My letter to Alberta Premier Jason Kenney - concerns about our provincial health care system

 August 28, 2020

Dear Premier Jason Kenney. 

Hello. My name is Laura Jean Rutherford and I live in a long term care facility, AgeCare-Skypointe in Calgary, Alberta. I am writing to you as a concerned Alberta citizen of the policies and bills you have pushed through since during the Spring/Summer 2020 sessions, specifically on healthcare. I am concerned as I feel you are truly not thinking of the impact to the Alberta citizens, only looking at how it benefits those who support or lobby for you, benefiting those large corporations who supports you and basically doing whatever you wish to do just because you have a massive majority government that the opposition parties cannot hold you accountable to the changes you are making for Alberta. 

Premier Kenney - Why are you and the UCP government advocating towards privatization system of our healthcare despite the frustrations being heard from Alberta citizens? Why are you wanting the United States system 2-tier system? Have you not seen the chaos the Americans citizens are facing presently due to their current healthcare system while fighting the Covid-19 pandemic? They are nearing 180,000 Americans who have lost their lives to Covid-19 and their hospitals are inadequately prepared and getting overwhelmed due to the volume of people infected. You want us to have private insurance in our province, which becomes costly as claims can be denied which forces us to pay out of pocket which leads to bankruptcy and unable to continue with our essential treatments to become healthy again. My question is Premier Kenney - Why? Look at Alberta, with truth and consistency of your message over these many months along with great teamwork from your Covid-19 team, we been able to flattened the curve since May, along with focusing on recent clusters as promptly as possible to keep the uptick of cases low. I am so fortunate to live in Canada and to have our healthcare system to keep me healthy without stressing if I can afford it. How does privatization of our medical services bring down the healthcare costs/person in our province? I do not see a cost-saving to this decision. For example, the recent news of Edmonton building a $200 million+ orthopaedic surgical facility that the Minister of Health Mr. Tyler Shandro (behind closed doors) has tentatively been given government approval to move forward to proceed with this project. It was recently explained to me from one of my physicians, the building of the surgical facility is funding the $200 million + through private donations (therefore not from the taxpayers) but is to work with AHS to support the decreasing of wait times of high demand orthopaedic surgeries like hip and knee replacements. I can only assume, if the wait time for an individual is still too long, they would have the option of paying out-of-pocket to have the surgical procedure completed quicker in Alberta? Is my assumption correct? My question - will the costs be the same for the same procedures - public hospital vs. private facility? I am thinking not, as one is based on public funding and the other is For-profit costs; the latter being more expensive as it’s for profit, making money for their stakeholders. By Mr. Shandro, (who acts on your behalf) supporting this project, are you not going to be sacrificing my Canadian public health care services to have a privatization system which is a for-profit system? My assumption is for-profit systems, shortcuts are taken to ensure a higher profit for their stakeholders are made as well as sacrificing the quality of care as well as equipment available to keep costs low for a higher profit margin. To me, the focus of privatization healthcare will change from the care of the patient, to how much money can I make, which is not good healthcare system. Can you explain to me Premier Kenney why is your government supporting this private orthopaedic surgical facility? Would this facility also support decreasing the wait times for cancer surgeries such as breast, prostate and intestinal? By having this private facility, how does this decrease the public healthcare costs per person in our province? My concern hearing about Edmonton’s private surgical facility, which will be using non-union healthcare workers (which decreases the salaries costs), who are providing the care has the potential to be suboptimal as the staff might not be fully trained compared to someone working in a hospital who are unionize. If a patient has complications from the surgery at the private facility, such as cardiac arrest, pulmonary embolism, DVT or suffer significant blood loss from surgery; will this facility have the resources onsite to handle these type of possible fatal postoperative complications? Or will the patient need to be transferred promptly to either U of A or Royal Alexander Hospitals for continuing of their care? If they are transferred, would these be counted a “medical tourism” admissions as they didn’t have the original surgery in our public hospitals? AHS has been capturing data on  medical tourism patients who is being admitted to our public acute care hospitals with postoperative complications when the original surgical procedures, such as joint replacements and cancer surgeries, are performed elsewhere in Canada or parts of the world, due to the long wait lists in Alberta. We having been capturing this data in Alberta due to the impact on our healthcare costs treating the postoperative complications in our hospitals. What if there are no beds readily available at these public hospitals, what is a patient care to look like? If surgeons are lured to work at this private facility, wouldn’t there be an under service at our public hospitals, so how does this decrease our surgical wait times? One of the reasons for our wait times, is that there is not enough surgical time slots open for general surgeons to perform them. Will this surgical facility be another option for any surgeons to perform there, if OR time slots are available? Are you able to provide truthful answers to my concerns?

Personally, I am reliant on our public Canadian health care system. If we had the US private/for-profit health care system in Canada, where a HMO and private insurance company would tell me where and how I could be treated; I would be left a pauper and homeless plain and simply. I was diagnosed with Guillian Barre Syndrome (GBS) in September 2016, which is a rare autoimmune disorder damaging all of my peripheral nerves where I am now a quadriplegic from the shoulders down. To describe the severity of my case - I spent a total of 700 days in the hospital before being transferred to a continuing care facility which offers me long term care as I require total care for my basic daily needs. I spent the first 365 days in Peter Lougheed Hospital’s ICU attached to a mechanical ventilation via my tracheostomy for over 300 days as well as having a feeding tube for the same duration. I had multiple complications which almost lead to fatal outcomes, but were it not for the great care I received by all of the Critical Care Team of doctors/specialists, nurses and therapists. In treating GBS/CIDP (chronic inflammatory demyelinating polyneuropathy) patients, they require 5 units of IVIG (intravenous immunoglobulin) for GBS but for CIDP patients they require IVIG continuously for many years. The cost for IVIG treatments cost thousands of dollars, but it is essential to have this treatment to stop the destruction of our peripheral nerves. Reading the horror stories and hoops from our Americans survivors from this disease have to go through with their insurance to receive approval of this important treatment for our disease, many get denied for coverage. Premier Kenney - I am so thankful for our Canadian health system. I am sure if I was in the US, my hospital bill would have been in the millions, what would I do as I am not a millionaire? Now add the cost of living in a long term care facility. In the US, these are privately (for-profit) facilities and the costs are thousands of dollars per month. As I live in Canada, I do have the option of private LTC care which would cost me between $5,000 - $10,000, which I cannot afford. I am fortunate to find a facility where I am able to receive subsidies which I can afford and still receive excellent care. Would I have still received the excellent care, knowing I could not afford the cost associated with it? Do you know how much it has helped my ongoing recovery from GBS; knowing that I only need to focus on getting healthy instead of the additional stress worrying about how I am going to pay for everything, has been priceless. 

Premier Kenney, question for you. When your Ministry of Finance, along with the Ministry of Health, Ministry of Infrastructure, Alberta Health and AHS look at how to decrease healthcare costs but still addressing the needs of Alberta citizens; do they look at the “big picture” to address all our province’s health needs? When they are looking at building a new facility, do they take into account what the needs will be in Alberta in 5, 10 or even 15 years from now? Do they take into account that once the facility is built are the needs the same or have they changed? Do they account for the changing population age, growing population and what is needed to care for them? Are these some of the criteria used when thinking of building healthcare facilities in Alberta? When I worked at AHS - Calgary Zone (2005-2016) in Data Collection section of Health Records, we captured data of those patients who were no longer considered an acute care status but an alternate level of care (ALC) status staying in the hospital. ALC patients are no longer considered acute cases as if they could have gone home or to a community care facility, they would not need to stay in the hospital. When ALC patients are using an acute care bed, the hospitals will be losing money since if they were unable to transfer the patient to a community care facility like Supportive Living, Hospice or LTC. If there was availability in the community, another patient who needs acute care hospitalization would have a bed.  Couldn’t this provide a positive ripple effects of opening up more surgical care beds which would decrease our surgical wait times? Why isn’t your government Premier Kenney, looking at building more community care facilities so those in hospitals and in the community can receive the care they need and deserve and not impact the acute care beds needed available in the hospitals? Another example of inadequate availability of ALC is rehabilitation care. Why does Edmonton have a multi-level rehabilitation facility, Glenrose Rehabilitation Hospital; but in Calgary we only have one rehabilitation designated floor with 45 beds at Foothills Medical Centre? Calgary has 15 rehab beds for brain injuries patients, 15 for stroke patients and 15 for spinal cord injuries. It serves the citizens living in the Calgary, Central, and South Zones as well as those cities/towns along either BC or Sask borders. Has your government thought that if they had a stand alone rehabilitation facility in Calgary, similar to Edmonton, you could increase the availability of acute care beds as well as increase LTC bed availability at the 3 Carewest LTC facilities who currently have designated subacute rehabilitation beds in Calgary. These facilities are Carewest Sacree, Carewest Glenmore and Carewest Dr. Vernon Fanning. 

In 10 short years (2031), the last of the baby boomers will turn 65 years old. Looking at our citizens at this age, majority will require more care which means increase healthcare costs. Being over 65, means we will be facing the need for increased joint replacement surgeries to treat osteoarthritis; community care facilities to support their declining health and family physicians who are dealing with patients having multiple complex comorbities like diabetes, obesity, hypertension, and respiratory diseases (COPD, asthma). Listening to the discussion of how family physicians were billed previously and what they will be expected to do now is unfair. You expect our Family GPs to accept to the care of a patient with multiple conditions in a 15 minute time slot instead of the original 30 minutes the Family GPs had under the previous contract which Minister of Health Tyler Shandro nicely tore up earlier this year? How is this improving the health of your citizens? Why are discriminating and sacrificing the health of these Alberta citizens? I thought all Albertans are important to you, but you push through and passed Bill 30. Doesn’t makes sense to me. Your words are saying one thing but your actions are saying the opposite. I am sorry Premier Kenney, a family physician could probably cover simple checkups or refilling medications in 15 minutes but for those Albertan citizens who have multiple pre-existing conditions, they need that extra time to ensure all their health concerns are being addressed correctly and properly. Why does it seem you are penalizing our family physicians for doing a good job taking care of their patients? Do you realize how difficult it is to find a family physicians taking new patients? Now with the changes Mr. Tyler Shandro are making on how these physicians are paid, it now will be a larger challenge for Albertans to find a family physician to care for them. The greatest impact by this change are to our rural family physicians, where in the end, can decide to leave the province altogether to another province where they are respected. With the publications of rural physicians closing their practices, what is Mr. Shandro’s plan to recruit physicians to service these rural areas in Alberta like Pincher Creek? How are these actions by your government, taking care of your citizens, who you are responsible for as our Premier. 

For the last 7 months, we have had to face the global deadly and highly contagious COVID-19 pandemic. As these are unprecedented times, I think yourself along with Dr. Deena Hinshaw, have been doing a good job trying to get the message out that this virus needs to be taken seriously. With loosening of restrictions for the general public and for LTC facilities slowly in hopes to reduce the spread of the virus while trying to get “back to normal” has not been easy but necessary. Even though many other provinces are in Stage 3 of reopening; and now that there is an uptick of cases in our province, we have remained cautious and have stayed at Stage 2 of reopening throughout the summer. Thank you Premier Kenney and Dr. Hinshaw putting our health above economics when dealing with Covid-19 pandemic. One of the major concerns that has come from dealing with Covid-19 is the need to improve community care living facilities. Definitely there is an insufficient number of staff members to care for all their residents and their daily basic needs. I can I see this at my facility. In Canada we have seen the insufficiencies of having shared rooms when it comes to communicable diseases such as influenza, bacterial pneumonias, Norwalk virus, and Covid-19 to name a few. There are so many benefits having private rooms - ability for isolation/quarantine; having a private space for loved ones to visit; and the privacy for their daily basic needs, and to have the room for their own belongings so it can feel like their “home”. We have 6 types of community care facilities and greatest need is the lack of LTC and Hospice facilities available in Alberta (these are both considered an ALC in the hospital). My facility, AgeCare - Skypointe, just received funding for 15 hospice beds in June 2020. It is the first hospice facility in the Northeast Quadrant of Calgary and did you know there are only around 150 hospice beds available for the whole of Calgary Zone, which is over 1.2 million in population. Wow, talk about an area that is under service in Alberta. My facility opened in May 2018 and in August 2020 there is already a year waiting list to be admitted and some LTC facilities in Calgary have a 2-3 year waiting list to be admitted. Premier Kenney that is a long time to wait in the acute care hospital beds for a community care facility. Another discrimination towards your the Albertans who fall in the category of being bariatric (obese) and those citizens who require LTC services but have underlying mental health conditions. Originally, AgeCare - Skypointe was not accepting bariatric residents, but I am so glad they made an exception in my case. Leadership gave me a room with a dual lift tracking system for both my safety and safety for those caring for me when transporting me from and back to bed. My feeling is that all LTC facilities moving forward should be built to accommodate a bariatric resident regardless if they weren’t “planning” on it as years go by, these residents will decline in health requiring more staff to provide care as well require lifting machines for transportation to and from bed. It is difficult to make changes to a facility after the fact due to structural designs, so why not plan ahead for all situations and for LTC rooms prepare for bariatric use. In November 2018, AHS gave funding to have a floor designated for residents with mental health conditions and require LTC needs, which is a total of 64 beds. We just simply need more designated facilities to provide the appropriate care they is required for these cut to enjoy a good quality of life like the rest of us.

In closing, Premier Kenney I urge you to stop the process of privatization of our province’s healthcare system and look at the “big picture” of delivering the best healthcare in Canada. I realize that healthcare takes approximately 40% of Alberta’s total budget, but what criteria is used in calculating the “healthcare costs per person” in our province? If we break it down to individual points, what efficiencies and savings can be found to help reduce the costs before cutting staff and wages? Are there some surgical procedures that could provide cost-savings by simply switching them from an inpatient care to a day surgery care? Since privatization equals for-profit, will the hip replacement surgery cost the same to the province compared if performed at the public hospital? If the cost is higher at the private which AHS is covering, how is this bringing down our province’s healthcare costs? I need to hear the benefits of privatization of our healthcare system before I can support it. 

Thank you for listening to my concerns on our province’s healthcare system. I wanted to acknowledge my appreciation of my care and compassion I have been receiving during this pandemic. In addition, I felt  needed to stand p and advocate for myself, for my fellow LTC residents who can not speak for themselves and for the healthcare professionals who cared for me in both the hospitals and at my LTC facility. 

I would appreciate an acknowledgment that my letter has been read by you.  If you wish to follow p with me on the information shared, feel free to contact me via email at laura2travel@yahoo.ca

Sincerely yours, 

Laura Jean Rutherford, CHIM 

Cc’d:

Honourable Erin O’Toole, Federal leader of Conservatives Party of Canada, Leader of Oppositon

Honourable Justin Trudeau - Prime Minister of Canada

Honourable Chrystia Freeman -  Deputy Prime Minister of Canada, Minister of Finance

Honourable Josephine Pon - Alberta Minister for Seniors and Housing 

Honourable Prasad Panda - Alberta Minister of Infrastructure, MLA Calgary-Skyview 

Honourable Rachel Notley - NDP Leader of Alberta, Provincial Leader of the Oppositon

Honourable Tyler Shandro  - Alberta’s Minister of Health

Honourable David Shepherd - Alberta’s NDP Critic of Health

Honourable Thomas Dang - Alberta’s NDP Critic of Infrastructural Critic

Honourable Lori Sigurdson - Alberta’s NDP Critic of Seniors and Housing 

Honourable Patty Harju - Federal Minister of Health 

Honourable Taylor Bachrach, Federal NDP critic for Infrastructure & Communities 

Honourable Don Davies, Federal NDP critic for Health

Honourable Matthew Jeneroux, Federal CPC critic for Health

Honourable Michael Chong, Federal CPC critic for Infrastructure, Communities & Urban Affairs

Honourable Travis Toews, Alberta’s Minister of Finance & President of Treasury Board

Honourable Doug Schweitzer, Minister of Jobs, Economy and Innovation 

Honourable Jason Nixon, Minister of Environment and Parks, House Leader

Mr. Naheed Nenshi, Mayor of Calgary

Dr. Christine P. Molnar, MD, FRCPC, President, Alberta Medical Association 

Dr. Katharine Smart, President-elect, Canadian Medical Association 

Dr. Vishal Bhella, President, Alberta College of Family Physicians

Dr. Scott McLeod, Registrar, College of Physicians and Surgeons of Alberta 

Ms. Shirley Schipper, President, College of Family Physicians of Canada 

Mr. David Weyant, Chair for Alberta Health Services Board

Dr. Verna Yiu - President/CEO of AHS