Alberta’s Opposition says Premier Danielle Smith must dump health spending accounts — and if she doesn’t dump them, clarify if she still believes they’re a good way to convince people to pay out of pocket for doctor visits and surgeries.
“Danielle Smith’s agenda is literally advocating for the dismantling of public health care,” NDP Leader Rachel Notley told reporters Monday.
“The wealthy will be able to create a health-care fund so they can get the health care they need while everyone else is left to do without.”
Notley was referring to a report and interviews last year in which Smith argued that Alberta’s health system is bending badly under the weight of soaring costs and complacent thinking, and that only a healthy injection of user-pay and insurance industry thinking can fix it.
Finance Minister Travis Toews has said the accounts, or HSAs for short, will be part of the budget in February.
Smith’s office, in a statement, rejected Notley’s accusations.
“The NDP’s suggestions that Albertans will have to pay user fees on doctor’s visits or other publicly funded services is not true,” it said.
“Premier Smith has committed to introducing health savings accounts to help Albertans afford health-care costs that are not covered by our publicly funded health system,” it said.
“The government will be ensuring Albertans have access to more health services and will not be delisting (from medicare) any that are currently provided.”
Health Minister Jason Copping said in an interview Monday he is working on the health spending accounts, but has not been directed to pursue any user-pay or deductible program or a plan to bring back health premiums.
Copping said he is focused on recruiting more health professionals, noting his department has reached an agreement with the Alberta Medical Association to remove the cap of 50 visits a day for family physicians in order to help doctors and deliver more access to care.
Health spending accounts were part of Smith’s successful campaign to win the leadership of the United Conservative Party to become premier.
She promised to give every Albertan $300 to start their own account. Her government would then give employers and individuals tax incentives to contribute more.
The accounts would pay for a variety of non-medicare services, such as a chiropractor, naturopath, dentist or counsellor.
But while Smith says the HSAs are not for medicare programs, she writes in a June 2021 policy paper for the University of Calgary that HSAs would be a way to get public buy-in to discuss a new way of funding health care, including services currently paid for by the public purse.
“Once people get used to the concept of paying out of pocket for more things themselves, then we can change the conversation on health care,” Smith wrote at the time.
“Instead of asking what services will the government delist, we would instead be asking what services are paid for directly by government and what services are paid for out of your health spending account.”
She added: “My view is that the entire budget for general practitioners should be paid for from health spending accounts.”
She wrote that from HSAs, the government could then move to broader reforms like co-pays and deductibles based on income for things like surgeries. From there could spring broader reforms like charter or private hospitals.
“The only option is to allow people to use more of their own money to pay their own way and use the power of innovation to deliver better services at a lower cost,” she wrote.
“I’m willing to bet most Albertans would be willing to pay up to $1,000 if it would reduce waiting times on vital treatments for themselves or a family member.”