Taking the “third way” will give Albertans faster care, more treatment options, an electronic health record and a healthier population, promises Evans’ plan. It also targets rising costs: basic health service expenditures rose by 3.9% in 2003/2004, reports the Alberta Health Care Insurance Plan Statistical Supplement. But amidst these varied goals “the government appears to be focused on greater private sector participation in healthcare funding and delivery,” says Lindenberg.
Just how much greater? That remains to be seen, according to David Dear, an Alberta Health and Wellness spokesperson in Edmonton. No details of the Healthcare Assurance Act have been worked out yet, he says. Nor has the government defined the kind of non-emergency health services private supplementary insurance might cover. An actuarial study will report on how viable private coverage might be in the fall. What is clear, he says, is that “Albertans want a healthcare system that offers more choice and better access.”
That alone should put employers on notice, says Lindenberg. Like Dear, he acknowledges that “it’s too early” to tell exactly how the planned changes will affect them. Some elements of the reforms are positive, such as a move to recognize—and reward—employers with successful healthy workplace programs. Others, like a redesign of the province’s pharmacare program, could mean parallel change for employers’ drug formularies.
With the ministry looking to trim its $1 billion a year prescription drug bill, employers may well do the same. This would be a shift, notes Lindenberg, since few Alberta plan sponsors have tried to manage their formularies to date. “Whatever is legally prescribed, that’s the coverage, whereas in other parts of the country they’ve chosen to manage the formulary in the context of cost containment.”
Overall, a bigger benefits bill seems inevitable. The reform plan also lets patients select from an expanded healthcare menu—they’ll be able to ask for an upgraded hospital room, or a deluxe, rather than standard, hip replacement—all for an additional fee. “This will create pressure on employee benefits plans to fund those expenses,” Lindenberg points out. At present, he notes, Alberta plan sponsors are already more generous than their provincial counterparts when it comes to supplemental benefits. “[They] may be paying more because they choose to pay more, just through plan design.”
With the system changes slated for late 2005, and into 2006/2007, plan sponsors will likely make different choices quite soon. Which way will the Third Way push them? Without reform plans details, it’s hard to predict, says Lindenberg. But he will make a call for the overall system: “fundamental change.”
Terri Goveia is a freelance writer living in Toronto. firstname.lastname@example.org