,~·'~.lll·· ":: Health pro vid'ers do' n't
": .,:. r



'11 .a111w'-

a_,':~'-' work' tooeth er y's . :-'_'., l..~.:


• Government accep ed all recommendatlons

• [Key points:
~ Pr~nlcip~e:s Iglulide' A.lberta'is hea! h system to
"- rte '_" It'h' "._. Alb... ·· a. Hie:a..1.','1. Act e 1 - P1ublic: E:ngalgelme,nt

Patie -·t 'Charter

~ Clear roles and r'es!pons~billitile,s

Current Heall,-L'h Le_-i',sll'~ tlor .
• Alberta Health Care lnsurance Act
Hosp itals A'."c ..t :
'- .. -. .:._:.. ....:.. ... I .,'
l .' _.'


• Nursing Homes Act

I. Health Insurance

• IH'elalth, Care IP rotsctl on' Act
Premium Act

• The Acts each


on a s,inlgie "pli: 9C 9"" of the system
1 I

.- Creates a pa,tchwor,k w,i~lhlv,a,rying def~nitjolns a,nd approachss - Doesn't proviitia ..i •. coordinated, slelam~e,sssystem

• Address tl·~ps

· current legislation istoric lillegi:sation

• Reduc,e, Iln'teg,8,te and consolidate

• ,Shl" 1 a,way from a f,ac~fity' nd doctor focus. 0 a person-centered a

ap... ro a'ch p ..
.f .. --

I. An Advisory

Committee established on January 20,

• Elngag 9 '1lhle public on MA'CH recommends Ions
l1 I

• Re,gional consultanons through He,alt" Advisory

,~ Input Bind Igu[i.~ncs on new ~e'gis_atlive framework a

t w·t~·. ey .-ealth system stakeholders k

Publlc Survey Fedback
Res Ilts:
• Support tor ,MA,C \ recommendatlons k ~~ d f • S ~ -f_IQjnr-'lcant ,s,/.eotlcism an~ mistrust 01 g'olvernm,ent



=..!:wel[ll,oe~s__§, and soolat determlnants olf healtn

• A call for less tailk and mora action

• BetlAr englalge the, front Uln1a

Choice across the publicly-funded Ihlea~\thsystem

Pub ic Focus Groups - -edback
s' Re'~' Its:
,'~ ',' I

• The Alberta Health Act: is not on thle IPubIiIC~Sradar

• H~glh levelof ,S -"tlcism

• Wai~-nmes and access to -'am!U-' doctors are the
number one conce [Ill

Regi···.··.nal Consultations - _eedback
.1 ,2,8community consultation


workshops open '10 the public in 23 Alberta communities - Nearly '70 0 Allbe,rtaln'S; have attended so far - Alii '112 Health ,Adviisory Counclls hostlnq the, community workshops • Online survey at ww'w.'y'o~.rhealtha,ct.ailberta.ca - Over BOIOI ~esPeAEleRts~~arOver 100 health stakehoider and community orqanizatlons invited lo make written subrnisslone

linister,ls A,dvis1o Y Co~-~'miHee, Heall~lh on
~ 1

Foundatlon -ealth Syst

fOI Our

Alberta Heallthl Act
IPh81se 1 ,~FaU 110) :20

"sl:t.h ., ::' , Hs',' ,II. I AcI"~1


('Jam\. 2010t

• Focus,on panents and families
'.' Plriintcwp~es

• R.,ep,laeing the five'

• P rlinc~ pLs II IPatient charter
• Proceas to engage Albertans


• -P'a~i,enll! charter

," Es~ab~ iishiing an independent, ~ev"dence,-b,ased

• P recess to engage. A!bertlil,ns. i'nf'u~uredec~si"ons

~'nfutur,9' deca\s~ons

• Determine phas'ing of [key issues ,ari,si'ng

'from:a new Alberta Health Act


Phase I~Bu·ld ng Public Confidence
• Principles for Albe-ta's

'aalth Sys"em

,. Charter " Health or patler t charter to build a shared understanding ."e~ee " the health syste __and tt Ie pUbUC


• Ro es and Respcnslbllltles - Clarify the roles 0f k~y goyernance Qrgan-z~tlons In the hea,lth system to build p-ublic confidence
ill III •


Phase I - B . ildinl··.·~.

• Patient Advocatle -- one accessible person/office that w~noversee concerns reiatling to the patient charter
• R'eplortinlg - PUl,lblilc reportlnq lof health system
performance information

• II spection -- consistent inspectlons and review
powers across the health system

Phase -I, L~gisllation
• Oonsolldatlon of fiive Acts that focus on how th healt·'] system is funded
• Going f ...ther in supporting a shift towards: r __.. Health providers w'lorking toqether and to fufl

scope of; ~. ractice - Fonow~nlgla patient throuqhout their journey o,f ca e ~ Focusing on patients and their falmilie,s

.. ase II - eglslat,io'n

• Ev dence to lntorrn cUn:call practice and dec'is,io-c: -makinq throuqhout this system

• Heallth providers ab!tlilty to opt-h and opt-out of the public health

Phase I - Legislation
Declisio,n's Based en Eviden'ce Current Slate,:
• Tbere a.ra a, number of iindependent research bodi'es j'n ,A~berta, but limned coordn a:t~Oll!1
• G,overnme t




support decision-mlakl~ng

wn many


1P1oli'c.y Slhift:

E:'vlil~ence ~{~.II e used to ~', 01J.ILd~,ci.s,io~ns b about health services, such '~~ d1irugS! devlcesJ c~I~ln~ca~1 procedures, fundwng models, and nealth workfon~e decl~s,lons


r .. -eglslation

d IOlpt-olut of Hes,llth ~,rov'ider's

Current Sta ie:
Some health providers thai bmi for publicly-funded serv~ces(leg. phYS1~cians some denrt~'S1slPerfonmiingl oral .surt~ler:Y)' mlust choose to be fuU, , in the hes!lth system or' f ' IJ}Lc..Ul. Other health provillders (.eg~ mi dwivB,g an-:'p armacists) can operate privately and pub, ~c:ly. .
ln boll 'the public

• There is an u~l~e've_::J Yi_n_9fi,eld for health providers 'working Pla and prlvatel'y funded hsalth system

[Ploll icy Sh lift: '. A,.pPUl ,title samls co .• ..'-' ms.o. all~t1eait~~ovide t
ns:[and la,lIow Q'Overnmont the: miexibiii'ty to reaUl~!atehealth pn)V~delflcomrnl '-, ant 'in the IPub~~cystem .. s

nase 11- Legislation
Foiliolwilng a patient t _ roughout thelr jo- -rney ot care (,Ililnk,age, tOI a, nlew Allberl's_ He,RI hi A,el):

'~~~~~~~~~~~~~~~~----~~~--~~~~--~ eallh Faclilily De,s,iigna,t'ion:
Curren~ State:
• Ih em are d irfferent:I'Ui9S for diffen19nt fJacii i~r s I(e .'9 nUlrs,ing home "versus supportiv,e a
UVlllg)t ~ ------


rhe provli'nce has


ho.s',D,mJ 'focused health care s:stem

• Funding and access J,. inco' .is-tent tor the' same. servlcee provided at dift[,eren~ tacl i,t~es (e, gm hospltal versus urgent care) -

• "

Pu bUcl~lflm~,ded services am typica~ only avs ihJb~,ein hospftals. or by phys,rcr,an s ~y Desi glna,tion and regu la~jonof feci Uties wou ld not Illm~t,abiilrty to fu 11d and/o,r p rovi"de [ s', !VIces, -

Po[llrnc~l ,Shift

._ . [:.[.... P'hase

-III t_l


Le'g' [lI!Is'la-t_I.::'. 1'-' :_ [I·O

Process 10 Establish Essa[ntia~Serv'ices

Current State:
• Ful'y, funded healtr service~ are Pf~dominantly d~t~~minedby_the .~lo.pation01

service (e.g. hoslPlltaOaind the provider (e.g. IPhyswc~an}, the needs of not

• 'There is not a clear process to de1termine essen~i'al'seIN~'ces

• Cu rrent services are


based [on a regular, rigo,r[ous,evlden ce-based p recess

Po icy Slhlft:
• D[eve![op [at clear 6 vide nee ..based process to determl ne heaU'h services that are 'fu~~y' ... 'f'unded~p,artial~y fiundedl and unfunded servlces. A transparent and el1gag[ng-dr~rV'en process 10 the publ~c would be part of its torrnaflon, ,~

rtlo -:'h-a's' e III - 1'~,".I~~ -I' 81 I"n,,' _',-":__:' _ Le' 'gl. ~~
Cu trent Slate:
• AI.~ertal~ pl~!b~!~icben,Bfult m ~~Iells;lafig,9 de~~nedby 'the f'acrnMty Alb ertans use or i ~y the' p,ro,vldler 1hey are able, to access
."'Ule: • S-s
~ I,..:.... . _:_.

• The current benettt model is restrictive and health status is j'mlpacted by more than hospij'ta~ and ph-ysi,cian services

Policy Shift:

mu rther 'than the current, narnJ'W scope and explore other funding models (,emg~
Insuwanee and cost ..savings accounts)

New' l~e~,~s~a.tion wU~enable glolv,e,rnmle~rt:o consider beneflt ml9de~s llhat 'go t

__se II - Legislatio a
surance Opt~o-s
Current Stat,s,:
• Prlvate in su Iranee

bitsd for' p ubl~cly-fu n ded servi cas

• There is, no e,vidence' th,81t private linsUlra' 'C8 negath/,e,ly impacts a pub,~ic heailh system

lssue.~ 11·· " '. _. .'.

Pf()hibiming private ~m'1ISU[ranGel limits choice in aooesslnq publi'ci'y-funded he,a~th services witbin ,A~bena(e g~private diiagnostie facilities)' and outside of Alberta ('8,.,lg. May,o C'lini,c)

lPoUcy Shift:
'. Cons~de,rp~ilV'ateitnsurance OID'tions for lli~:miled health services
~ ~ ::::a::;,.1

Regulations coubj enable and n3gu~late scope and 'operation o,f p,rivate


ran ce


. .

Current Statel:


11- Legisla' ton

Ou -ot-Prevlnee and Ou1-ofl~Caluntry' Health Services
• AI b srta pays 1'0r a Il~ hospi1tsl an dins u red physi:c~:a.nservl c.es fo r i~Jsrssl dents carle in omher provlnces land a, portion on an emergency basis when outside the,

• S,hauld! ,Aiib1enaliincenm or limit: fund~'nglf'or' out-ot-provlnce


of out-oi-country



F Ile,xjib~l~lirty out-of -cou n!ry an d 0 ut-of .. rovl n ce flundi ng can bean ave nu e' 10 ~ n p re~li eve pressures or add rsss s usta~nabili'ty



Phase I ... egislation L
Issues t,· at lml,ay arise p--~b-_cly aut 'willi not be revie'wed (Iinlkag,e to ,8 nlew Alberta Health Act):

Phase II - Legislation
Queu'e ,Julmpi[ng
Current S,tate:'
• A]bert~ ~oes,r!t sup~'~r:tIqu.~uejumping. ~ut only.eXir·lic.i~Iy.~pr-evenrts in the I~t He,alth ICare Protection Aclfor non-hosplta~ surgl~Caj fac.~I~t~es

.. Desplte tl~ls p rohl~bilon i qu eua Jump,ing occurs ~in t many wa'ys

.. Theile are '9aps, in Ileg is b3[tion-that al h:)w work-arounos • Queue jum1ping on!y appllli!es'~O p,ublicly..;funded health services Po~licy,Sh~ft:

• None or an expansion o,f current state. Albe-rta. can either malntaln 'the prohibition or expand beyond soll'e!l-y the ron-nospdal su:trgi'caJ~ faollltles

Current State:
• P'rohibit~ionon lb~~[liIing and above goV'en~lment fiund~'ng'f-or essen lia~1 over services; pfedorm'ilnaml y appl has,to phys:~cli1anls • This; compiles wi~'"C mhe Canada Health',Act

'. The prohibition must be malntalned in order to comply with the ,Canada Health,


Po'llicy Sh~ft::
• N~'ne~ A.pro~,ibition o~ ,e-xtrti,-,~~IUng required for AIDberta to q--a,lify for Federal is. Canada Hsalfh Transfer fu ndmng

Next Steps
• ~rnpilleme~lt hase I of: legislatlon, i·-clluldling development p ot rsqutations

.' Falll comrrumlcatlons and m!le,~,sla!gJng wi:111 include a number lof annor mcernents related to MAC,H • Co· sultauon Ion phase I~ot le,:~·lslatjlon; this couki occur in staqes .

• Butildingl po Hey· and research oapaclty to aocrese the i,S,SUI9,S IB,lrisi'ng ln Phase ~I

Looking f,oward

"The goal is for Alberta to have the high,est performing publicly-funded health system

in Canada" -Pre,misr Ed ,Stelma'ch


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