadians.”

The report shows that every year from 2007 to 2010, Health Canada took longer than its European counterpart, the European Medicines Agency (EMA), to approve new drugs; the largest gap was in 2010, when Health Canada approval was 448 days compared to 319 at the EMA. Health Canada was just 10 days faster than the EMA in 2011.

Health Canada also took longer to approve new medicines than the U.S. Food and Drug Administration (FDA) in four out of five years from 2007 to 2011; the largest gap was again in 2010, when Health Canada approval was 448 days compared to 299 at the FDA.

Critically, Canadians do not have access to new medicines until they have received a Notice of Compliance certifying that Health Canada considers the new medicine safe for public use. A similar process is followed in Europe and the United States.

The report suggests that Canada’s federal government could improve access to new medicines through harmonization and mutual recognition with international regulatory agencies.

“Specifically, FDA or EMA approval decisions could be accepted as equivalent to Health Canada decisions, thus reducing the cost of drug approvals in Canada for both taxpayers and drug manufacturers, while simultaneously speeding Canadians’ access to new medicines,” Esmail said.