Alberta Premier Smith muses ‘wait guarantee’ to tackle long surgery times

Alberta Premier Danielle Smith floated the idea of a “wait guarantee” on her province-wide talk show Saturday, though adding the province remains focused on its new funding model for surgeries.

Smith broached the topic after a caller complained on “Your Province, Your Premier” Saturday.

Marcel says he went to Mexico to get a hip replacement surgery because of a three and a half year wait time.

Smith then touted her government’s new payment model for surgeries, “activity-based funding.” She says chartered facilities are taking on more surgeries year-over-year, while Alberta Health Services (AHS) surgeries are dropping as the government provides it with billions in funding.

“Let’s make sure that we’re funding the emergency procedures and the emergent issues and the overhead one way, but then let’s reward them for doing more procedures, and that’s how we hope to be able to clear the backlogs for hips, for knees, for eyes, for any scheduled surgery. So we want to put that in place,” she said.

“Just have a little bit more patience.”

But she also said in the past they’ve contemplated so-called “wait-time guarantees.”

Under which, if a trip out of province is needed for a procedure because of an unreasonable wait time, the province would compensate you fully.

“We’ve tossed that idea around many times, but for me, I’d rather fix the system, because I’d rather people be able to get their care right here at home … so they can convalesce in their community and with their family,” Smith said.

She said to give it a year, noting if there are additional funds in the bank, they can be used to “clear the backlog” of waitlists.

“Then let those different entities say, ‘Hey, I could do 5,000 over here, or ‘I could do 500 over there.’ But we have to put the network in the system in place in order to reward those entities if they can increase the number of surgeries,” Smith said.

Meanwhile, while she says chartered surgical surgeries outperform AHS, data from the Parkland Institute suggests the opposite is true.

According to the report, since the inception of the Alberta Surgical Initiative (ASI) in 2019, provincial spending on public operating rooms happened once in 2022-23. It increased by 14 per cent while AHS-delivered surgeries increased by 13 per cent.

However, funding for chartered facilities increased by three per cent while surgeries dropped by eight per cent. Accordingly, public payments to for-profit facilities increased by 225 per cent since ASI began.

Last week, the Premier and Health Minister Adriana LaGrange announced the change to activity-based funding for procedures, the plan to base funding on the number and type of operations performed.

Smith said routine eye, hip and knee surgeries in publicly funded, privately run surgical facilities can be done much faster than in public hospitals. She claims the new model will see government funding follow the patient, making health care more efficient, lowering wait times, providing more transparency and attracting more surgeons to the province.

Smith’s United Conservative government is in the midst of dismantling AHS, once responsible for overseeing the entire provincial health system, and reducing it to a hospital services provider.

One of four new public health organizations being created, Acute Care Alberta, began operations a week ago.

With files from The Canadian Press