President of the National Union of Public and General Employees (NUPGE), Larry Brown, wrote the following letter to Prime Minister Trudeau and Minister Hajdu regarding the Alberta Government’s Bill 30 and the potential for conflict with the Canada Health Act.
Dear Prime Minister Trudeau and Minister Hajdu:
Re: Alberta Government’s Bill 30 and the Potential for Conflict with the Canada Health Act
On behalf of the National Union of Public and General Employees (NUPGE), I am writing regarding Bill 30, the Health Statutes Amendment Act, 2020, which is currently before the Alberta legislature. If passed, this legislation has the potential to affect health care across Canada, particularly whether provisions of the Canada Health Act that prohibit extra billing and user charges are undermined.
While Bill 30 may not violate the Canada Health Act, the conditions it appears likely to create will. Under the legislation, it will become easier for the provincial government to approve private for-profit surgical facilities. Bill 30 repeals existing legislation that prohibits contracting out when it harms the public system. Changes to the approval process for private surgical facilities will mean decisions will no longer have to be made public.
Alberta already permits private surgical facilities to perform both private-pay services and public funded services. With the changes that Bill 30 will make, the danger of extra billing or user fees will increase.
The combination of Bill 30 and the stated intent of the Alberta government to contract out 30% of surgeries means more patients will be referred to private facilities that perform both publicly funded and private pay surgeries. It will be all too easy for those facilities to offer “enhanced medical services” or faster treatment for a fee.
As your government recognized when it obtained intervenor status in the Cambie case (Cambie Surgeries Corporation, et al. v. Attorney General of British Columbia, et al) in British Columbia, the prohibition of extra billing and user charges is necessary to ensure all Canadians have equal access to health care, regardless of income. If that prohibition is undermined it will become possible for wealthy individuals to buy their way to the front of the line and we will have a two-tier health care system.
There is also the impact on the public health care system. In other countries, particularly the United Kingdom, an increase in two-tier health care weakened the public system. Research has shown that two-tier health care systems draw resources out of the public system and increase waiting times for public funded surgeries. Having two-tier systems can also result in some of the problems with private health facilities, such as the tendency to sell unnecessary medical procures, to become more common in the public system.
If the Alberta legislature passes Bill 30, NUPGE would strongly urge the federal government to closely monitor the situation there to make sure the Canada Health Act is not being violated.
Because of the seriousness of this issue, we feel there is a need to discuss this matter further. For that reason, we would like to request a meeting with you and your staff to discuss what steps the federal government will be taking to respond to the threat to our health care system posed by the Alberta government’s Bill 30.