Those of us who have followed public policy debates and discussions will recall that health care has never been far from the boil. Every now and then, it bubbles up, a large amount of cash is poured in to the system and it subsides for a while. Then it bubbles up again and on and on it goes in an endless three-year cycle. It has ever been thus. Reports have been commissioned – from the Rainbow Report in the 1980s to the health summit in the 1990s to the Mazankowski Report in 2002 to…well, no one has really bothered since then. Mazankowski’s report (which appears to have gone missing from the province’s website), was roundly vilified by those who have the most to gain from maintenance of the status quo. Particularly loathsome to critics was the fact that Mazankowski had a board connection to a private insurance company. This was pointed to regularly by leaders and affiliates of organizations who monopolize the system’s labour pool and whose coffers consequently rise almost every time spending on health care grows. Such hypocrisies were irrelevant, however, and there was much scoffing at the former deputy prime minister’s assertion that “unless we are prepared to change how we fund and how we deliver health-care services, the health-care system in Alberta is not sustainable.” Bull feathers, cried the Parkland Institute, a left-wing think-tank. “Any rational and reasonably educated person reading the Mazankowski Report, and particularly the appendixes, would come to the conclusion that the costs of health care in Canada, and especially in Alberta, are a bargain,” said Dr. Trevor Harrison, at the time the research director of the Parkland Institute and a sociology professor at the University of Lethbridge who co-authored Parkland’s response with health researcher Dr. Tammy Horne and Gillian Steward, a former managing editor of The Calgary Herald. Well, let’s see. Alberta spent $6.8 billion on health care in 2002. This past year the province was scheduled to spend $12 billion – an increase of 76 per cent in six years, which is somewhat faster than most Albertans’ incomes have risen over the same period. Three of the four parties in last month’s election were promising accelerated spending on health care and decreased financing for it via the elimination of the $1 billion in annual revenue retrieved via health-care premium payments. Even if spending is kept only to the levels of increase experienced in the past six years, its current pace of growth will put it at $21.12 billion by 2014 for an overall increase in cost of close to $15 billion a year in 12 years. That’s about $6 billion more a year than the largest budget surplus – $9 billion – Alberta was able to record at the height of its boom. It is almost equivalent to the entire budget for the province – $21.6 billion – allocated by the government in 2001-2002. Overall provincial spending grew by $11.4 billion from 2002 to 2008. Of that total, $5.2 billion, or 46 per cent, was due to health care. In ’01-’02, health spending consumed 31 per cent of provincial spending. In ’07-’08, even with very large overall spending increases (52 per cent in six years thanks to other areas such as infrastructure) health care consumed better than 36 per cent. That’s an increase of 16 per cent on a proportional basis, which extrapolated, means that even if other government spending continues to grow at the breakneck pace of the past six years, health care will consume 65 per cent of all provincial spending 24 years from now when my children are in their mid-40s. Alberta spent $1,950 per capita on health care in 2000/2001 and last year was spending $4,100 – by far the most of any province. Yet when one visits any of the city’s public health-care facilities, whether emergency rooms, regional clinics, drop-in clinics or health services centres, the experience (there is no kind way to put it) is utterly grey and vaguely Soviet. Rooms filled with weary, impatient people evoke memories of the public sector monopoly days when one had to take half a day off work to get one’s car registered. I am an enormous fan of universal access to health care and of the people who bring it to us. But Mazankowski, whose report contained too many inconvenient truths for the status quo and has long since died, decayed and mummified at the back of the health-care queue, was right. Six years on, the fundamentals of the system haven’t changed and neither has the truth.