De-Listing of Services - Alberta's shame

Note how they call Medicare a "beast"
Certainly, these people are offensive!

The province is considering delisting about 30 services from medicare that don't require coverage under the Canada Health Act, Alberta's employment and immigration minister told an audience in Grimshaw this week.
Hector Goudreau said the province is debating whether services such as chiropractic care and mole extraction should be removed from coverage.
"There's no need to cover them," Goudreau told a Grimshaw Rotary club meeting on Tuesday, according to the Mile Zero News, a weekly paper in the town south of Peace River.
"Our system is totally not sustainable."
The weekly newspaper's story on the minister's speech is slated to run Feb. 11.
Goudreau, who is the area's MLA, said the money saved would be used to bulk up coverage under Alberta Blue Cross.
After speaking with the local newspaper, Goudreau wasn't available for an interview with The Journal.
Health Minister Ron Liepert said the government is going line by line through the entire health budget to make sure money is being spent properly.
"Quite frankly, I wouldn't be doing my job as minister if we didn't look at every line of expenditure in our budget and ask the question, do we need to spend that money?" Liepert said, noting that anything protected under the Canada Health Act will continue to be covered.
Currently, Alberta covers some services not listed under the Canada Health Act, including up to $200 in chiropractic care, up to $250 for foot care and free annual eye exams for seniors and children.
Liepert said the government regularly examines what to cover and not cover. Last year, for instance, the province announced it would cover expensive catastrophic drug costs for Albertans with rare disorders.
"Are we going to spend the same amount of dollars on the same amount of programs that we spent last year?" he said. "I can't say that we are, because we have to go through our budget to ensure that every budget expenditure is justified."
During an interview, Liepert initially said the province had no plans for delisting, then reversed course.
"I don't think I said there were no plans to do any delisting," he said. "I guess it depends on what you call delisting. All I said is we are in the process of preparing our budget."
In 2003, a report commissioned by the government found the province could save $40 million a year by reducing -- but not completely cutting -- coverage for chiropractic services, podiatry care and annual eye exams for children and seniors.
But the government axed the idea as soon as the report was released, saying the millions in savings were insignificant compared with the $7.3-billion health budget.
Bob Westbury, chairman of the panel that produced the report, said at the time, "I am absolutely terrified that if we don't get control of this beast we are going to be in very, very serious difficulties."
Since then, the budget has ballooned to $13.4 billion and Alberta Health Services is facing a $1.3-billion deficit.
John Church, a political science professor at the University of Alberta who focuses on health policy, said he suspects the government wants MLAs to speak about the issue to see how much the public will push back, especially in traditional Tory territory.
He said the government has more political leverage now than in 2003 to consider delisting, because of the bad economic times.
He said the government will likely be careful about what services to delist, and suspects wart removal won't be a hot-button issue, although chiropractic care may be another matter.
"This has been controversial because deciding what is basic health care involves a bit of a value judgment, and it's quite complicated," Church said.
David Eggen, executive director with Friends of Medicare, said all the services are medically necessary.
'ARBITRARY DECISION'
"What makes them necessary one day and not necessary the next?" Eggen said. "It's an arbitrary decision by the government to narrow the scope of public health care. If they are changing the definition of what is medically necessary, they are not doing it for medical reasons, they're doing it for political and economic reasons."
He said if services are delisted, people will chose not to have medical procedures done for financial rather than health reasons.
"I don't think Albertans will find this acceptable," Eggen said.
"The government best be careful. They are playing with dynamite when they start delisting medically necessary services ... You still have to provide these services to the public. It's not as if the health issues go away."
Phylis Matousek, a longtime seniors activist who requires $758 orthotic shoes, said any move to delist services must take into consideration the financial reality for seniors. She is squeezed by housing and food costs, as well as other payments for non-medical services -- $20 to have her house vacuumed, $15 to have someone buy her groceries -- because her health limits her.
"It's going to really cut into the fingernails when some of us are hanging on by our fingernails," Matousek said. "We're going to have a financial manicure."
Liberal Leader David Swann called on Liepert -- not rural MLAs -- to speak publicly about any changes planned for the health-care system.
"For a province that's been in multibillion-dollar surpluses this past 12 years, it's pretty hard to swallow that this government is now unable to provide medically necessary services to people the first year we have been faced with less than a $12-billion surplus," Swann said.
"This will raise hackles and raise serious medical concerns about whether we're being penny wise and pound foolish, because if these things are neglected, they're only going to come back and add to the health system problems and the wait lists and the chronic health issues."
jsinnema@thejournal.canwest.com