The prescription for health-care reform could prove to be a bitter pill to swallow for thousands of Alberta companies faced with the looming possibility of rising premium costs. The Premier’s Advisory Council on Health, chaired by former deputy prime minister Don Mazankowski, last week issued a sweeping set of recommendations designed to provoke an overhaul of medicare to ensure the sustainability of health care.
But while applauding the “long overdue” initiative for change to the stressed-out system, representatives of small and medium-sized businesses fret they will bear the brunt of a proposed hike in health-care premiums.
“Already, many employers in Alberta and across Canada are struggling to keep up with the rising costs of employee benefits,” says Dan Kelly, vice-president of the prairie region for the Canadian Federation of Independent Business.
Members of the CFIB, which represents 8,700 small and medium-sized businesses in Alberta and more than 100,000 across Canada, generally support the idea of users paying for services that are provided, says Kelly.
But increasing health premiums – which he calls a form of payroll-based tax – might cause some small businesses to either cease offering them, or cut into salary increases or their ability to hire more employees, says Kelly.
According to Alberta Health, health-care premiums account for 10.5 per cent of total health spending in Alberta, much of which is for services other than insured services.
The council has estimated that premiums make up about 15 per cent of insured services spending, and the report suggests the province consider raising premiums until they cover up to 20 per cent.
An expert panel will be set up to make decisions on what services should be publicly insured in addition to those required under the Canada Health Act. It’s not known how many small and medium-sized Alberta businesses pay health-care premiums for their employees, but Kelly estimates most companies spend more than 10 per cent of their revenue on all benefits, which could include Employment Insurance, Canada Pension Plan, Blue Cross or extended health and dental coverage.
In Calgary, Chamber of Commerce president Barry Rempel praised the Mazan-kowski report, saying business should be able to play more of a role in helping draft a new plan for the future.
“But we’re not coming out swinging in the way other groups are about the need for a private health-care system,” says Rempel. “Our board policy is that it’s a publicly funded system and the need for accountability is paramount.”
Instead of just focusing on premiums as a hidden tax, Rempel urges businesses and government to look at new ways to fund health-care delivery.
“While not coming out overtly as an advocate for a private sector involvement, we are also saying: ‘Don’t throw that out without talking about it,’ ” he says.
“One of the ways that happens is through the kinds of discussion that is being generated by this report.”
Meanwhile, the president of the Progressive Group for Independent Business (PGIB) says the Klein government has been somewhat myopic when it comes to supporting business in Alberta.
“I don’t think the Klein government has ever really been favourable to small business. They are a government that’s favoured the oilpatch and big business more than anyone else,” says Craig Chandler, PGIB president. Rising health-care premiums will force smaller businesses to hire more workers on contract without health benefits, he predicts.
“The government seems to think we have deep pockets, and if you own a business, you’re rich,” he adds. “They seem to forget that we pay ourselves last. I think if they’re going to ask us to take part in the increased premiums, they should ask us to have a voice in how it’s going to be implemented.”
The CFIB’s Kelly agrees the voice of small business should be heard, and not just on the issue of premiums.
“The report speaks to having a larger role of private sector in the front-line delivery of health-care services,” Kelly says.
“Businesses are prepared to give careful consideration to new means of financing health care in this province. However, I think simply increasing the existing form of taxation is probably too limited in our exploration of ways of implementing some form of user contribution.”
Klein has asked Health Minister Gary Mar to review the recommendations, and says his government will respond to the report on Jan. 23.
He will also discuss the issue on Jan. 21 during a 20-minute televised program titled Health First: Alberta Leading the Way.