Alberta
Albertans endure some of the longest health-care waits in Canada
From the Fraser Institute
By Mackenzie Moir and Tegan Hill
Alberta’s long wait times come despite high levels of health-care spending. The province ranked second-highest on health-care spending per person (adjusted for age and sex) among provinces in 2021
Last week, the president of the Alberta Medical Association sounded the alarm about Alberta hospital wait times, saying they’re as “as bad as we’ve seen it in 25 years.”
But in fact, it’s worse than that.
According to a new study, in Alberta the median wait in 2023 between a family doctor’s referral for a specialist appointment and receipt of treatment was 33.5 weeks—that’s the longest total median wait outside the Maritime provinces and almost six weeks longer than the national median wait (27.7 weeks). And Albertans now wait 23 weeks longer than they did in 1993 when the wait for care was only 10.5 weeks.
Alberta’s long wait times come despite high levels of health-care spending. The province ranked second-highest on health-care spending per person (adjusted for age and sex) among provinces in 2021, the latest year of available data. In 2023/24, health-care spending will consume a projected 41.2 per cent of Alberta’s program spending.
Moreover, Canada itself is a relatively high spender among universal health-care countries, yet ranks poorly on the availability of hospital beds, doctors and key diagnostic technologies such as MRIs. In other words, Alberta is a comparatively high spender and poor performer in an already high spending and poorly performing country.
Of course, there are serious consequences from lengthy delays for medically necessary care including ongoing pain, worsening of health outcomes and psychological distress. Unfortunately for Albertans, the median wait for treatment after seeing a specialist was almost two months longer than what doctors in the province consider reasonable.
The unreasonableness of these waits also varied significantly depending on the specialty. For example, after seeing a specialist, Albertans who needed an orthopedic procedure, which includes knee replacements and spinal surgeries, could expect to wait 40.1 weeks for care—more than 28 weeks longer than what physicians deemed reasonable that year. For those needing care for ears, nose and throat, the wait for treatment was 13 weeks beyond what’s considered appropriate.
Regardless of the specialty, waiting for treatment has become the defining issue for health care in Alberta. And these waits have been increasing since at least the early ’90s. The president of the Alberta Medical Association is right to sound the alarm, but the province’s health-care system has been struggling for years. Albertans obviously deserve better than this, but without a fundamental departure from the status quo they’re unlikely to see any long-term relief from the unreasonable waits they endure for routine care.
Authors:
From the Fraser Institute
By Tegan Hill
According to the recent mid-year update tabled Thursday, the Smith government projects a $4.6 billion surplus in 2024/25, up from the $2.9 billion surplus projected just a few months ago. Despite the good news, Premier Smith must reduce spending to avoid budget deficits.
The fiscal update projects resource revenue of $20.3 billion in 2024/25. Today’s relatively high—but very volatile—resource revenue (including oil and gas royalties) is helping finance today’s spending and maintain a balanced budget. But it will not last forever.
For perspective, in just the last decade the Alberta government’s annual resource revenue has been as low as $2.8 billion (2015/16) and as high as $25.2 billion (2022/23).
And while the resource revenue rollercoaster is currently in Alberta’s favor, Finance Minister Nate Horner acknowledges that “risks are on the rise” as oil prices have dropped considerably and forecasters are projecting downward pressure on prices—all of which impacts resource revenue.
In fact, the government’s own estimates show a $1 change in oil prices results in an estimated $630 million revenue swing. So while the Smith government plans to maintain a surplus in 2024/25, a small change in oil prices could quickly plunge Alberta back into deficit. Premier Smith has warned that her government may fall into a budget deficit this fiscal year.
This should come as no surprise. Alberta’s been on the resource revenue rollercoaster for decades. Successive governments have increased spending during the good times of high resource revenue, but failed to rein in spending when resource revenues fell.
Previous research has shown that, in Alberta, a $1 increase in resource revenue is associated with an estimated 56-cent increase in program spending the following fiscal year (on a per-person, inflation-adjusted basis). However, a decline in resource revenue is not similarly associated with a reduction in program spending. This pattern has led to historically high levels of government spending—and budget deficits—even in more recent years.
Consider this: If this fiscal year the Smith government received an average level of resource revenue (based on levels over the last 10 years), it would receive approximately $13,000 per Albertan. Yet the government plans to spend nearly $15,000 per Albertan this fiscal year (after adjusting for inflation). That’s a huge gap of roughly $2,000—and it means the government is continuing to take big risks with the provincial budget.
Of course, if the government falls back into deficit there are implications for everyday Albertans.
When the government runs a deficit, it accumulates debt, which Albertans must pay to service. In 2024/25, the government’s debt interest payments will cost each Albertan nearly $650. That’s largely because, despite running surpluses over the last few years, Albertans are still paying for debt accumulated during the most recent string of deficits from 2008/09 to 2020/21 (excluding 2014/15), which only ended when the government enjoyed an unexpected windfall in resource revenue in 2021/22.
According to Thursday’s mid-year fiscal update, Alberta’s finances continue to be at risk. To avoid deficits, the Smith government should meaningfully reduce spending so that it’s aligned with more reliable, stable levels of revenue.
Author:
Better, faster, more affordable auto insurance
Alberta’s government is introducing a new auto insurance system that will provide better and faster services to Albertans while reducing auto insurance premiums.
After hearing from more than 16,000 Albertans through an online survey about their priorities for auto insurance policies, Alberta’s government is introducing a new privately delivered, care-focused auto insurance system.
Right now, insurance in the province is not affordable or care focused. Despite high premiums, Albertans injured in collisions do not get the timely medical care and income support they need in a system that is complex to navigate. When fully implemented, Alberta’s new auto insurance system will deliver better and faster care for those involved in collisions, and Albertans will see cost savings up to $400 per year.
“Albertans have been clear they need an auto insurance system that provides better, faster care and is more affordable. When it’s implemented, our new privately delivered, care-centred insurance system will put the focus on Albertans’ recovery, providing more effective support and will deliver lower rates.”
“High auto insurance rates put strain on Albertans. By shifting to a system that offers improved benefits and support, we are providing better and faster care to Albertans, with lower costs.”
Albertans who suffer injuries due to a collision currently wait months for a simple claim to be resolved and can wait years for claims related to more serious and life-changing injuries to addressed. Additionally, the medical and financial benefits they receive often expire before they’re fully recovered.
Under the new system, Albertans who suffer catastrophic injuries will receive treatment and care for the rest of their lives. Those who sustain serious injuries will receive treatment until they are fully recovered. These changes mirror and build upon the Saskatchewan insurance model, where at-fault drivers can be sued for pain and suffering damages if they are convicted of a criminal offence, such as impaired driving or dangerous driving, or conviction of certain offenses under the Traffic Safety Act.
Work on this new auto insurance system will require legislation in the spring of 2025. In order to reconfigure auto insurance policies for 3.4 million Albertans, auto insurance companies need time to create and implement the new system. Alberta’s government expects the new system to be fully implemented by January 2027.
In the interim, starting in January 2025, the good driver rate cap will be adjusted to a 7.5% increase due to high legal costs, increasing vehicle damage repair costs and natural disaster costs. This protects good drivers from significant rate increases while ensuring that auto insurance providers remain financially viable in Alberta.
Albertans have been clear that they still want premiums to be based on risk. Bad drivers will continue to pay higher premiums than good drivers.
By providing significantly enhanced medical, rehabilitation and income support benefits, this system supports Albertans injured in collisions while reducing the impact of litigation costs on the amount that Albertans pay for their insurance.
“Keeping more money in Albertans’ pockets is one of the best ways to address the rising cost of living. This shift to a care-first automobile insurance system will do just that by helping lower premiums for people across the province.”
Quick facts
- Alberta’s government commissioned two auto insurance reports, which showed that legal fees and litigation costs tied to the province’s current system significantly increase premiums.
- A 2023 report by MNP shows
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