Category Archives: privatisation

How Much are we Subsidizing Private Education?

I have been actively involved lately in plenty of discussion about the public funding of private education that we do in Alberta. I don’t believe that we should be providing any public funds to private education. If you decide that the public system is not for you, that’s fine, then you should pay for it with your own funds.

A common retort that I hear is, “we pay taxes and so we should have the funding go to the school we choose.” As I am apt to do, I decided to do some math on the situation. Here is my analysis.

Every calculation involves assumptions, so I will let you know that the numbers come from the Alberta government’s projected 2016 budget and the calculations are based on an average two parent family with two average income earners and two school aged students.

Alberta will collect $11.4 billion in personal income tax in 2016 and there are an estimated 2.26 million employed Albertans. This results in an average of $5,044 in provincial income tax per employed Albertan, or $10,088 for the test family.

Let’s say that this family also owns a home, they will pay $2.48 in education property tax per $1,000 that their home is worth. The average home sold in Alberta so far this year was worth $386,000 (http://creastats.crea.ca/area/). So this average couple will also contribute $957 in education property tax, for a total of $11,045 in direct provincial taxes.

Education, including capital projects, amounts to 16.4% of the provincial budget ($9.8 billion out of $59.6 billion), so of this family’s $11,045 in provincial taxes, $1,811 will go to education. So, for the hypothetical family with two kids, they contribute $906 per child in taxes to their education.

An accredited private school receives $4,676 in base funding per pupil, plus $71 in Equity of Opportunity funding plus $462 in plant operations and maintenance for a total of $5,209 per student in public funding (plus a few other non-capitated grants).

Bottom line: in public funding for private schools, $906 per student comes from the parents and the other $4,303 is subsidized by the government.

An average parent’s contribution through provincial tax to the education of their child is only 5.9% of the total per pupil cost. So why are private schools getting 70% of the base instructional grant?

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Bill 17: De-democratizing healthcare

My time lately has been consumed by two grad courses, an active full-time job and home and family commitments. But one emergent and urgent issue has forced me to tend to my oft-neglected blog. (Yes, Minister Zwozdesky, I do consider healthcare to be urgent.)

If I was at all surprised about the contents of Bill 17, the new Alberta Health Act, it was in how accurate my predictions for it were. While it is being positioned by government as sticking up for Albertans through a “health charter”, “health advocate” and improved “public input,” it is actually much more about removing power from Albertans and placing it at the cabinet table. Let’s look at those three concepts and how Bill 17 is positioned to improve the power of cabinet.

Section 2 of the bill calls on the Minister to “establish a Health Charter to guide the actions of regional health authorities, provincial health boards, operators, health providers, professional colleges, Albertans, and any other persons specified in the regulations.” Sounds great. Let’s develop a document that outlines the rights of patients and responsibilities of the players in the system. While it is called a charter to make us think that it has some sort of higher power status like the Canadian Charter of Rights and Freedoms (part of our constitution), Bill 17 allows it to be changed by the whim of Cabinet. Section 12(c) allows the Cabinet to make regulations “respecting the establishment and review of the Health Charter.” This means that your sacred Health Charter can be changed by an “Order in Council” at a roughly bi-weekly private meeting.

“Relax,” you say, “the Health Charter will be enforced by the Health Advocate.” But section 6(1) of the act ensures that the Advocate reports to the Minister of Health as opposed to the legislature and section 12(f) allows the Cabinet to “make regulations respecting the powers and duties of the Health Advocate.” So, while the position of the Health Advocate may be valuable within itself, he or she will be under the strict control of Cabinet.

This type of act is considered enabling legislation, because it lacks restrictive clauses and enables the Cabinet and Health Minister to govern the system by regulation. Section 12 contains 11 areas for which Cabinet can enact regulations. Section 13 allows the Minister of Health to make regulations “respecting the designation of other persons as health providers” and “respecting the roles and responsibilities of (regional health authorities, provincial health boards and professional colleges).” Previously, making changes to the roles and responsibilities of regional health authorities, provincial health boards and professional colleges would mean changing legislation and having those changes approved by the democratically elected legislative assembly. With Bill 17, those changes can be made at the whim of the Minister of Health (no need to worry any longer about the pesky College of Physicians and Surgeons).

Perhaps we need not worry, perhaps we should trust the discretion of Cabinet and the Minister of Health (you do know that Ron Liepert could be reappointed as Health Minister, right?). After all, Bill 17 assures us that regulations can only be made if “the Minister has published a notice of the proposed regulation on the public website” and a “time period during which members of the public and stakeholders may submit comments, has expired” and that time period “must not end until at least 30 days after the Minister gives notice.” BUT, Bill 17 also says the Minister has to pass on to Cabinet the changes which he or she considers appropriate. It also says that Cabinet may or may not make changes to the regulation, whether or not such changes are referred to in the Minister’s report. Furthermore, the time period for submission of comments can be changed if in the Minister’s opinion, “the urgency of the situation requires it, the proposed regulation clarifies the intent, or the proposed regulation is of a minor or technical nature.” Oh and by the way, “no regulation made (by Cabinet or the Minister) is invalid as a result of non-compliance” with the Public Input section of the Act.

In the off chance that this argument is too wordy or technical, what all of this means is that the Minister has to seek Public Input, unless he doesn’t want to, and Cabinet has to change regulations after listening to the Public Input, unless they don’t want to.

The big intent behind Bill 17 is to remove governance of our health care system from the control of our democratically elected legislative assembly and place it neatly under the thumb of Cabinet – and done all in the name of seeking Public Input and protecting patients.

No Thanks!

Call your MLA today and demand they return democracy to our healthcare system.

Your Alberta Health Act: Opening Doors for Private Healthcare.

“We’d be a lot better off if we had funding follow the patient”

The comment hung in the air, a pinata, colorful, attention seeking, begging for a reaction.

I figured I would have to swing at it, or at least give it a poke.

I tapped the edge, “Hmmm, really? What makes you say that?”

“Competition. If you make the clinics compete for funding, then they will have to find efficiencies,” replied my tablemate as I chewed on my cookie waiting for MLA Fred Horne to get the evening started.

About 80 Edmonton and area citizens came to the public consultation on the Alberta Health Act on this warm June evening. I came because I wanted to help ensure that high quality accessible health care is available for all Albertans when they need it. After having a brief discussion with my tablemate, I was glad that I came to balance his perspective.

I value medicare: free, accessible, effective, outstanding, public medicare.

Unfortunately, medicare in Alberta is once again at risk. The Conservatives are introducing a bill in the fall sitting of the legislature which will create a brand new Alberta Health Act and while they say it is needed to “facilitate current and future health system initiatives,” they are being quite guarded about what those initiatives might be.

The purpose of the legislation emerged as the evening progressed, evident by the types of questions that were being asked and the answers that were already filled in. Progressive Conservatives in Alberta have tried numerous times over the years to bring in private delivery of health care. Their challenge has always been in bringing in the enabling legislation. Its not like you can just open up the hospital doors and lay out a welcome mat for private investors. The legislative framework must be in place and policies for monitoring the operators must be enacted. Much like the doomed Bill 11, this upcoming piece of legislation will attempt to enable private delivery of healthcare and place fences around the process.

There were a few things from the consultation process that make me think that the new Health Act will be used to introduce private for-profit health care.

One of the topics of discussion was on the principles that should be included in the legislation. The report of the Minister’s Advisory Committee on Health assures us that the principles of the Canada Health Act will be incorporated into the new Alberta Health Act, including the addition of some made in Alberta principles. However, while the Canada Health Act incorporates explicitly the principle of “public administration,” our discussion paper says the Alberta Health Act will integrate, “what these principles have come to mean to Canadians – a publicly funded health system that is accessible to all regardless of ability to pay.” These weasel words clearly leave out public administration, suggesting that it is not a principle that matters to Canadians and that the new legislation will enable private for-profit providers. 

Another topic of discussion was around the concept of a patient charter. A patient charter outlines the rights and responsibilities of patients. The discussion paper calls for a “full and transparent discussion around what it can be used for, including issues of accountability and liability.” There are a number of pitfalls here, the most significant of which is the possibility that patients could be denied service if they don’t live up to their responsibilities, including “making healthy choices” (ask Americans what they think about ‘pre-existing conditions’). However, that is not the thesis of my argument. My argument is that this concept of a patients charter is being used to enable private health care delivery. The reason we would need a charter is so that the government can regulate the activity of service providers. Interestingly, concepts such as “being ensured of privacy of information” and “having timely and reasonable access to information” are already protected within public institutions through the Freedom of Information and Protection of Privacy Act. This charter is not about placing regulations on public institutions like Alberta Health Services it is about regulating private service providers.

A third discussion had to do with “ensuring ongoing citizen engagement in the development of legislation, regulation and policy.” I summed this up as governance and argued that the government has already completely failed on this matter. The most effective forms of governance are distributed to local communities, because decision makers in individual communities are more closely aware of the circumstances and contexts of the community, thus they are in the best position to make informed decisions. I argued that the PCs missed on governance with two epic fails: removing democratically elected health boards and amalgamating heath regions into AHS. This discussion was really about testing the waters in Alberta about private governance. The PCs need answers to the question, “what decisions can be made without public consultation and public accountability and what types of public input is minimally necessary for those decisions that need it.”

The final question was blatant: “What changes are you open to? What assurances are important?” Here the government was looking for data on the specific issues of private delivery – what can we get away with politically? I have to respect Horne and the PCs for finally realizing that they cannot afford to get health care reform wrong again. Albertans care too deeply and a misstep here may spell the end of their reign. With this consultation process the PCs are attempting to get a very specific reading on Albertans’ appetites for changes.

Shockingly, before we broke up into our discussion groups my table mate from the start of the evening revealed something very telling about his views on medicare. He essentially asked, why shouldn’t someone who can afford better treatment get it – after all that’s how the rest of our world works.

For people like me, who want to defend public medicare – we need to mobilize and get the message out. Otherwise, the government will end up believing that the true sentiment of Albertans is that of my tablemate’s and the concept of universal public healthcare will be in jeopardy.

You can still have your say by visiting http://yourhealthact.alberta.ca.

For a further glimpse into why private delivery will not benefit us, see this post.