Fresh Takes

COVID-19: Alberta Needs Broader Reform to Tackle Surgical Backlog

The Alberta government committed record funding to health care in its 2021-2024 Fiscal Plan. Building upon recommendations stemming from an Alberta Health Services performance review, the government funded strategic priorities such as the Alberta Surgical Initiative (ASI), and it “remains committed to improving care while finding efficiencies.”

Addressing the surgical backlog, which has worsened with the accumulation of cancelled procedures due to COVID-19, is certainly crucial. Between March and June 2020, there were almost 17,000 cancelled or postponed surgeries and procedures in the province, and the government expects that number to have reached 36,000 by the end of March 2021.

The Alberta government established the ASI based on the 2010 Saskatchewan Surgical Initiative (SSI), which promised that by 2014 no patient would wait more than three months for surgery. Indeed, by 2016, Saskatchewan’s wait times for elective surgery were among the shortest in Canada. The SSI changed how wait lists were managed by prioritizing patients and using private, for-profit clinics to deliver day-surgery procedures, covered publicly.

In Alberta, private surgical facilities began offering more publicly funded procedures to Albertans in December 2020 to begin to chip away at the mountain of postponed procedures, with promises to ramp up those efforts in 2021. The government has allocated $120 million to the ASI, and additional funding from the province’s $1.25-billion COVID-19 contingency plan will also be used to address the surgical backlog caused by the pandemic.

Though the SSI dramatically reduced wait times in Saskatchewan, capacity had to be increased, which meant devoting more money to an already expensive health care system. When the increased SSI funding ended, wait times again began to creep up, increasing 29% between 2015 and 2018.

So while the Alberta government is taking a step in the right direction by emulating Saskatchewan and utilizing private surgical facilities to perform publicly paid surgeries and reduce its backlog, broader reform is needed. For more inspiration, we should look to the successful policies of European countries with universal health care systems. These provide better access to care and increased patient choice through competition and entrepreneurship. Alberta, and the rest of Canada too, should follow suit and use market principles to help improve their health systems.

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