LYTLE: Seriously... my neighbour's dog gets faster medical service than I do

There is a science to problem-solving that has fed innumerable books and seminars. When I was a young engineer, my corporate cohort was given the book and sent to Kepner-Tregoe seminars about defining and then solving problems — all kinds of problems. Now, as a cranky retired engineer, it seems the art of problem solving is being lost. But that could be just me.The existential problem of today seems to be fixing health care. When the federal government cut health care transfer payments in the early 1990s, Premier Ralph Klein considered leaving the Canada Health program. I was hoping that he would do so.In 1998, at a public address dealing with the existential crisis of that year — fixing health care, I won the door prize of a set of glasses embossed with the image of Ralph Klein. Karma. Twenty seven years later, one wonders when someone is actually going to fix health care. Here is my contribution to the quest.As per my Kepner-Tregoe training, the place to start is by uncovering and then examining the assumptions that exist but are never questioned. Sometimes we refer to these as 'the elephant in the room.'It seems to me that the huge, “elephant in the room,” assumption in the health care discussion is the need to stick with the Canada Health Act and the money transfer that comes with it. Therefore, a good question to ask is,“If we want to fix a problem, then why remain slavishly devoted to the issue that provides most of its cancer-producing sugar?”I am not an expert in the constitutional arguments surrounding the application of the five pillars of Canada Healthcare. So, in my ignorance I ask,“Why don’t Albertans just opt out of the legislation? Why not invoke the Sovereignty Act and say ‘nyet’ to the whole mess?”Let’s let the federal government take us to court to force participation. I am motivated to ask this question by two things. The first is the work done by SecondStreet.org in defining the health care problem in granular detail. I can’t go into their arguments here, but they are well considered and explained. The second force is my experience with the public/private healthcare system in Peru. I paid a small, monthly fee to belong to a private clinic while maintaining access to the general, if poorer quality, offerings of the public system. The private clinic was staffed by specialist physicians who were trained at the best hospitals in the United States and had access to the latest diagnostic equipment. So, if I needed an MRI, I would pay $75 and get it the next day. If I needed a cardiac workover, stress test and diagnostic imaging, I paid $200 and got it the next day. It left the public hospitals more time and room to deal with those who opted not to pay for privately delivered healthcare.Could a similar private-public system be made available in Alberta? SecondStreet has done enough work to suggest that it would be possible.“But that is a two-tiered system!” you shout. To which I counter that such a statement is like being horrified that my neighbour can afford a Lexus and I can't. Also I notice that my neighbour’s dog has access to better medical treatment than I do because we allow options in the “doggyworld” medical system. “Rocky” doesn’t wait for his operations. It is stupid beyond words that our slavish devotion to an unworkable system allows his dog to get better medical care than I do.But how do we finance a system with an almost $8 billion funding hole? The 2024-25 Alberta budget is estimated at $73 billion, and healthcare represents $26 billion of that expense or 36% of the total budget. The $8 billion healthcare contribution from the federal government represents 31% of that cost and 11% of the total budget. Could we find places to cut 11% of the current total budget? Of course we can, but it requires a conversation. More importantly, is it necessary to give the federal government the taxes in the first place? Could we not hold back $8 billion and set off on our own? Could we threaten to hold back $8 billion unless and until changes that are necessary to the sustainability of the healthcare program are made in the following five pillars? These are:1. Universality of coverage: provinces must cover 100 percent of doctor’s and hospital costs.2. Portability of coverage: provinces must cover healthcare costs of citizens from other provinces at the level of service of the providing province3. Reasonable accessibility to services: user fees and other financial charges must not become barriers to access4. Comprehensiveness of services: services must cover all “medically necessary” activities provided by doctors or within hospitals.5. Public administration: services must be offered by a province or a body accountable to the province.With these pillars in mind, what changes might be considered? Again, I am not an expert but here are some thoughts. 1. Perhaps we should return to the views of Tommy Douglas on comprehensiveness and universality. Must the system cover everything"? Perhaps it needs to only cover basic procedures and allow private insurance to cover add-ons like specific diagnostic treatments, sports medicine, cosmetic surgery and other “non-basic” treatments? 2. In a free, capitalist system should I not be able to enter into a private transaction with my doctor in which I pay an annual or monthly fee for enhanced services? 3. Many provinces do not properly reimburse Alberta Health for care given to their residents when visiting Alberta. Perhaps there needs to be better “financial recovery mechanisms” that include not providing services to provinces that shirk?4. Lots of countries besides Peru (Ireland, Australia, France) offer mixed private and public health care systems that provide services without inordinate wait times and doctor shortages.The basic assumptions of Alberta’s participation in the Canada Health system must be challenged. Until they are, there will be no solution to the ongoing, upward creep in smothering healthcare costs. We also know with certainty that the federal government will not cover this ongoing budgetary creep.Alberta Health is like the person trying to save the drowning swimmer. The more the drowning swimmer — Canadian healthcare system — panics and thrashes around the more likely the life-saver, Alberta Health, will also be drowned. The Friends of Medicare will howl and gnash their teeth at what I am proposing. However, they have had from 1998 until today to offer up their solutions and their silence is not encouraging. It is time to break from the five pillars and build a new healthcare system that at least rivals that of my neighbour’s dog.