Budget 2020: Health budget sees doubling of private clinic surgeries, deductibles on seniors drug plan

Alberta plans to double the number of surgeries done in private clinics over the next three years as part of an effort to cut wait times laid out Thursday in Budget 2020.

Over the next three years, the province will stick close to current spending levels on health, planning for an annual health services bill between $20.6 billion and $20.8 billion, injecting $2.5 billion into new construction, renovations and equipment.

At present, about 15 per cent of Alberta surgeries are contracted out to private clinics. By 2022-23, Alberta hopes to have increased that proportion to roughly 30 per cent, or around 90,000 a year. 

In 2018-19, 294,000 surgeries were performed across Alberta.

Through the newly announced Alberta Surgical Initiative, the government estimates it can reduce wait times for surgeries and complete an extra 80,000 procedures by 2022-23, starting with an extra 7,500 in 2019-20 and increasing to an extra 30,000 procedures in 2022-23.

"This is a move to increase the efficiency of delivering ... publicly funded health care to Albertans," Finance Minister Travis Toews said at a news conference Thursday.

"That's an ambitious plan. We won't get there by just staying with status quo. We absolutely have to look at making some fundamental changes to improving or efficiency." 

The province has earmarked $500 million for its surgical initiative, including $100 million for upgrading and building surgery facilities.

Opposition health critic David Shepherd said he's concerned about the government's plan to shift resources to private clinics. 

"They're taking money away from primary care, from doctors and family physicians," Shepherd said. "They're taking money away from acute care in hospitals. And they're putting it toward this surgical initiative to fund more private, for-profit surgery clinics in the public system."

Friends of Medicare executive director Sandra Azocar called the move "unfortunate."

"It's not an innovative type of fix to the health-care system," she said. "It's basically ideologically bent in terms of this endless quest to make that choice."

Savings from AHS review

To foot the bill for the extra surgeries and other new health spending, the government plans to use money saved by implementing recommendations laid out in a recent review of Alberta Health Services (AHS) by Ernst & Young, released earlier this month.

The report made 57 recommendations and identified 72 savings opportunities it claims will save between $1.5 billion and $1.9 billion per year. 

According to the budget documents, the province has accepted the Ernst & Young recommendations, with the exception of closing hospitals or consolidating urban trauma centres.

There's also a plan to invest $35 million in a revitalization program for rural health facilities.

One revenue generator includes introducing "income tested deductibles" to the provincial seniors drug program. 

Low-income seniors won't be asked to pay, but seniors who make enough money will have to pitch in on the cost of their medications.

Details about implementation are still to come, but the province estimates it will save $52 million a year. 

The government previously committed to cutting coverage for spouses and dependents who are younger than 65 and who could previously get coverage through the seniors drug program.

Supportive Living Initiative to return

Budget documents also highlighted savings through reducing physician compensation; earlier this month, Health Minister Tyler Shandro ended the master agreement that outlines the way doctors are paid.

Other savings will be achieved by transitioning patients to lower cost versions of medications.

The government also used the budget to unveil a plan to revive the Alberta Supportive Living Initiative. 

The program, which provides capital grants to private companies for building continuing care facilities, was initiated under the former Progressive Conservative government, then cancelled when the NDP was in power.

The province will spend $164 million on what its describes as a "new and improved" version of the program.

The budget also highlights spending on previously announced upgrades to the Gene Zwozdesky Centre at Norwood, Red Deer Regional Hospital and the Peter Lougheed Centre in Calgary.

Edmonton and northern Alberta will also get a boost with $15 million for laboratory equipment upgrades: $1 million for planning and coming up with a list of priorities with AHS, and $14 million will be spent on actual equipment.