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Alberta

Bureaucratic shuffle not enough to fix health care in Alberta

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From the Fraser Institute

By Nadeem Esmail

Alberta Premier Danielle Smith spent a good portion of her yearend interviews discussing upcoming changes to the province’s health-care system including the shift from the single Alberta Health Services to multiple authorities each tasked with overseeing one area of the health-care system. But will the government pair this bureaucratic shuffle with reforms that will actually improve matters for Albertans?

Indeed, Albertans shouldn’t get too excited about reforms to the health-care system’s administrative structure. Back in 2008, Alberta Health Services replaced nine regional health boards, which themselves were amalgamated from 17 authorities created in 1994. Yet wait lists grew continuously over the entire period up to new record highs in 2023.

In 1993, a typical Albertan could expect to wait 10.5 weeks between GP referral and treatment by a medical specialist. By 2008, that wait time had increased to 18.5 weeks and now stands at a remarkable 33.5 weeks (longer than the national median wait of 27.7 weeks).

A lack of money is absolutely not to blame. On the contrary, Alberta’s provincial health-care spending ranked second-highest per person (after adjusting for age and sex) in 2021, while Canada nationally is a relatively high spender among universal health-care countries. At the same time, Canada 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.

In other words, there’s much more wrong with health care in Alberta than the number of authorities overseeing the governmental system.

So what’s the solution?

Simply put, Alberta should learn from other countries that deliver more timely universal care with comparable spending such as Switzerland, Australia and Germany. For example, in 2020 (the latest year of available data) only 62 per cent of patients in Canada received elective care within four months compared to 72 per cent in Australia, 94 per cent in Switzerland and 99 per cent in Germany.

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.

Based on details released so far, the Smith government’s bureaucratic shuffle appears to bear little resemblance to these higher-performing approaches pursued abroad. In fact, it looks a lot like the provincial government working from the same old playbook, with another costly exercise to distract Albertans from the real problems in their health-care system. If that’s all this reform amounts to, then we can expect no real improvement for Albertans in need of care or the taxpayers who fund it.

On the bright side, there’s some hope that the Smith government is setting the stage for more meaningful reform. To move toward a higher-performing model with competitive patient-focused delivery, the government must first separate and clearly define the roles of the purchaser of health care and the providers of that care. If moving from one large health authority to multiple authorities is 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 be on the road to shorter wait times and higher-quality health care.

But we’ll have to wait and see.

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Alberta

Big win for Alberta and Canada: Statement from Premier Smith

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Premier Danielle Smith issued the following statement on the April 2, 2025 U.S. tariff announcement:

“Today was an important win for Canada and Alberta, as it appears the United States has decided to uphold the majority of the free trade agreement (CUSMA) between our two nations. It also appears this will continue to be the case until after the Canadian federal election has concluded and the newly elected Canadian government is able to renegotiate CUSMA with the U.S. administration.

“This is precisely what I have been advocating for from the U.S. administration for months.

“It means that the majority of goods sold into the United States from Canada will have no tariffs applied to them, including zero per cent tariffs on energy, minerals, agricultural products, uranium, seafood, potash and host of other Canadian goods.

“There is still work to be done, of course. Unfortunately, tariffs previously announced by the United States on Canadian automobiles, steel and aluminum have not been removed. The efforts of premiers and the federal government should therefore shift towards removing or significantly reducing these remaining tariffs as we go forward and ensuring affected workers across Canada are generously supported until the situation is resolved.

“I again call on all involved in our national advocacy efforts to focus on diplomacy and persuasion while avoiding unnecessary escalation. Clearly, this strategy has been the most effective to this point.

“As it appears the worst of this tariff dispute is behind us (though there is still work to be done), it is my sincere hope that we, as Canadians, can abandon the disastrous policies that have made Canada vulnerable to and overly dependent on the United States, fast-track national resource corridors, get out of the way of provincial resource development and turn our country into an independent economic juggernaut and energy superpower.”

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Alberta

Energy sector will fuel Alberta economy and Canada’s exports for many years to come

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From the Fraser Institute

By Jock Finlayson

By any measure, Alberta is an energy powerhouse—within Canada, but also on a global scale. In 2023, it produced 85 per cent of Canada’s oil and three-fifths of the country’s natural gas. Most of Canada’s oil reserves are in Alberta, along with a majority of natural gas reserves. Alberta is the beating heart of the Canadian energy economy. And energy, in turn, accounts for one-quarter of Canada’s international exports.

Consider some key facts about the province’s energy landscape, as noted in the Alberta Energy Regulator’s (AER) 2023 annual report. Oil and natural gas production continued to rise (on a volume basis) in 2023, on the heels of steady increases over the preceding half decade. However, the dollar value of Alberta’s oil and gas production fell in 2023, as the surging prices recorded in 2022 following Russia’s invasion of Ukraine retreated. Capital spending in the province’s energy sector reached $30 billion in 2023, making it the leading driver of private-sector investment. And completion of the Trans Mountain pipeline expansion project has opened new offshore export avenues for Canada’s oil industry and should boost Alberta’s energy production and exports going forward.

In a world striving to address climate change, Alberta’s hydrocarbon-heavy energy sector faces challenges. At some point, the world may start to consume less oil and, later, less natural gas (in absolute terms). But such “peak” consumption hasn’t arrived yet, nor does it appear imminent. While the demand for certain refined petroleum products is trending down in some advanced economies, particularly in Europe, we should take a broader global perspective when assessing energy demand and supply trends.

Looking at the worldwide picture, Goldman Sachs’ 2024 global energy forecast predicts that “oil usage will increase through 2034” thanks to strong demand in emerging markets and growing production of petrochemicals that depend on oil as the principal feedstock. Global demand for natural gas (including LNG) will also continue to increase, particularly since natural gas is the least carbon-intensive fossil fuel and more of it is being traded in the form of liquefied natural gas (LNG).

Against this backdrop, there are reasons to be optimistic about the prospects for Alberta’s energy sector, particularly if the federal government dials back some of the economically destructive energy and climate policies adopted by the last government. According to the AER’s “base case” forecast, overall energy output will expand over the next 10 years. Oilsands output is projected to grow modestly; natural gas production will also rise, in part due to greater demand for Alberta’s upstream gas from LNG operators in British Columbia.

The AER’s forecast also points to a positive trajectory for capital spending across the province’s energy sector. The agency sees annual investment rising from almost $30 billion to $40 billion by 2033. Most of this takes place in the oil and gas industry, but “emerging” energy resources and projects aimed at climate mitigation are expected to represent a bigger slice of energy-related capital spending going forward.

Like many other oil and gas producing jurisdictions, Alberta must navigate the bumpy journey to a lower-carbon future. But the world is set to remain dependent on fossil fuels for decades to come. This suggests the energy sector will continue to underpin not only the Alberta economy but also Canada’s export portfolio for the foreseeable future.

Jock Finlayson

Senior Fellow, Fraser Institute
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