Part 1

Earlier this week, Premier Ralph Klein proposed a new approach to health care in Alberta: private providers delivering care funded by the provincial government. Though the idea may seem revolutionary to Canadians, many other nations in the developed world have been enjoying the immense benefits such policies create. Injecting a little competition into the health care system, however, is only the first step towards the creation of a truly world class health care program in Alberta and, perhaps, in all of Canada.

A truly world class universal access health care program is characterized by either the very best outcomes health care can deliver, or the absence of waiting times, or both. Nine nations meet the requirements: Austria, Belgium, France, Germany, Japan, Luxembourg, and Switzerland have programs that provide health services without waiting lists, while Australia, France, Japan, and Sweden outperform Canada on measures of health outcomes from care. All of these nations incorporate private hospitals within their public health care programs.

Innovative private entrepreneurs have generated immense benefits for patients in the aforementioned countries as well as others. In Spain, for example, introducing publicly funded contracts with private providers was a core component of a very successful package that dramatically reduced average waiting times (by roughly 68 percent) in the late 1990s. The introduction of privately owned hospitals and a more competitive hospital sector in Sweden led to more cost-efficient delivery of services and to a reduction in waiting times for patients receiving publicly funded care.

These are but two examples of the benefits that competition and privately provided care create when incorporated into a public health care program. For Alberta, however, reform must not stop there. The goal for Mr. Klein and all Albertans should be the creation of a truly great health care program that delivers high quality health care without waiting times, not just better services and shorter waiting times.

Accomplishing this will take much more than Klein's 'third way'. While no nation has eliminated waiting times without private competitive delivery of publicly funded services, none of those 9 nations with world-class health programs managed that performance without two other vital components of a well functioning health care program: responsibility for patients to cover some of the cost of health services they consume and the freedom to access private providers with private resources.