[Star Strider]

So, it would appear that my initial posting - even if could have been a more appropriate thread, something that this one corrects - was pretty close at 1.5 beds per 1,000 although the granular counts are quite valuable.

However, if we are really going to "get into the weeds" on the number of acute care beds available per 1,000 residents, we probably also need to deduct those acute care beds which aren't actually available for acute care patients as they're already occupied by alternative care patients who can't check out because there's nowhere for them to go. The most recent numbers I've been able to find for that bed count is:

• Sturgeon Community Hospital (St. Albert): 22.5%/38 beds
• Royal Alexandra Hospital: 18.7%/163 beds
• Misericordia Community Hospital: 17.4%/54 beds
• University of Alberta Hospital: 15.2%/134 beds
• Grey Nuns Community Hospital: 10.8%/39 beds

This reduces the above bed count from 2,846 to 2,418 and from 1.68 beds per 1,000 to 1.43 beds per 1,000.

Well I won't disagree that the hospital bed ratio seems low in Alberta. And with the surge in population growth in recent years the ratio will continue to drop.

So how does Alberta go about fixing this?

As I recall you, and others, felt the province shouldn't be looking to build HSR because of this low bed ratio.

But the province already spends far far more on healthcare than transportation infrastructure.

And other ministries, like education, are similarly stressed by the population surge. I'm not sure adjusting provincial budget proportions is the appropriate solution.

It's a very complex issue, with a whole lot of variables, I may keep digging into this as I have time.

High level, bed ratio leader Japan spends a smaller proportion of its GDP on health care than Canada, (10.9% vs 12.7%) yet seems to get much better results.

I'm still interested in knowing how they use those beds, as overall they seem to be a much healthier people too. Their obesity rates are a fraction of Canada's, to use just one example. (3.6% vs 30%)

I'm still inclined to believe they have floor upon floor of unused rooms in their facilities, and maybe that's part of the solution for Alberta?

When a new facility is built, massively overbuild the structure, and perform final fittings of rooms and treatment areas as needed in future.

Sherwood Park did this to a small extent, with 'shells' for 36 additional beds built but not fitted. I believe the SE hospital in Calgary did this as well.

End of the day though, its important to remember that no particular amount of health care spending or hospital beds are going to grant any of us immortality. (only Lao Tzu and friends can do that!) So the improvements need to be proportionate and affordable. Raising taxes on an already debt strapped people isn't the answer either...

 

[kcantor]

...

As I recall you, and others, felt the province shouldn't be looking to build HSR because of this low bed ratio.

...

If there was an economic case to made for building HSR, I and others would be less inclined to object our tax dollars being invested in it. It's not a matter of "no HSR because of our low bed ratio. It's a matter of relative returns on investment for a limited amount of available tax dollars all of which must come from the public.

Increasing the low bed ratio makes sense economically because a healthier longer lived population contributes more to the economy in terms of productivity, taxes paid and reduced services needed from the health system. A proper allocation of additional health care dollars - as noted above - doesn't necessarily even have to go to new acute care beds if more alternative care/supportive care beds can be provided at a lower cost and free up an equivalent number of acute care beds.

Dollars spent in education and in research similarly increase productivity and taxes paid.

Both education and healthcare also support increased levels of immigration of those in the prime most productive years of their lives...

It’s not HSR vs hospital beds, it’s about HSR needing to meet the same criteria as anything else before it gets public money.

 

[David A]

I don't like how things get often turned into an either this or that for totally unrelated things. These are not the only two possible things for government to spend on. Each should be decided on its own merits.

I feel we really do more acute care beds which the low ratio indicates. A lot of other things get messed up, ambulances and emergency care gets backed up because of beds not available.

Although we probably also need more alternative and supportive care beds too.

 

[Star Strider]

If there was an economic case to made for building HSR, I and others would be less inclined to object our tax dollars being invested in it. It's not a matter of "no HSR because of our low bed ratio. It's a matter of relative returns on investment for a limited amount of available tax dollars all of which must come from the public.

Increasing the low bed ratio makes sense economically because a healthier longer lived population contributes more to the economy in terms of productivity, taxes paid and reduced services needed from the health system. A proper allocation of additional health care dollars - as noted above - doesn't necessarily even have to go to new acute care beds if more alternative care/supportive care beds can be provided at a lower cost and free up an equivalent number of acute care beds.

Dollars spent in education and in research similarly increase productivity and taxes paid.

Both education and healthcare also support increased levels of immigration of those in the prime most productive years of their lives...

It’s not HSR vs hospital beds, it’s about HSR needing to meet the same criteria as anything else before it gets public money.

Well at the risk of re-railing the healthcare thread (haha) from what I understand the province received at least two unsolicited proposals for HSR projects, but per comments at the open house session, they don't want to give control of the corridor to private interests. I suppose we won't know more until the plan is released, but my guess would be some sort of P3 for HSR, while regional and commuter rail would be more likely to be subsidized by the various governments.

Back to healthcare, I'm not disputing the value of it, and I'm very glad we aren't in a situation where people can lose their homes or go bankrupt from a car accident or heart attack.

But it seems pretty clear that Canada isn't getting the best value from the many many billions spent on the system, and improving that warrants further discussion.

Alternative treatments are good, I suspect things like elder care being moved to other agencies like Capital Care and CareWest, and improved medical techniques resulting in improved recovery times could be partly responsible for the decline of Canada's bed ratio over the years.

If the population surge in AB and the rest of Canada stabilizes, and new energy projects get completed there will of course be new revenue to help pay for more nice things, like new hospitals, which would help enormously.

But even better would be ways to reduce usage. This is where I think things like spending money on bike lanes and active use infrastructure could actually break even long term as it encourages healthier lifestyles.

Even climate change could have a silver lining, with shorter winters leading to less sedentary time and improved health outcomes as people get out and enjoy the longer summers.

The city's plastic bag ban seems to have worked reasonably well, it made a convert out of me to the point where I even keep a reusable grocery bag in my overseas travel kit.

Maybe something similar, like a junk food tax could help fund further health improvements?

Two dollars on every happymeal to fund future Stollery expansions. A dollar on every liter of cola sold to fund local diabetes treatment. And so on.
Discourages use and funds treatments at the same time.

I have no idea what the province is spending on overdose treatments from the opiate crisis, but getting those people into a more rigorous treatment program would definitely take some load off the hospitals, and make them safer places too.

New ideas are needed if we want to break the status quo..