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Why and how the Wildrose 'wait time guarantee' adds up to two-tier health care

If you, dear reader, are one of the thousands of Albertans who has come to the conclusion the Wildrose Party's health care wait-time guarantee sounds like a pretty good idea, there may be some value as voting day draws nigh to revisiting how this scheme is actually supposed to work.

Because it's pretty plain on the face of it why and how this is an example of two-tier health care in which those who can pay get the treatment and those who can’t get to be sick, and possibly die.

Yet I can’t recall ever reading a journalistic account of this idea that really clearly spelled out how it's supposed to work, or that does the arithmetic -- although, in fairness, the Wildrose Party itself has been clear enough, even if they haven't dwelled on it amid all their rhetoric about their (doubtful) commitment to preserving publicly funded health care.

What you usually hear from the Wildrose Party is this, as their Policy "Green Book" states: They will … "further reduce surgical and specialist wait times by funding needed services for Alberta patients outside the province should timely access to a medically necessary procedures (sic) be unavailable in Alberta."

What you don't hear repeated so often are the sentences that follow: "In such cases, the cost to the government to have that same procedure performed in Alberta would instead be sent to the out-of-Alberta health provider. The patient would be responsible for costs over and above that amount." (Emphasis added.)

Got that? The patient would be responsible for costs over and above that amount.

Never mind for a moment the propensity of business people, and especially health care business people, to jack their prices up to what the market will bear, something that is bound to happen as word gets around that patients from Alberta are coming to the market with the cost of a safe, efficient, publicly provided procedure in their pocket.

So let's imagine you require something drastic, like a lung transplant, in order to survive.

According to the Public Health Agency of Canada, recent estimates of the cost of a lung transplant in Canada including hospitalization range from about $100,000 to $150,000.

So let's also imagine that a public facility is not available in Alberta that can do the job, assuming the availability of a transplantable lung, within the period set out in the Wildrose "wait time guarantee."

So the Government of Alberta, vows the Wildrose Party, will forward that $150,000 to the out-of-province health care provider. (Or, for that matter, to the fully private operator within the province, the establishment and nurturing of which is surely part of the Wildrose plan.)

Not being a medical statistician, there is some risk I’m not comparing oranges and oranges here -- I may even be comparing oranges and tangerines. But a 2010 story that I found on the Internet with Google’s assistance in 0.35 seconds indicates that the average U.S. cost of the same procedure for a severely ill patient is approximately $277,000, with total full-year costs around $292,000.

If these figures are an accurate reflection of the differences in cost between a for-profit U.S. procedure and a publicly financed procedure in Canada, you and your family could expect to be on the hook for the difference, which would be $127,000 or more.

If the only clinic that could provide the procedure were in, say, Florida, presumably you and your family would be on the hook for the cost of flights to and from, possibly medical flights, accommodation and sustenance for a month or so.

You won't be going on this trip alone, presumably, so let’s be crazy generous and say $1,000 for the flights (in the unlikely event you’re capable of flying tourist class), $1,000 for car rental in Florida, $1,000 for incidentals, $5,000 for accommodation and a couple of thousand for food. So add at least another $10,000 and come up with $137,000.

The cost of following up any complications, of course, will be covered by Alberta’s beleaguered health care system, which no doubt will be beset by a shortage of surgeons as health care professionals here in Alberta abandon public practice to set up their own highly profitable private clinics.

So if you're one of those who can’t pay, wait times will grow even longer.

Of course, your Wildrose government will then tell you that you have even more "choices" -- you can buy private insurance to cover your out of province costs. If you don't have a pre-existing condition, that is. You know, like needing a lung transplant.

But never mind all that detail stuff and the many costs for you and your family associated with it. Just ask your self if you can afford an extra $140,000 or so to take the Wildrose Party up on its "wait time guarantee."

If it's knee surgery you need, maybe you'll only be out only $10,000 or $15,000.

But please don't tell me the Wildrose Party isn't proposing a two-tier health care system!

This post also appears on David Climenhaga's blog, Alberta Diary.

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