Conflict of interest in the public sector

Worth A Look, Healthcare & Welfare, Frontier Centre

Never underestimate the ability of status quo proponents to mislead and fear-monger on health-care reform. A new study out from the Edmonton-based Parkland Institute is an example of, at best, fear overpowering reason. At worst, it’s a disinformation campaign financed by government labour. It arrives courtesy of two authors with strong B.C. public-sector union ties.

Victorians won’t know much about the Parkland Institute though they might recognize its soul-mate, the unofficial NDP think-tank, the Canadian Centre for Policy Alternatives.

Last week, I chatted with Colleen Fuller, one of the study’s authors, about The Bottom Line, which focuses on the purported Alberta threat to health care.

Alberta Premier Ralph Klein has chatted up health-care reform and possible increased private-sector involvement almost since the day he became Alberta’s premier in 1992. His Bill 11, which status-quo types thought was such a threat to “public” health care, restricted private clinics in a manner even former B.C. premier Glen Clark never attempted.

More openness to private-sector health-care innovation began under left-leaning B.C. and Quebec governments in the 1990s. And kudos to them.

But the anti-Alberta, anti-private-health-care study is not apt to let facts or logic get in the way of a narrative with a decent plot:

Government-controlled and union-delivered health care good and private-sector guys bad. There’s even a scary ending: How any reform that involves private sector delivery or insurance will destroy universal access to health services.

As part of the vast health-care conspiracy, the Parkland pamphlet thus flails at Don Mazankowski. Several years ago, the former Mulroney-era federal cabinet minister held hearings and wrote a report for the Alberta government at the same time former Saskatchewan premier Roy Romanow toured the country in anticipation of his own study for the federal government.

Fuller and co-author Diana Gibson criticize Mazankowski for having sat on insurance company boards. This, they argue, was a conflict of interest.

Mazankowski’s association with private companies apparently made him suspect because his recommendations might benefit the insurance industry.

Perhaps, though that ignores the central point: Are someone’s recommendations sensible all on their own?

But let’s accept the conflict-of-interest charge. Such logic then applies even more so to politicians whose party is directly funded by government labour.

So imagine, say, an NDP government whose party apparatus is funded and partly controlled by the very public-sector unions with whom they must negotiate. OK, forget the visualization experiment.

Just recall the NDP’s 1991-2001 reign, where New Democrat politicians and public-sector labour lovingly scratched each other’s backs. It was and is a recipe for monopoly control that always results in inflexible service, above-market wages and benefits, misdirected resources, and for patients — longer queues. It’s also a direct conflict of interest.

It helps if a buyer of services has choices. In health, that means private, non-profit or public-sector providers. That allows for options. In that scenario, wage costs, which account for about 62 per cent of B.C.’s health-care budget, can be better controlled so as to provide more room for additional equipment, more staff, and new drugs.

Fuller and other Parkland/CCPA/ NDP types claim they are in favour of health-care reform. But their version is to put injured workers on Workers’ Compensation in the same killer lineups as the rest of us. Some reform.

The trio also regularly miscast any private involvement as a slippery slope to the end of universality. Wrong. Reform is about 100-per-cent access to health care but with multiple providers a la Europe, or, horrors, perhaps even 100-per-cent access with multiple providers and multiple insurers.

Instead, the axis of anti-reform interests prefers the current system. It’s where most medically necessary services are monopolized by government insurance and mostly delivered by inflexible public-sector unions. How convenient for them. How unfortunate for patients.

Mark Milke is author of the forthcoming A Nation of Serfs?