Sunday, April 19, 2009

The real reason gender reassignment surgery was delisted.

I love debate! For a few reasons. First, it helps me to think comprehensively about an issue. I truly enjoy considering what others have to say about an issue, while I analyze my own biasses on the issue. Furthermore, debate allows for effective policy making. So long as the participants debate the merits of the issue and avoid partisan and personal attacks, we end up with well thought out decisions.

I enjoy twitter because it is a forum to share information and interesting stories, and it is a forum that encourages healthy public debate (reminiscent of London's speaker's corner). Today's blog post is inspired by the discussion I had last night with Doug Griffith (@GriffMLA) and one of our friends from Alberta: Get Rich or Die Trying (@AB_get_rich). The topic was delisting of gender reassignment surgery (GRS).

What I am about to say requires a couple of important caveats. I acknowledge that I have no idea what it's like to be born into a body of the wrong gender. So whenever I'm in the situation of speaking about people for whom I don't know what its like, my motto is to be compassionate. I also acknowledge that no segmented group will speak with one voice - there will always be individual opinions within a group of people with similar lived experiences.

I decided shortly after budget day that I would discuss the delisting of GRS regularly. I decided this because I suspect that most transgendered people just want to live their lives happily and comfortably - they don't want to have to get into public debate over this very personal matter. Therefore, on this issue, I know that they are going to need as much help and support as they can possibly get. Ultimately, that is what makes the decision to delist GRS so repugnant - we are forcing a small disadvantaged marginalised group of people to stand up for something that in many ways only matters to them, but matters so much to them.

My argument today, though, has less to do with morality and more to do with finance.

Generally speaking, there are two types of budgeting: status quo and zero based. In status quo budgeting you begin with the budget from last year and add and delete items to create the new budget. In zero based budgeting, you start with nothing and simply add the items that you want to have to create the new budget. To the best of my knowledge, the Alberta government uses a status quo based approach.

The benefit of status quo budgeting is that it is faster and easier. One of the problems, however, is that you end up with a lot of "beige" programs staying on the books - programs that have no inherent problems, but have no great benefit either. When it comes time to trim spending what typically happens is someone goes through the items and tries to identify the ones that need to go. The items that cost the most tend to be examined more thoroughly and the ones that cost the least tend to stay put.

Thus, I come to my biggest concern with the decision to delist GRS. People involved in the budgeting process were given the task of cutting spending (I suspect that Liepert also suggested to do so by delisting procedures). While big fish like chiropractic care were targetted, someone chose specifically to chase after the tiny fish of GRS. The financial savings amount to around 1/200th of a percent of the health care budget, or the equivalent of 20 cents per Albertan. The reason why GRS was chosen was not financial, it was political. The people who approved this strategy knew they could get away with it - because typical Albertans and the Conservative base would applaud the move and the people who are affected by it are a small group of people that we don't understand. The owner of the gym I go to, essentially called them freaks.

This type of politics is appalling. We need to make decisions based on what is the right thing to do and what is in the best interests of the people of Alberta. Our politicians need to ask the question, why was this decision made and not accept finance as the answer - because it simply isn't so.

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