Delisting of health back on agenda
Tories consider forming panel to look at cuts
By Renata D'Aliesio And Michelle Lang, Calgary Herald April 15, 2009 3:01 AM

In the strongest sign yet that the Alberta government could soon delist more medical services, Health Minister Ron Liepert said Tuesday the province is examining the creation of an expert panel to review what procedures the province will pay for--and what the public must shoulder.
One week after the province announced it would no longer pick up the tab for chiropractic care and sex change operations, both Liepert and Premier Ed Stelmach raised the prospect more non-essential services could be cut as soon as this fall.
Stelmach said his health minister will talk with Albertans and the new medical superboard about delisting services before cabinet makes a decision on any changes.
"Keep in mind that in a lot of the services that we offer, many of them are outside the Canada Health Act,"Stelmach told reporters at the legislature.
"I'm not saying that we have to look at all the services, but we're going to have to ensure that we preserve our public health-care system for the future."
Liepert said the Canada Health Act is not clear on what procedures the government must fund and the province is contemplating asking a group of experts to examine "what is medically necessary, what is essential, what needs to be covered, what doesn't need to be covered."
Pro-medicare groups and unions slammed talk of delisting services and the possibility of an expert panel, arguing the government is returning to the contentious Klein-era health reforms.
They noted former premier Ralph Klein established a panel following the 2002 Mazankowski report to review provincial coverage of services like podiatry.
"Mr. Liepert laid his cards on the table today," said Dave Eggen, executive director of Friends of Medicare.
"He wants to get away with as much as he can in terms of privatizing and delisting."
The United Nurses of Alberta said Stelmach should not delist any procedures, noting the Conservatives did not raise the possibility of health cuts during last year's provincial election.
"It's a huge betrayal of the public interest and trust," said Heather Smith, president of the nurses' union.
The debate comes one week after the province's$13-billion health budget announced Alberta slashed funding for two procedures.
Alberta Health is discontinuing subsidies for patients' chiropractic care, saving the provincial purse around $53 million annually, and won't continue funding gender reassignment surgeries, which cost government about $700,000 a year.
On Tuesday, about two dozen people went to the legislature to protest the decision on the sex change operations.
Opposition parties accused the Conservatives of discriminating against Alberta's transgendered population, but Liepert said the tight budget necessitated difficult decisions.
"There were some very tough decisions that had to be made, everything from cancelling some programs around youth suicide prevention to programs around certain surgeries," he said.
The possibility of delisting nonessential medical services has been discussed in Alberta for years.
A major review of the medical system, conducted by former deputy prime minister Don Mazankowski, recommended establishing an expert panel to review funding for services that aren't considered medically necessary.
In 2003, the advisory panel suggested reducing or eliminating funding in several areas.
The Klein government, however, did not follow through on the panel's recommendations.
The issue of delisting non-essential services resurfaced earlier this year when Employment Minister Hector Goudreau was quoted as saying government wants to delist about 30 services like podiatry.
On Tuesday, Liepert said he couldn't elaborate on the possibility of creating an expert panel because the idea is in the early stages.
Ultimately, Stelmach said cabinet, not the panel, will have the final say on any changes.
"The decision rests with cabinet and that's where we're going to show leadership," he said.
Calgary Liberal MLA Dave Taylor suggested government is raising the prospect of delisting medical services to scare Albertans and pave the way for tax increases.
But NDP Leader Brian Mason urged Albertans to take the Stelmach government's delisting talk seriously.
"They can cry poverty right now and say, 'We have to do it for financial reasons,' but in fact they've been wanting to do this for a long time," Mason said.
The health minister said his goal is to ensure the health care system is sustainable for the future.
While final figures won't be available until June, Liepert said Tuesday the health superboard's operating deficit for last year will be about $500 million -- about $200 million smaller than earlier estimates.
Alberta Health transferred about $200 million in operating funding to the superboard last year in addition to its regular budget. Government officials said the funds were to deal with cost pressures and insisted they were not for the projected deficit.
rdaliesio@theherald.canwest.com
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