Calgary tests waters with private health careCALGARY, Alberta (MarketWatch) — In the oil-rich town of Calgary, there’s no shortage of deal-making swagger. But there’s a growing shortage of patience with strains on the local health-care system that’s pitting free-market enthusiasts against supporters of the popular public health program.

It’s part of a broader debate taking place not just across the Canadian province of Alberta, but in the United States as well.

American voters are set to weigh in on the first wave of President Barack Obama’s health-overhaul changes in the midterm elections Nov. 2 after a prolonged and at times bitter dispute over the proper role of government in financing health care. Even in Canada, where the public system is a point of national pride, signs of strain are showing as the population ages and health care shifts outside traditional hospital settings.


Calgary weighs private optionsIn Canada, rising health-care costs are prompting a call for changes to the country's popular public program. The Chamber of Commerce is making its case for a greater role for the private sector. MarketWatch's Kristen Gerencher reports.
The U.S. is preparing to increase the role of government by covering 32 million more Americans through tighter regulation of private health insurers and an expansion of the Medicaid program, with the biggest changes starting in 2014.

North of the border, Canadian provinces are tinkering with becoming more profit-driven, making now the right time to foster more health-care discussions between the two nations, said Tom Noseworthy, professor of health policy and management at the University of Calgary.

“You’re going to become more universal. We’re going to become more private,” he said. “Can we please talk about the implications and learn from each other?”

Calgary is a fast-growing, business-friendly city nestled in the mountains of southern Alberta, a geographically large province with 3.7 million residents. Taxes are low, company profits are high and, as in the rest of Canada, health care for medically necessary doctor and hospital services is guaranteed to every legal resident at virtually no out-of-pocket cost to the patient. The big-ticket items left out of the public plan include prescription drugs, long-term care and home care. But workers typically receive supplemental employer benefits that cover drugs, and many provinces cover seniors’ medications.



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Health care at crossroads
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• Canada's limited health-care opportunities
• Calgary weighs private options for care /conga/story/2010/10/canada-health-care.html 106278 Wait times for services and costs are two of the main concerns with the provincial health program. Some patients had to wait as long as 51 weeks from decision to treatment for a knee replacement during 2009-2010, according to Alberta Health and Wellness. The wait for cataract surgery for all of Alberta averaged 41 weeks last year before the government embarked on several surgery “blitzes” aimed at increasing capacity and decreasing wait times.

Health care comprised nearly 40% of provincial expenditures this year. That figure grabbed the attention of the Calgary Chamber of Commerce, whose members deemed health care a high priority for 2010.

“This was surprising because health care hasn’t come up in the top five priorities for as long as I can remember,” said Ben Brunnen, director of policy and research. The Chamber wants the government to allow a greater role for the private sector, which it says would alleviate wait lists and reduce costs.

Different views on costs
Changes may be in store if health care’s portion of the budget rises much higher, but it’s unclear where the tipping point may be, said John Church, associate professor at the University of Alberta’s School of Public Health in Edmonton.

“Canadians love their health-care system, so that magic number could actually get to be quite high,” he said. “My guess is 50% would really start to turn up the political heat.”

“If we aren’t going to continue to allow the health-care portion of the pie to increase, where are we going to have to draw boundaries around what’s going to be covered publicly and what’s financed by private means?” Church said.

Supporters say the system isn’t perfect but would only be harmed by courting for-profit ventures.

Joan Teghtmeyer, a member of the Calgary chapter of Friends of Medicare, which aims to strengthen public health care, said the transition to more out-of-pocket costs brings with it the dangers of the American system, which now leaves 50 million uninsured and mostly at the mercy of private insurers.

“I don’t want to pay for the kinds of games you have to play with insurance companies for insurance outside the system,” she said.

Allowing for-profit outfits to corner the market on some medical services would take needed money out of the public program, said Ted Woynillowicz, chairman of the Calgary chapter of Friends of Medicare.

“I’ve got grandchildren, so I want to see them continue to have a reliable and predictable program,” he said.