Why do folk clutch at straws when there is a lifeboat on hand?
The Mazankowski committee considered all too familiar problems with the Alberta healthcare system, in particular expenditure inflation and public "affordability," and the efficiency of the provision of care to the population. The remedies if offers are incomplete and unconvincing because of the failure to use rigorously the evidence base. Is the system unaffordable when the modest effects of the aging of the population and efficient health technology assessment could control inflation? Why advocate "competition" when it is not defined and managed care in the United States has failed? The Council's report glosses over the crucial issues of how physicians ration healthcare in Alberta and how the profession has failed to evaluate and manage major variations in medical activity and outcomes. Investment in these areas together with global budgets and equitable financial allocations offers better health for the Alberta population. Many of the Council's proposals are not consistent with the goals of expenditure control, equity and efficiency.
Maynard
Alan
A
York Health Policy Group, University of York, England.
D000416:Alberta; D003659:Decision Making, Organizational; D004465:Economic Competition; D005381:Financing, Organized; D018166:Health Care Reform / Q000458:organization & administration*; D006286:Health Planning Councils; D006297:Health Services Accessibility; D006801:Humans; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*