Alberta 2015 Election Campaign

Question 1 response: 

Alberta’s NDP has committed to ensuring that our public health care system improves after years of neglect by the PCs, so that Albertans get the care they need when they need it. Our Party has always been a vocal in the need to stabilize the system and ensure that we fix the capacity issues we have seen over the last several years by. We’ll start by:

I. Committing stable funding over the long-term and reserve the $1 billion dollar cut in the recent Prentice budget so that our health system can catch up and keep up with the growth our province has seen.

II. Build capacity for long-term care by building 2,000 long-term care spaces that will serve to take pressures off the acute care system

III. Cancelling plans for yet another AHS reorganization, and channeling the millions of dollars earmarked for that project into frontline care.

IV. Investing in strong, public homecare to keep people in their home, rather than in hospitals.

V. Helping families get better access to Primary Care Networks so that we can substantially increase the number of Albertans who have a family doctor.

Alberta’s NDP has committed to ensuring that residents of both major cities have access to integrative, all-under-one-roof cancer care centre, including treatment, care, and research. We know that this is the best model for cancer care, and that by integrating physical healing, cutting edge research, and whole-person care we can do our best to help Albertans in their fight.

Question 2 response:

The NDP stands firmly in support of publicly funded and delivered health care in this province. While other parties will take actions to circumvent the Canada Health Act, Alberta’s NDP understands the incredible power of a system that allows us to get the care we need, regardless of our walk of life. By strengthening these systems, we are strengthening the fabric of Alberta.

Question 3 response:

Alberta’s NDP will work within the public system to ensure that our health system is focusing on frontline services. In order to do this, and avoid the chaos that we’ve seen created by near constant PC reorganizations, we are not committing to any major realignments of services in order to promote stability and growth within the system. One change that we would work toward, if given the opportunity, would be to work with physicians and other health professionals to expand access to Primary Care Networks. In particular, we would look to create opportunities for new patients to find family doctors, and for clinics to stay open longer hours.

Question 4 response:

Alberta’s NDP has a strong plan to focus resources into homecare, strengthening it and moving more services under the public umbrella so that cancer survivors (and others) can have high quality, reliable, and accessible services. In terms of financial assistance during and after sickness, Alberta’s NDP has long been an advocate of ensuring that people are able to have their needs, both medically and otherwise, met if they get sick. The NDP believes that we can work to strengthen existing programs like Alberta Works, AISH (which the NDP fought to have raised and tied to inflation, and won), and working with federal partners to improve CPP disability benefits.

Question 5 response:

Alberta’s NDP is committed to reversing PC cuts to Alberta’s prescription drug programs, and restore funding to our health system so that people can get the care they need. Our Party has always been a strong advocate of expanding our public system, and a strong voice across our province and country to move toward a publicly implemented Pharmacare program that would save Albertans money. By working on key issues of access to care while stabilizing a healthcare system that is straining from years of PC neglect, Alberta’s NDP is fighting to ensure that patients in our province get the highest quality, most advanced care possible. The recent PC budget cuts make this fight even more important and our platform provides the resources and commitments to take us forward in all areas of health care.

As a breast cancer survivor myself, I understand the challenges that cancer care presents to the Alberta Health Care system. My own experience was less than satisfactory and in the end, I sought alternative treatments outside of Canada with much success. I was fortunate enough to have had a critical illness insurance policy that covered most of these costs.

I can confidently say that the delivery of cancer care and other healthcare services in Alberta needs to be fully examined and discussed by all the stakeholders including survivors. As such, we would commission a task force to draft an integrated plan for the care, communication and delivery of cancer treatments to patients. This would be done as a fully publicly funded healthcare system now and in the future under a Green Party government.

Included in this report would be the examination of what is necessary to support cancer patients in their long term management and/or recovery of their related cancer treatments and side effects.

Upon receiving the recommendations of the task force, we would set about allocating the necessary funds to implement the plan, with a provision to review and improve the recommendations every 2 years.

Theoretically, this model could be used across the healthcare delivery system.

I personally believe that all patients in the healthcare system need an advocate with the power to intervene in a patients care when they feel that the best interests of the patient are not being met. This person can be the patient themselves if well enough, a family member or friend or an appointed representative if none of the aforementioned is available.

I can personally attest to the fact that going through cancer and cancer “care” is challenging at physical, emotional and social levels and a network of support with the appropriate power to advocate is vital to the recovery of the patient.

The Green Party of Canada supports the adoption of a Universal Pharmacare system where we would have the power to bulk buy drugs in order to make them more affordable to all Canadians. Alberta Greens agree.

The Greens fully support the Canada Health Act (CHA) and all of its principles. We oppose any level of privatized, for-profit health care. The five criteria of the CHA guiding the provincial public health insurance plans, which we believe to be non-negotiable, are:

Public Administration – The public health insurance plan must be managed in a public, not-for-profit fashion;
Comprehensiveness – All residents must be covered for ‘medically necessary’ health services;
Universality – All residents must be covered by the public insurance plan on uniform terms and conditions;
Portability – All residents must be covered by their public plan, wherever they are treated in Canada;
Accessibility – All residents must have access to insured health care services on uniform terms and conditions without direct or indirect financial charges, or discrimination based on age, health status, or financial circumstances.
I hope this sufficiently answers the questions put forward by The Canadian Cancer Survivor Network.

Dr. David M. Reid, Calgary-Bow
Coral Bliss Taylor, Chestermere-Rocky View
Martin Blake, Highwood

Question 1 response:

A) Having fortunately never had cancer, and my mother having a professional and caring experience that saved her life, I cannot say that I understand the issues facing cancer care delivery in Alberta. Out of respect for those currently tackling those issues, I will refrain from commenting on this question other than saying that I would do what I could to address health care delivery issues and will defer to the advice of those on the front lines. In my own life, I have required medical care at hospitals several times and the main issue seems to be a shortage of people and of beds. Shortages of nurses, who when surveyed in two years ago described being burnt out. Shortages of specialty doctors (mind you, the shortage seems to be in recruitment/facilities, not practitioners if this article is correct http://news.nationalpost.com/news/doctor-shortages-a-myth-nearly-one-in-six-new-medical-specialists-cant-find-work-report-suggests). The shortages in beds and ambulances are obvious. The shortage of beds and ambulances requires additional capital spending to alleviate. Whether that is additional overall spending or just spending redirected from other parts of the health system Making things “more efficient” will not help the fact that so many people need an ambulance or so many people need a hospital bed. Another ambulance is going to cost money. Another bed is going to cost money. But that money needs to be spent so that Albertans can receive quality care. I do not understand the exact reasons for a shortage of nurses nor a shortage of doctors and without understanding the root of those two problems, I cannot have a solution.

B) Under a Liberal government, health care would remain publicly funded. There is no question about that.

C) I cannot say how I would restructure health care delivery in Alberta before having a chance to discuss the current problems with front line staff members. This is not my area of knowledge. Please contact another Liberal candidate, such as Dr. Swann, who would have expertise in this area.

D) When my mother was diagnosed with cancer, support such as you described was handled by generous neighbours and my great family. Some people may not be so fortunate to have all the support available just from those around them. How this would be delivered is again, something that I do not know. However, I do support it being done in some form as it was a critical factor in my mother’s recovery.

Question 2 responses:

This brings us to the larger issue of public vs private drug funding in Alberta and in Canada overall and whether some form of Pharmacare should be implemented, either on the provincial or national level. Should it be single payer, a mix of both systems, or should drug coverage should be entirely the domain of private insurers, with subsidies for the low income (the suggested solution from the Fraser Institute)? I think that on this issue there are two key points, both of which point some form of Pharmcare as the preferable option.

1) The economics: Does it make financial sense for society to pay for these drugs, can we afford them, and what are the financial consequences of society as a whole paying instead of individually/as part of corporate benefits?

At the end of the day, the cancer drugs are needed to survive/live with a reasonable quality life. They are not optional in any way. Therefore, the dollars consumed will generally be the same no matter who pays (lets assume that the bulk discounts negate the increase in usage because certain individuals could not otherwise pay without public/charitable help). Therefore the bill will be the same assuming that administration costs do not drop. Therefore, the only question is, who gets the bill? Society as a whole decided that we should pay for health care, so why is it different for medication, which I am sure most physicians will say is an essential part of that care?

2) The duties of our society/health care accessibility:

The main point of this that point towards pharmacare are that private insurance only goes so far. I have health insurance through Queen’s University, and it would reimburse me 80% of drug costs up to $2000. Now look at this article: http://globalnews.ca/news/1656699/the-cost-of-cancer-how-much-do-cancer-drugs-cost-canadians/ . $2000 annually is little help for a drug that costs $8000 a month. If I required that drug as a student, I most certainly do not have the financial resources to absorb that cost and do not really have the assets to even borrow that much money. My parents are well off, but they do not have that kind of money on hand. Unless my parents’ health care plan covered the drug, they would have to borrow money to save my life were I resident in Ontario or Atlantic Canada. I find it to be a very bizarre interpretation of societal obligation to say that the financial burden shall be shared with regard to health expenses, but only when one is sick in a hospital. If you are sick elsewhere, you are on your own. I realize that in Alberta this is not the case for live saving medication to a certain extent, but consider drugs such as Neulasta, which at the time of my mother’s cancer were not covered by AB. My father’s employer insurance at the time covered it, but his old one would not, and most plans are not that generous and access to care should not be dependent on whether one has good employer coverage. It is now covered (http://www.drugcoverage.ca/en-ca/search-results.aspx?ID=1327) but I see what you mean by the wait times and how they harm patient care.

I think that the Fraser institute is wrong about private drug plans solving the problem. My Queen’s drug plan would not have helped much and I expect that most drug plans would not be sufficiently helpful either. Medication is an important part of health care and should to a greater extent be covered by the government. The savings by bulk buying and administration will likely pay for themselves. Yes, taxes may go up, but costs per person will go down. The only difference would be that a portion of money spent currently on private/employer insurance would instead be used to fund government insurance of some sort and that would mean lower overall costs per person.

Keep in mind that many of these are my views, and may not be official party policy. I can only speak for what I would support, not what other candidates would support. I apologize for this being so long, I have a fair bit to say on the issue.

Answer:

Thank you for contacting me about your concerns Liberal stand for pubic health. We are opposed to any private for profit involvement. We firstly will make certain that the public system operates in an efficient manner so that we get the best value for our money. Cancer treatment will receive special attention. Making sure that the health system operates in an efficient manner will shorten the time line for drug approvals.

Thank you Ron

Answer:

Thank you very much for providing the opportunity to discuss this issue. The Alberta Liberal Party will be completing the survey on our (candidates) behalf so you have a more coherent understanding of the Liberal position. Might I just add that as someone who has lost both parents to cancer I will be at the forefront of advocating for better and more timely treatment wherever and whenever I can.

Answer:

This is an area where more funding is needed. For example, some cancer patients require immune boosters during chemo treatments. These can cost thousands of dollars. Currently only seniors qualify for coverage from the Government. If someone needs a drug or treatment prescribed by their doctor, it should be covered and shouldn’t depend on their age or financial circumstance. We are also concerned about the slowness of the process for approval of new drugs and would work to streamline this to ensure timely access to needed treatments. This may require higher levels of funding, however, in a province as wealthy as Alberta, meeting these requirements can be done.

Question 1 response: 

The PC government is committed to improving access and delivery of all health care services in Alberta, including cancer care. To this end, Budget 2015 provides a total of $18.9 billion for health care in 2015-16. This includes $13.4 billion for Alberta Health Services, which funds a wide variety of cancer screening and treatment programs as well as supports for cancer patients and their families.

Over the next five years, our Capital Plan will invest $3.4 billion in Alberta’s health facilities, including $653 million in maintenance and preservation for existing facilities and $3.4 billion for a new cancer centre at Calgary’s South Health Campus. This new Calgary cancer facility will be the first phase of a two-site model for cancer care in that region, with the second phase to be built at the Foothills Medical Centre in the future.

- Will your government continue to provide a publicly funded healthcare system or would it institute a private healthcare system?

The PC government remains fully committed to a publicly funded public health care system in our province.

- How will your government restructure healthcare delivery in Alberta?

In September 2014, Health Minister Stephen Mandel asked Dr. Richard Starke, MLA for Vermillion-Lloydminster to lead a complete review of rural health care in Alberta. The Rural Health Services Review Committee delivered its final report in March 2015 and recommended actions – a number of which are underway, including:

· Developing a provincial EMS service delivery model.

· Establishing eight to 10 Alberta Health Services (AHS) operational districts to give communities a stronger voice in local decision-making.

· Recognizing the vital role that health care services and facilities play in the economic viability of rural communities, and taking steps to evaluate each facility’s potential for better usage or re-purposing.

· Dr. Starke’s report also recommended expanding school-based mental health education and intervention programs and Budget 2015 provides funding to expand such programs across the province.

- How will your government ensure that cancer patients receive the services they need, including home care, financial assistance during recovery and for long-term side effects of cancer and/or treatment?

Alberta has a wide range of programs to help ensure all patients receive the support they need during and after treatment, including home care. The Government of Alberta spends approximately $2 billion each year on continuing care, which includes funding for home care. AHS has plans to expand the program over the coming years in order to accommodate an increase in clients. Home care clients in Alberta pay no fees for health and personal care services.

Question 2 response:

Publicly funded medications that improve Albertans’ health and quality of life are an essential part of our health system. This year alone, we are spending $448 million on drugs and other supplementary health benefits and approximately $2.2 billion over the next five years.

We are always adding new drugs to our coverage list, including 32 last year, and we’re working to ensure Albertans have access to the best new medications available while continuing to manage drug costs by:

· Covering the lower cost version and negotiating lower prices for new drugs.

· Working with our provincial and federal partners to develop a national approach to rare disease drugs.

· Continuing to fund programs that protect low-income Albertans from the high cost of some drugs.

Question 1 response:

A) How will your government improve the delivery of cancer care and other healthcare services in Alberta?

Albertans have been paying more and more for health care, but are not getting better results. Our system ranks near the bottom in Canada when it comes to wait times for most critical health care treatments and procedures.

Wildrose will sit down with doctors and nurses to make sure that the concrete changes they are asking for really happen. We need a system that cures the patient, rather than focusing on the procedure, provider, and bureaucracy.

B) Will your government continue to provide a publicly funded healthcare system or would it institute a private healthcare system?

Wildrose is committed to improving the system inside of the Canada Health Act. We will not institute a private health care system.

C) How will your government restructure healthcare delivery in Alberta?

Wildrose will create a Patient-Centered Healthcare System, which puts patients first, empowers them to make informed decisions, and supports partnerships between patients and health care providers.

We will focus on the patient-care based funding model to include community-based out-patient health services, primary care services, and publicly contracted community based surgical service facilities. There are many underused rural hospitals in Alberta and we need to find innovative ways to make use of them.

Wildrose will gradually decentralize the delivery of health care services to the local or facility level, and work on a model of local decision-making for ambulance service.

D) How will your government ensure that cancer patients receive the services they need, including home care, financial assistance during recovery and for long-term side effects of cancer and/or treatment?

Wildrose will reallocate funding (at least $50m) for home care as part of a more patient-friendly system.

Question 2 response:

A key element of providing timely treatment for cancer patients is ensuring that they have access to the medications they need at the time they need them. Unfortunately, this is not always the case in Alberta.

On average between 2004-2010, Alberta approved for public reimbursement 17.7% of the 306 new drugs approved by Health Canada, compared to the cross-country provincial average for the same period of 23.44% (Access Delayed, Access Denied: Waiting for New Medicines in Canada, Mark Rovere and Brett J. Skinner, Studies in Health Policy, April 2012, The Fraser Institute).

If elected, will your government commit to increasing the number of new cancer and other drugs approved for public reimbursement so that all Albertans have timely access to the drugs they need, and if so, how will this be accomplished?

Wildrose has a strong history of advocating for both a healthy, streamlined health system overall, and the timely inclusion of drugs that need to be available for Albertans. We are committed to working with health professionals to find ways to improve this system and ensure that resources are focused on health services, and not on an inefficient bureaucracy.

Wildrose supports efforts to negotiate lower prices for new drugs, and find other creative ways to maximize the rate of new approvals.