Who should pay for the health-care infrastructure in our city? The simple answer is that we all should, according to our ability to contribute. The answer that governments and individuals try to sort out on an ongoing basis is more complicated.
The Prince Albert Parkland Health Region board recently came to city council to ask for help in paying for the shortfall in the funding for the new Pineview Terrace care home. The province contributed the lion’s share of the funding for this new facility, but according to provincial regulations, a portion must come from the local community. The health board is a few dollars short on this portion, as some of the smaller municipalities surrounding Prince Albert have declined to contribute their per capita share.
The hope was that the city would be willing to release money from a reserve created with health-care in mind to cover the shortfall; however, council said no, citing future needs for that fund and the idea of fairness. If Prince Albert can contribute, why not the other municipalities, too?
That all seems logical, but the story is more complicated. First, it’s a bit disingenuous for Prince Albert city council to criticize other councils for not contributing, given the heel-dragging they did when originally asked to contribute to Pineview. In the end, we all gave our $27 per residence per year for three years and helped pay for something that is much needed to provide care for seniors and others who need long-term care.
Secondly, there are some big differences between Prince Albert and the surrounding municipalities. If you’re part of a village, or in a rural municipality, your ability to ask more in taxes – even a fairly small amount – is far more limited than in a city. Plus, you have to pay proportionally more for a lot of services. If you need a new water treatment system, as the Village of St. Louis does, it must be built to provincial environmental and health standards that cost a certain amount. You have fewer people to share the costs, so it’s a heavier burden for each taxpayer.
And thirdly, just how wide and how inclusive is our “community”? When it comes to paying the bills, apparently it extends quite a distance in the view of our council. When it comes to rural people shopping in our stores, retailers are happy to have people from many miles away come to Prince Albert and join in our community of commerce.
When it comes to use of recreational facilities, there’s debate about why Prince Albert residents should be paying the full cost of creating and maintaining them while rural residents can use them for the same entry cost as city folks. And when it comes to negative activities in our city, the police are only too quick to point out that a large proportion of the people who are arrested are from out of town.
In the bigger picture, it would reflect more positively on Prince Albert if our civic leaders could accept that our city has a role to play as a regional centre, a role that includes both good and bad. We gain from the influx of shoppers and service consumers who travel hundreds of kilometres from the north and a radius of about fifty kilometres around the city to spend their dollars here. In return, we provide other services – sports, arts, entertainment – at what is essentially a cut rate for these visitors, since they didn’t pay the capital costs. It’s no different than when we go to Saskatoon to a concert or to Regina for a football game. Who is paying the extra taxes for the new Roughrider stadium? Not us, but some Prince Albertans will be there enjoying it, to be sure.
As for health-care capital dollars, this is a mess made over many years by a succession of provincial governments. The province pays the tab for health services, but not the full bill for capital. When a new hospital or care home is needed, these new buildings need furnishing, or the hospital needs new equipment, it’s up to the local community to provide dollars through taxes or donations. I have always thought this system is ridiculous, since the capital cost of facilities and diagnostic equipment is both huge and essential to health-care today, but this is the way it is, like it or not.
At the same time, the province has removed the ability of the health board to enforce any local payment. In the days when it was Victoria Union Hospital, those municipalities within the union area paid in a levy. We also had Holy Family Hospital serving Prince Albert, and most local municipalities voluntarily contributed in a similar way to help fund it. Then, health facilities were rationalized. Funding systems changed. The health board is left with no power to levy or enforce payment, and an expectation from the province that local funding will be contributed for capital needs.
In the end, who pays? We, the taxpayers, pay either through provincial income and sales taxes or through local taxes. But like all taxation questions, it’s a debate over what’s fair. The definition of “fair” to one individual, or one community, is likely the smallest amount possible unless you consider the other person’s point of view.
It’s a whole lot easier to point fingers, but it’s more helpful to look at the big picture and have a rational discussion of how do we get done what needs to be done.
Barb Gustafson is a lifelong resident of Prince Albert and a former managing editor and publisher of the Prince Albert Daily Herald. Email: firstname.lastname@example.org