machado: alberta's failed lab privatization deal is another costly example of governments not listening to those who know best
as long as leaders refuse to consider us important partners who must be at every decision-making table, we will continue to be the ones who pay the price for their costly decisions and indecision.
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"the reality is if policy drivers and leaders were to approach the average joe — the cog in the system, like me — we would be happy to tell them how we think things should be done," says dr. etienne mahe, a calgary-based pathologist commenting on alberta's lab privatization attempt.
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“the reality is if policy drivers and leaders were to approach the average joe — the cog in the system, like me — we would be happy to tell them how we think things should be done.” this is what dr. etienne mahe, a calgary-based pathologist, told the cbc earlier this month regarding the alberta health services (ahs) failed plan to privatize community lab services. the original deal, signed in 2022, saw dynalife medical labs, a private, for-profit company, begin expanding its lab operations to include calgary and southern areas of the provinces (the company had been providing lab services in edmonton and northern areas for years) that december. it was an effort to create, according to the province’s then health minister jason copping, “efficiencies” and save $18 million to $36 million per year.
but by april 2023, calgarians were waiting months for lab tests — those who had their tests done in hospital were pushed out into the community as dynalife stopped community blood collection at many hospitals, forcing patients requiring urgent tests to find other clinics where they would pay for the tests, languish for hours in emergency departments or wait nervously as their health potentially worsened. the impact of the privatization attempt was so dire that it made it into premier danielle smith’s august 2023 four-page mandate letter, along with direction to newly-minted health minister adrian legrange to resolve “unacceptable lab services delay challenges.”
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and so then began the painful backpedalling as ahs and dynalife signed yet another agreement to bring lab services once again under ahs, a shift that lagrange said was necessary “to make sure albertans can get their lab work done when and where they need it and get timely results.”
if only that was where the sad story ended. it turns out that copping’s wishful savings of potentially $36 million vanished into thin air, according to alberta’s february budget, replaced instead by costs totalling almost $100 million (choke), which include the price to buy out dynalife, as well as what the government called “assumed liabilities.” of course, not mentioned in the budget were the costs to patients and caregivers for out-of-pocket spending on lab tests at other clinics, to fund travel to get to these centres and well, time, which is pretty damn valuable when you are sick and tired, trying to stay well, and, um, have things you need to do, like work. and let’s not forget those for whom paying for tests, much less travelling to get them, is financially, or even physically, impossible.
mahe has it exactly right. if only someone had asked the “average joe,” patients, caregivers and lab workers could have been spared a whole lot of distress and inconvenience, and the province would have had a whopping $100 million to throw at real healthcare system gaps, instead of being left with a mind-numbing bill.
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but then again, no one ever asks, at least not with any real intent to act on what they hear, and so here we are.
and it’s not necessarily a public-versus-private healthcare debate — the services provided by dynalife before the original deal were not shoddy. in fact, fiona clement, a professor who specializes in health policy in the department of community health sciences at the university of calgary, told the cbc that it has a “decades-long history of providing excellent care up north” in the province. there were a whole slew of reasons the expansion didn’t work. but there is a larger message here, which is that privately delivered health services aren’t necessarily better — for people or for the bottom line.
it’s not even clear that lab operations in calgary needed a whole lot of improvement in the first place. according mahe, who is also a clinical professor at the university of calgary, lab services “were working well before the takeover,” suggesting that what was well enough should have been left alone.
the question then becomes, what is it about healthcare, arguably the most important service for humans, that makes our governments feel it appropriate to throw lots of money at dubious endeavours like the dynalife deal, instead of supporting and improving existing systems and models? as health policy analyst steven lewis recently wrote in the saskatoon starphoenix, when it comes to fixing what’s wrong about canada’s healthcare system, “spending is not the problem; it’s getting nothing for it time and again.” and certainly, a lot of it has to do with politicking, but it’s also a brutal example of leading with closed eyes and ears. which isn’t really leading at all.
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there’s something else though, and it goes back to mahe’s suggestion to ask the “cogs in the system,” (which is everyone), what we think and valuing those insights. consider this: alberta health services decided on the contract with dynalife without holding any public or stakeholder consultations, according to chris gallaway, executive director of the non-profit friends of medicare. what’s more, lab workers were not informed about the details of the deal and how it would impact them, such as who their employer would be and the effects on their pension. a week after the ahs announced the agreement, rebecca graff-mcrae, a parkland institute researcher published a report that looked at the impact privatizing alberta’s lab system would have on patient outcomes and taxpayers and concluded that “all albertans stand to lose from this deal.” many labour and health advocacy groups also weighed in with criticism, including the health sciences association of alberta (hsaa), a union representing about 29,000 employees in the public and private health-care sectors of alberta, and friends of medicare.
where that leaves us, yet again, is facing the reminder that as long as our leaders overlook the value of the input of the “average joes,” refuse to consider us important partners who must be at every decision-making table, and are not brave enough to act on what they hear, we will continue to be the ones who pay the price for their costly decisions and indecision.
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and i’m not sure how much more we — and our healthcare system — can take.
lisa machado is the executive producer of healthing’s advocacy & better health. send her your thoughts at lmachado@postmedia.com.
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