Involvement of non-governmental health operators could boost access to health care in Alberta, if done properly, says MEI researcher

Calgary, September 3, 2024 – If properly executed, the Smith government’s plans to have management of some hospitals transferred to independent operators could help improve access to health care, according to a researcher at the Montreal Economic Institute.

“The wait times that have become characteristic of Alberta’s and Canada’s health systems are amongst the longest in the developed world,” explains Krystle Wittevrongel, director of research at the MEI. “When we look at European countries that perform better on access to care than we do, the existence of competition between care providers is the norm.”

Alberta Premier Danielle Smith has announced plans to introduce competition to the province’s health care system by transferring authority over hospital management to non-governmental health operators.

The move is intended to drive better performance from Alberta Health Services.

A recent MEI publication found that autonomous not-for-profit hospitals tend to perform better than their government-run peers, as seen in Germany, France and the Netherlands.

However, according to the researcher two key ingredients are necessary for the model to function effectively.

The first is managerial autonomy, which has been shown to help bring decision-making closer to front-line health professionals and lead to faster and more efficient adaptation to changing health needs in a region.

The second ingredient is the reliance on an activity-based funding model in which a hospital receives a set amount of money for each treatment carried out within its walls. Under this system, Wittevrongel says, each additional patient treated represents an immediate source of revenue for the facility.

Under the current funding model, hospitals receive a fixed budgetary envelope every year, which they then spend on patient treatment over the course of the following twelve months. Since every new patient is a source of cost, this often leads to rationing of services, explains the researcher.

“With the right incentives and competition, our province’s hospitals could treat more patients than they do now,” notes Ms. Wittevrongel. “By introducing such competition, the Smith government is taking a step in the right direction.

“It just needs to make sure it enacts the right incentives for this reform to reach its full potential and increase access to care in the way Albertans want and deserve.”

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The MEI is an independent public policy think tank with offices in Montreal and Calgary. Through its publications, media appearances, and advisory services to policymakers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship.

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