Alberta continues to look at health spending accounts

EDMONTON – Alberta’s Premier, Danielle Smith, is continuing to explore the possibility of private, health spending accounts for citizens. This month, she issued a mandate letter to minister of Technology and Innovation Nate Glubish (pictured), outlining what she’d like to see his ministry produce for Albertans. Glubish has been instructed to “explore the feasibility of creating Alberta health spending accounts.”

Global News reported that it’s a change in language from November 2022, when Smith told him to “lead the development (of) the technology required to create and operationalize the Alberta Health Spending Account.”

Instead, the Premier appears to be acknowledging the complexity of the task by asking for an exploration of the issue. Not only does the project involve technology, but it also requires a significant policy component.

“This is a really important task that’s going to be a complicated one,” Glubish told Global News.

“My approach here first is we need to get the policy right before we worry about building the technology. And we’ve got a lot of work to do with the minister of finance, minister of health, and probably a few other ministers to make sure that we’ve thought through all of the angles of what would a spending account look like, what should it look like and let’s make sure that it’s designed well from the ground up. And then we’ll get on to figuring out the rest of the technology.”

For her part, Premier Smith has been talking about health spending accounts for years, publishing a paper through the University of Calgary’s School of Public Policy in 2021 with a prescription to create $4 billion in new user fees.

Before becoming premier, Smith claimed the province could “no longer afford” to entirely pay for social programs like healthcare from tax revenue and wanted to see a shift toward private individuals, employers and insurance companies.

She also suggested that health services not covered by the Alberta Health Care Insurance Plan would be covered by the health spending accounts and could be used to cover as many as 10 visits a year to general practitioners.

Health spending accounts featured prominently in her campaign to become UCP leader in 2022.

When asked about health spending accounts before and during the spring election, Smith pointed to the 10-year $24-billion healthcare agreement she signed with the federal government “where we jointly agree to uphold the principles of the Canada Health Act.”

“One of those main principles is no one pays out-of-pocket for a family doctor, and no one pays for hospital services. That’s in writing,” Smith said on April 25.

“Obviously this would be a significant technological proposal, would require quite a bit of work on behalf of the government, quite a bit of expense to stand up,” Edmonton-Centre MLA David Shepherd told Global News. “And what we’ve seen from the UCP government is they have been pretty bad at this before when they’ve tried to set up other similar payment programs and systems for Albertans.”

Meanwhile, Glubish said while he’s excited to fulfill the rest of his mandate around tech and innovation, he has to “take the time to get this right” given the scale and possible consequences of a program like this.

“You got to do it right and you’ve got to do the due diligence,” Glubish said. “And that’s where the feasibility assessment comes in.”

Glubish has also been instructed to review the effectiveness of IT systems used in the province’s healthcare system with an eye to improve the system via technology.

The mandate letter addressing new Health Minister Adriana LaGrange has yet to be issued.