Alberta
Alberta’s bureaucratic shuffle bears little resemblance to necessary health-care reforms
From the Fraser Institute
Sometime soon, the Smith government will begin a major shift in the administrative structure of the province’s health-care system, switching from a single overarching health authority (Alberta Health Services) to multiple authorities each tasked with overseeing one area of the health-care system. Unsurprisingly, the usual defenders of the status quo were quick to decry the reform as unnecessary or problematic. To other critics, this seems a lot like a distraction tactic from the old playbook where the deck chairs on the Titanic are shuffled to make it appear as if the government is finally doing something about the province’s failing health-care system while nothing will really change.
Then again, it’s also possible that the provincial government is building the structure for some very positive reforms that will meaningfully benefit Alberta’s patients in the future. Alberta’s health-care system is not known for being efficient, effective or timely—and reforms are badly needed.
Among the provinces, Alberta’s provincial health spending ranked second-highest (after adjusting for age and sex) in 2021, the latest year of available data, while Albertans endure health-care wait times that are longer than the national average. Nationally, Canada is a relatively high spender among universal health-care countries, yet ranks near the bottom for the availability of medical professionals, medical technologies and hospital resources. And Canadian patients suffer some of the longest delays for access to care in the developed world.
Put simply, Albertans spend more and get less than their counterparts in other developed countries when it comes to universal health care. The solution to this problem is to learn from countries such as Switzerland, Australia and Germany, which all deliver more timely universal care with comparable health spending to our own.
So what do these countries do differently? They all have private competitive providers delivering universally accessible services within the public system, and payment for such care is based on actual delivery of services, known as “activity-based” funding. Alberta’s new bureaucratic shuffle appears to bear little resemblance to these higher-performing approaches pursued elsewhere. And if the bureaucratic shuffle is the entire goal, then this reform will likely generate little to no improvement.
But again, perhaps the Smith government is setting the stage for meaningful reform. Before moving from a government-dominated health-care system (like we have in Alberta and every other province) to a higher-performing model with competitive patient-focused delivery, governments must first separate and clearly define the roles of the purchaser of health care and the providers of that care. The Alberta Health Services, which the Smith government will soon begin to dissect, directly provides, oversees and pays for health-care services (e.g. surgeries) in the province. This leads to a lack of transparency and the politicization of health-care decision-making.
A shift to multiple health authorities focused on the delivery of care, accountable to other authorities and the provincial government, has hints of the more transparent and contractual relationships between payers and providers that have reduced wait times and enhanced health system efficiency in a number of European countries. If that’s indeed the government’s goal, Albertans could soon benefit from an improved health-care system.
In other words, if this reform, to move from one large health authority to multiple authorities, is really about more clearly defining government’s role as the purchaser and oversight authority for universal health care, with authorities and providers being transparently accountable for delivering timely quality care to patients, then Albertans may well be on the road to shorter wait times and a higher-quality health-care system.
However, if this is the provincial government working from the same old playbook, with another administrative shuffle to distract Albertans from the real problems in the health-care system, then nothing will really change and patients will pay the price.
Author:
Alberta
Alberta activates contingency mail delivery plan
Alberta’s government has a plan to ensure critical government mail continues to be delivered during the service interruption at Canada Post.
In response to the service disruption at Canada Post, Alberta’s government is taking steps to ensure critical mail between Albertans and the government continues to flow.
Starting Tuesday, Nov. 19, mail can be accepted from Albertans at designated Alberta government offices across the province to ensure it reaches the proper destination. No stamps are required. The full list of designated buildings is available on Alberta.ca.
Albertans who receive mail from the provincial government will receive a notification by email or phone indicating where and when they can pick-up/drop-off their mail. Alberta’s government will never ask for personal information over the phone or for anyone to click on a link in an email. Non-critical mail will be held by the originating department until Canada Post mail service resumes.
Some departments are participating in a Canada Post program to deliver social-economic cheques once a month during the disruption. Many departments that issue cheques also offer direct deposit. For more information, or to inquire about signing up for direct deposit, Albertans should contact the government department that issues the payment.
Additional information will be posted online as it becomes available.
Quick facts
- Only critical mail can be delivered to the general public during a work interruption. Non-critical or promotional mail should not be sent during this time.
- Ministries must arrange for staff serving the public to accept and forward critical mail from Albertans to the appropriate government recipients.
- Critical mail is material that must reach its intended recipient to avoid health, safety, financial or other significant harm to Albertans, significant risk or loss to government, or legislative non-compliance and that cannot be delivered expediently by courier, fax, electronic or other means.
- Canada Post employees will deliver federal and provincial government socio-economic cheques one day per month during a work interruption.
- Additional information will be posted on Alberta.ca as it becomes available.
Related information
Government mail drop locations – Effective November 19
City / Town | Drop Point | Address |
---|---|---|
Airdrie | Agricultural Centre | 97 East Lake Ramp NE, Airdrie, AB T4A 0C3 |
Athabasca | Jewell Building | #2, 3603 – 53 St., Athabasca, AB T9S 1A9 |
Barrhead | AFSC | 4924 50 Ave, Barrhead, AB T7N 1A4 |
Blairmore | Provincial Building | 12501 – Crowsnest Pass Provincial Building, Blairmore, AB T0K 1E0 |
Bonnyville | Provincial Building | P.O. Box 5244, 4904 – 50 Ave., Bonnyville, AB T9N 2G4 |
Brooks | Provincial Building | 220 – 4 Ave. W, Brooks, AB T1R 1C6 |
Calgary | West Direct Express | Bay 30, 333 28 Street NE, Calgary, AB T2A 7P4 |
Camrose | AFSC | P.O. Box 5000, 4910 – 52 St., Camrose, AB T4V 2V4 |
Canmore | Provincial Building | 3rd Floor, 800 – Railway Ave., Canmore, AB T1W 1P1 |
Cardston | Provincial Building | 576 – Main St., Cardston, AB T0K 0K0 |
Caroline | Alberta Highway Services Yard | P.O. Box 160, Caroline, AB T0M 0M0 |
Castor | Alberta Health Services | 4911 – 50 Avenue Castor, AB T0C 0X0 |
Claresholm | Provincial Building | P.O. Box 1650, 109 – 46 Ave. W, Claresholm, AB T0L 0T0 |
Coaldale | RCMP Detachment | 705 – 19A Avenue, Coaldale, AB T1M 1A7 |
Cochrane | Provincial Building | 2nd Floor, 213 – 1 St. W, Cochrane, AB T4C 1A5 |
Cold Lake | AB Supports | #408 6501B – 51 Street, Cold Lake, AB T9M 1P2 |
Consort | Provincial Building | 4916 – 50 St., Consort, AB T0C 1B0 |
Drayton Valley | Provincial Building | 5136 – 51 Ave., Drayton Valley, AB T7A 1S4 |
Drumheller | Riverside Centre | 180 – Riverside Centre, Drumheller, AB T0J 0Y4 |
Edmonton | MSV Building | 12360 – 142 Street NW, Edmonton, AB T5L 2H1 |
Edson | Provincial Building | 111 – 54 St., Edson, AB T7E 1T2 |
Evansburg | Health Centre | 5525 – 50 St., Evansburg, AB T0E 0T0 |
Fairview | AARD | #213, 10209 – 109 St., Fairview, AB T0H 1L0 |
Falher | AFSC | 701 – Main St., Falher, AB T0H 1M0 |
Foremost | Provincial Building | 218 – Main St., Foremost, AB T0K 0X0 |
Fort MacLeod | Fort MacLeod Healthcare Centre | P.O. Box 520, 744 – 26 St., Fort MacLeod, AB T0L 0Z0 |
Fort McMurray | Provincial Building | 9915 – Franklin Ave., Fort McMurray, AB T9H 2K4 |
Fort Saskatchewan | Correctional Centre | Bag 10, 7802 – 101 St., Fort Saskatchewan, AB T8L 2P3 |
Fort Vermilion | Ranger Station | 5001 46 Ave Fort Vermilion, AB T0H 1N0 |
Fox Creek | Ranger Station | 201 Kaybob Drive, Fox Creek, AB T0H 1P0 |
Grande Prairie | Provincial Building | 10320 – 99 St., Grande Prairie, AB T8V 6J4 |
Grimshaw | AFSC | 5306 – 50 Street, Grimshaw, AB T0H 1W0 |
Hanna | Provinical Building | 401 – Centre St., Hanna, AB T0J 1P0 |
High Level | Provincial Building | 10106 – 100 Ave., High Level, AB T0H 1Z0 |
High Prairie | Provincial Building | 5226 – 53 Ave., High Prairie, AB T0G 1E0 |
High River | Spitzee Crossing Building | 124 – 4 Avenue SW, High River, AB T1V 1M3 |
Hinton | Hinton Training Centre | 1176 – Switzer Dr., Hinton, AB T7V 1V3 |
Innisfail | Eastgate Mall | Bay 11, 4804 – 42 Ave., Innisfail, AB T4G 1V2 |
Killam | Killam Mental Health Clinic | 4811 – 49 Ave., Killam, AB T0B 2L0 |
Lac La Biche | Health Centre | 9503 – Beaver Hill Rd., Lac La Biche, AB T0A 2C0 |
Lacombe | AFSC | 5718 – 56 Ave., Lacombe, AB T4L 1B1 |
Lamont | AFSC | 5014 – 50 Ave., Lamont, AB T0B 2R0 |
Leduc | Provincial Courthouse | 4612 – 50 St., Leduc, AB T9E 6L1 |
Lethbridge | Provincial Building | 200 – 5 Ave. S, Lethbridge, AB T1J 4L1 |
Lloydminster | Provincial Building | 5124 – 50 St., Lloydminster, AB T9V 0M3 |
Manning | Environment and Parks | #400, 2nd Street SW, Manning, AB T0H 2M0 |
McLennan | Kirkland Building | P.O. Box 326, 205 – 1 St. E, McLennan, AB T0H 2L0 |
Medicine Hat | Provincial Building | #1-106, 346 – 3 St. SE, Medicine Hat, AB T1A 0G7 |
Morniville | Provincial Building | 10008 – 107 St., Morinville, AB T8R 1L3 |
Olds | Provincial Building | 5030 – 50 St., Olds, AB T4H 1S1 |
Peace River | Provincial Building | Bag 900, 9621 – 96 Ave., Peace River, AB T8S 1T4 |
Pincher Creek | Provincial Building | 782 – Main St., Pincher Creek, AB T0K 1W0 |
Ponoka | Provincial Building | P.O. Box 4426, 5110 – 49 Ave., Ponoka, AB T4J 1S1 |
Provost | Provincial Building | 5419 – 44 Ave., Provost, AB T0B 3S0 |
Red Deer | Provincial Building | 4920 – 51 St., Red Deer, AB T4N 6K8 |
Rimbey | Provincial Building | 2nd Floor, 5025 – 55 St., Rimbey, AB T0C 2J0 |
Rocky Mountain House | Provincial Building | 2nd Floor, 4919 – 51 St., Rocky Mountain House, AB T4T 1B3 |
St. Albert | Provincial Building | 30 – Sir Winston Churchill Ave., St. Albert, AB T8N 3A3 |
St. Paul | Provincial Building | 5025 – 49 Ave., St. Paul, AB T0A 3A4 |
Sedgewick | Flagstaff Building | 4701 – 48 Ave., Sedgewick, AB T0B 4C0 |
Sherwood Park | Centre Plaza | 190 Chippewa Road, Sherwood Park, AB T8A 4H5 |
Slave Lake | Government Centre | 101- 3rd Street SW, Slave Lake, AB T0G 2A4 |
Smoky Lake | Provincial Building | 2nd Floor, 108 – Wheatland Ave., Smoky Lake, AB T0A 3C0 |
AB Tree Improvement | P.O. Box 750, 59162 – R.R. 155, Smoky Lake, AB T0A 3C0 | |
Spirit River | AFSC | 4202 – 50 Street, Spirit River, AB T0H 3G0 |
Spruce Grove | Provincial Building | #1, 250 – Diamond Ave., Spruce Grove, AB T7X 4C7 |
Stettler | Provincial Building | 4705 – 49 Ave., Stettler, AB T0C 2L0 |
Stony Plain | Provincial Building | 4709 – 44 Ave., Stony Plain, AB T7Z 1N4 |
Strathmore | AFSC | 325 – 3 Ave., Strathmore, AB T1P 1B4 |
Sundre | Ranger Station | P.O. Box 519, 127 – 1 St. NW, Sundre, AB T0M 1X0 |
Taber | Provincial Building | 5011 – 49 Ave., Taber, AB T1G 1V9 |
Three Hills | AFSC | 128 – 3 Avenue, Tofield, AB T0M 2A0 |
Tofield | Provincial Building | 5024 51 Ave , Tofield, AB T0B 4J0 |
Ukrainian Village | Ukrainian Village | c/o 8820 – 112 St., Edmonton, AB T6G 2P8 |
Valleyview | Provincial Building | 5102 – 50 Ave., Valleyview, AB T0H 3N0 |
Vegreville | Haverhill Building | 5121 – 49 Street E, Vegreville, AB T9C 1S7 |
Vermilion | Provincial Building | P.O. Box 30, 4701 – 52 St., Vermilion, AB T9X 1J9 |
Vulcan | AFSC | 104 Centre Street E, Vulcan, AB T0L 2B0 |
Wainwright | Provincial Building | #4, 810 – 14 Ave., Wainwright, AB T9W 1R2 |
Westlock | Provincial Building | 2nd Floor, 10003 – 100 St., Westlock, AB T7P 2E8 |
Wetaskiwin | Provincial Building | 5201 – 50 Ave., Wetaskiwin, AB T9A 0S7 |
Whitecourt | Provincial Building | 5020 – 52 Ave., Whitecourt, AB T7S 1N2 |
Youngstown | Special Areas | 404 – 2 Ave , Youngstown, AB T0J 3P0 |
Alberta
On gender, Alberta is following the science
Despite falling into disrepute in recent years, “follow the science” remains our best shot at getting at the truth of the physical sciences.
But science, if we are to place our trust in it, must be properly defined and understood; it is at its essence an ever-changing process, a relentless pursuit of truth that is never “settled,” and one that is unafraid to discard old hypotheses in the face of new evidence.
And it is in this light—in the unforgiving glare of honest science—that Alberta Premier Danielle Smith’s three new legislative initiatives around gender policy are properly understood, notwithstanding the opprobrium they’ve attracted from critics.
Bill 26, the Health Statutes Amendment Act, proposes to prohibit the prescription of puberty blockers and cross-gender hormones for the treatment of gender dysphoria to youth aged 15 and under. It would allow minors aged 16 and 17 to begin puberty blockers and hormone therapies for gender “reassignment” and “affirmation” purposes only with parental, physician, and psychologist approval. The bill also prohibits health professionals from performing sex reassignment surgeries on minors.
Bill 27, the Education Amendment Act, seeks to enshrine parents’ rights to be notified if their kids change their names/pronouns at school, and it gives parents the right to “opt in” to what sort of gender and sex education their kids are exposed to in school.
And Bill 29, the Fairness and Safety in Sports Act, is designed to protect females in sports by ensuring that women and girls can compete in biological female-only divisions, while supporting the formation of co-ed opportunities to support transgender athletes.
Each of these initiatives is entirely reasonable, given what we know of the science underpinning “gender care,” and of the undeniable advantages that a male physique confers upon biological males competing in sports.
The notion that the trifecta of puberty blockers, cross-gender hormones, and revisionist surgery is a pathway to good health was a hypothesis initially devised by Dutch researchers, who were looking to ease the discomfort of transgender adults struggling with incongruence between their physical appearance and their gender identities. As a hypothesis, it was perhaps reasonable.
But as the UK’s Cass Review exposed in withering detail last spring, its premises were wholly unsupported by evidence, and its implementation has caused grievous harm for youth. As Finnish psychiatrist Riittakerttu Kaltiala, one of the architects of that country’s gender program, put it last year, “Gender affirming care is dangerous. I know, because I helped pioneer it.”
It’s no accident, then, that numerous European jurisdictions have pulled back from the “gender affirming care” pathway for youth, such as Sweden, Finland, Belgium, the Netherlands, and the United Kingdom.
It makes perfect sense that Canadians should be cautious as well, and that parents should be apprised if their children are being exposed to these theories at school and informed if their kids are caught up in their premises.
Yet the Canadian medical establishment has remained curiously intransigent on this issue, continuing to insist that the drug-and-surgery-based gender-affirming care model is rooted in evidence.
Premier Smith was asked by a reporter last month whether decisions on these matters aren’t best left to discussions between doctors and their patients; to which she replied:
“I would say doctors aren’t always right.”
Which is rather an understatement, as anyone familiar with the opioid drug crisis can attest, or as anyone acquainted with the darker corners of medical history knows: the frontal lobotomy saga, the thalidomide catastrophe, and the “recovered memories of sexual abuse” scandal are just a few examples of where doctors didn’t “get it right.”
As physicians, we advocate strongly for self-regulation and for the principle that medical decisions are private matters between physicians and patients. But self-regulation isn’t infallible, and when it fails it can be very much in the interests of the public—and especially of patients—for others to intervene, whether they be journalists, lawyers, or political leaders.
The trans discussion shouldn’t be a partisan issue, although it certainly has become one in Canada. It’s worth noting that Britain’s freshly elected Labour Party chose to carry on with the cautious approach adopted by the preceding administration in light of the Cass Review.
Premier Smith’s new polices are eminently sensible and in line with the stance taken by our European colleagues. None of her initiatives are “anti-trans.” Instead, they are pro-child, pro-women, and pro-athlete, and it’s difficult to see how anyone can quibble with that.
Dr. J. Edward Les, MD, is a pediatrician in Calgary, senior fellow at the Aristotle Foundation for Public Policy, and co-author of Teenagers, Children, and Gender Transition Policy: A Comparison of Transgender Medical Policy for Minors in Canada, the United States, and Europe.
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