Profits over health in Alberta

By C. Rockarts

On Thursday, May 14, Alberta “relaunched the economy” and began the first phase of the plan to re-open golf courses, provincial parks, as well as some retail stores, daycares, and museums. While many of the prairie provinces have decided to re-open, the comparison of cases between Alberta, Saskatchewan and Manitoba is stark. As of this publication, Alberta has had over 6,800 cases of coronavirus, with Saskatchewan and Manitoba having 630 and 292 respectively. 89 people in Alberta have died, with the majority of cases being concentrated in Calgary. 61 of these deaths occurred at long-term care facilities.

Outbreak

Alberta has been the province with the largest single-site outbreak of COVID-19 in Canada. Two workers have died and over 900 workers were infected at a Cargill meat packing plant in High River. Workers have been raising workplace safety issues there for over a month. The second largest single site case of COVID-19 is at the JBS Canada beef facility in Brooks, where approximately 390 workers have tested positive for the virus. With Calgary and Brooks planning to re-open Monday, the question is, should the province be so quick to open before we have eliminated active cases? Given that many other countries have been unsuccessful in their relaunch and early reopening has resulted in second and third resurgences of the virus, the reopening plan should give workers pause.

Before the first reports of coronavirus were confirmed in Alberta, premier Jason Kenney and the UCP were set to freeze healthcare funding (reducing spending by 9%) and privatize the system. At the end of November, the Kenney government planned on firing 740 nurses, 3,000 full time equivalencies (FTEs) in general support services, 400 auxiliary nursing care FTEs, and over 1000 professional healthcare workers.

Alberta’s public service commissioner Tim Grant made clear the indication to privatize home-care, nursing, palliative and paediatric care, government legal work, emergency, non-emergency and all patient transfer ambulance services, as well as privatize portions of Alberta Precision Laboratories (formerly Alberta Public Laboratories). This also follows the proposed cancellation of upgrades to Alberta Health Services (AHS) laundry facilities, which was set to be contracted out.

The provincial budget indicated that these significant cuts were coming to the healthcare system, with $54 million cut from hospital operating system and $38 million cut from diagnostics. Much of the budget stemmed from the $2 million dollar government commissioned report from Ernst & Young, which reviewed AHS in order to “drive greater efficiencies, examine administrative costs and improve access and service levels”. The report recommended integrating public-private partnerships into the healthcare system, cutting laundry, housekeeping and food services, and diverting public money to for-profit private companies. 

Federal funding and healthcare in Alberta

Since the mid 1980’s, healthcare in Alberta has become one the biggest targets for privatization and cuts. Hospitals were quickly targeted as the biggest line in the provincial budget, followed by physician compensation, which has recently been a target of the present UCP government. 

In 1984, the Canada Health Act was passed, which required provinces to meet five set criteria in order to receive cash transfers to pay for health-care programs. The five principles are that care must be universal, portable, comprehensive, accessible, and publicly administered. As coverage under the Act has eroded and more services are delivered outside of hospitals, for profit health care providers have increased and the federal government has shifted the onus of paying for particular medicare services to provinces. This has resulted in austerity governments across the country taking this as an opportunity to move services into the private sector. Because the CHA is optional for provinces, there has been minimal enforcement of the Act, resulting in private health facilities receiving public provincial and federal dollars.

The federal Liberal government has been systematically reducing the transfers to the provinces that help fund healthcare by tens of billions of dollars since the 1970’s, and has slowly moved away from a 50/50 cost share agreement with provinces. According to a 2017 report commissioned by the Canadian Health Coalition and Ontario Health Coalition, the Trudeau government has created a massive deficit in health services, with Alberta making up $3.43 billion of the $31 billion dollar shortfall nationally. Today, federal funding is only 20%, and medicare advocates are calling on the federal government to cover a minimum of 25% by 2025.

Spin doctors vs. doctors 

Alberta has had a history of austerity. Ralph Klein began his premiership by claiming that healthcare spending had tripled during the last administration. Klein’s response was to gut spending by 25% by the end of his first term, resulting in Alberta plummeting provincial health spending to the second-lowest per capita of all the provinces. Hospitals shut down, the Calgary hospital was blown up, and over 10,000 health care professionals left the province. The effects of Klein’s assault on workers resulted in a 45% reduction in the public sector.

In 1994, Klein regionalized the entire healthcare service, abolishing 250 hospitals, public health boards, and long-term care. They were replaced with 17 health authorities in an effort to pay down the debt, but resulted in dramatically reducing hospital beds (4.5 to 2.4 bed per 1,000 people). That same year, the federal, provincial and territorial health ministers met, and all but Alberta’s minister Shirley McClellan (Klein’s first Minister of Health) agreed to ensure that the CHA requirements were upheld and that the development of private clinics funded partially by the public system and by patients was regulated. Today, McClellan sits on the Board of Covenant Health with former premier Ed Stelmach, which is the largest Catholic healthcare provider in Canada (and refuses to provide abortions and medically assisted dying) and runs 71 out of 79 palliative care beds in Edmonton.

In 1999, Klein announced his plan to privatize healthcare and open up the system to private funding through Bill 11: “The Health Care Protection Act”, legislation which would allow for public money to be used to pay private, for-profit clinics and perform a range of procedures only in hospitals, as well as authorize private clinics to keep patients overnight and specialize in particular surgical operations. When the Bill passed, advocacy group Friends of Medicare and healthcare unions across the province organized one of the largest campaigns against the Klein government, which had nightly protests attended by thousands of Albertans. 

Earlier this year, Health Minister Tyler Shandro implemented new rules that froze physician compensation. In response, the Alberta Medical Association (AMA) is now suing the government for bargaining in bad faith and bringing the province back to the table. Shandro made headlines when he attacked and harassed physicians for calling attention to his wife’s position as Co-Founder of Vital Partners, an insurance company that allegedly made money off changes to the physician reimbursement process. While this has since been disproved, it is notable that Vital Partners connects customers with private coverage for diagnostic testing.

Many physicians are warning of the same drain that nurses and doctors faced in the 90’s during the Klein cuts, which would see a mass migration of health care providers out of the province to find more profitable work.

Privatization of Labs

For decades, conservative governments in Alberta have attempted to privatize public lab services, leaving the system under resourced. In 1995, Klein privatized lab services in Edmonton regional hospitals, including contracting out laboratory services to DynaLife Dx at the Royal Alexandra Hospital. In Calgary, the Health Resources Centre (HRC) was a private surgery facility after being more expensive than alternative public services, failed to improve wait times, and cost Albertans millions of dollars following its bankruptcy.  In 2006, after a decade of issues with delayed service and mixed-up test results, lab services in both Edmonton and Calgary were brought back into the public sector. 

When the NDP rose to power in 2015, one of the first things they did was roll back the privatization of lab services, promising to phase out DynaLife and ensure that all Alberta labs were brought under provincial ownership by 2022. This came with a promise to construct a ‘superlab’ in Edmonton, which would have filled the infrastructure gaps existing labs have been dealing with. 

Three days into forming government, the UCP cancelled construction, despite $23 million dollars already invested in the planning and construction of the project. The UCP has additionally used the MacKinnon report and Ernst and Young review of AHS to inoculate Albertans towards the privatization of healthcare, including selling off public long-term care providers Capital Care, and Carewest. It is worth noting that COVID-19 deaths in Canada are approximately four times the rate in private long-term care facilities than in public facilities.

Not Going Back

The UCP continues to maintain that the economy is ready to re-open despite the decades of cuts and deteriorating capacity to the public system. The province has stated that in order to shift to the next stage of re-opening, they want to see “stronger international border control, an increase in provincial testing rates, and continued contact tracing”. 

What we need now is not increased criminalization of migrant workers who make up a majority of the workforce that is continuing to clean workplaces, supply Canada’s food, and provide front-line care. Workers and labour organizations in Alberta must demand major investment in public health care jobs and infrastructure to make up for the decades of reckless austerity and privatization that has left our system worse off in slowing down the spread. What we need now is an end to policing and state surveillance of primarily racialized communities under the guise of limiting exposure rates.   

Negotiations have been suspended since COVID-19 began, with AUPE and UNA having ensured job guarantees until May 31. There has been no promise from the government that they will not follow through with the planned healthcare cuts once the pandemic is over. Shandro promised last month that healthcare aides would receive a $2 raise, a wage increase that has yet to be seen by these workers. 
Conservatives in Alberta have long claimed that because healthcare makes up 40% of the budget, it should be the first thing on the chopping block. Coronavirus has exposed the gaps that have left workers behind in the name of colossal profits and corporate bailouts. Workers must reject the frame of having to choose between people’s lives and the economy, and demand federal funding and provincial investment in public healthcare to meet the needs of an aging and growing population.