Smith wants to shift the burden of paying for health care from taxpayers to individuals, employers, and insurers. Her vision involves the government providing $375 per person in a health spending account that Albertans could use on services such as massage, dieticians, and pharmaceuticals. Smith puzzlingly characterizes these services as “largely preventative,” even though they clearly play an important role in treating various conditions.
Smith’s plan perpetuates a two-tiered system whereby those with the means to match the government’s contribution get more health spending dollars than those who don’t. This could make access to some services contingent on employment and ability to pay, and leave unemployed or indigent Albertans with less money for the services covered by health spending accounts.
Smith would also have health spending accounts cover “the entire budget for general practitioners.” Although she claims that this would not compromise the principle that access be based on need rather than ability to pay, this is exactly what her plan would do.
Co-payments are also counter-productive to Smith’s stated goals of prevention and relieving the burden on hospitals, given that they can incentivize people to put off seeking care until health needs become acute. Furthermore, any model that involves financial barriers to medically necessary services risks violating the Canada Health Act and jeopardizes federal transfer payments.
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