The work to make health spending accounts a reality in Alberta appears to be further away than it appeared seven months ago.
On Wednesday, Premier Danielle Smith issued a mandate letter to Minister of Technology and Innovation Nate Glubish, outlining what she’d like to see his ministry produce for Albertans.
In addition to implementing the province’s tech and innovation strategy, upgrading the province’s tech for its services, and making the province more attractive for tech companies and workers, Glubish has been instructed to “explore the feasibility of creating Alberta health spending accounts.”
It’s a change in language from November 2022, when Smith told him to “lead the development (of) the technology required to create and operationalize the Alberta Health Spending Account.”
“This is a really important task that’s going to be a complicated one,” Glubish told Global News.
“My approach here first is we need to get the policy right before we worry about building the technology. And we’ve got a lot of work to do with the minister of finance, minister of health, and probably a few other ministers to make sure that we’ve thought through all of the angles of what would a spending account look like, what should it look like and let’s make sure that it’s designed well from the ground up, and then we’ll get on to figuring out the rest of the technology.”
Smith has been talking about health spending accounts for years, publishing a paper through the University of Calgary’s School of Public Policy in 2021 with a prescription to create $4 billion in new user fees.
Before becoming premier, Smith claimed the province could “no longer afford” to entirely pay for social programs like health care from tax revenue and wanted to see a shift toward private individuals, employers and insurance companies. She also suggested that health services not covered by the Alberta Health Care Insurance Plan would be covered by the health spending accounts and could be used to cover as many as 10 visits a year to general practitioners.
Health spending accounts featured prominently in her campaign to become UCP leader in 2022.
When asked about health spending accounts before and during the spring election, Smith pointed to the 10-year $24-billion health-care agreement she signed with the federal government “where we jointly agree to uphold the principles of the Canada Health Act.”
“One of those main principles is no one pays out-of-pocket for a family doctor, and no one pays for hospital services. That’s in writing,” Smith said on April 25.
The Opposition’s technology and innovation critic called health spending accounts “simply another scheme to get Albertans used to the idea of paying for more of their health care out of their own pocket.”
“This should be deeply concerning to all Albertans who expect their government to focus on fixing public health care, not pushing a privatization agenda that will require Albertans to pay more,” Calgary-Foothills MLA Court Ellingson said in a statement.
The Alberta NDP’s health critic said Smith’s notions of a health spending account shows her “incredible levels of ignorance about the basics of how government functions, let alone the health care system.”
“Obviously this would be a significant technological proposal, would require quite a bit of work on behalf of the government, quite a bit of expense to stand up,” Edmonton-Centre MLA David Shepherd told Global News. “And what we’ve seen from the UCP government is they have been pretty bad at this before when they’ve tried to set up other similar payment programs and systems for Albertans.”
Lorian Hardcastle, an associate professor in the Faculty of Law and Cumming School of Medicine at the University of Calgary, previously described health spending accounts as an “extremely inefficient way of trying to improve access to health services,” one that does not address the unequal distribution of health issues within a population.
The Strathcona-Sherwood Park MLA said while he’s excited to fulfill the rest of his mandate around tech and innovation, he has to “take the time to get this right” given the scale and possible consequences of a program like this.
“You got to do it right and you’ve got to do the due diligence,” Glubish said. “And that’s where the feasibility assessment comes in.”
Glubish has also been instructed to review the effectiveness of IT systems used in the province’s health-care system with an eye to improve the system via technology.
The mandate letter addressing new Health Minister Adriana LaGrange has yet to be issued.
–With files from Saif Kaisar and Caley Gibson, Global News, and The Canadian Press.