Alberta
Bureaucratic shuffle not enough to fix health care in Alberta
From the Fraser Institute
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.
Author:
Alberta
Keynote address of Premier Danielle Smith at 2025 UCP AGM
Alberta
Net Zero goal is a fundamental flaw in the Ottawa-Alberta MOU
From the Fraser Institute
By Jason Clemens and Elmira Aliakbari
The challenge of GHG emissions in 2050 is not in the industrial world but rather in the developing world, where there is still significant basic energy consumption using timber and biomass.
The new Memorandum of Understanding (MOU) between the federal and Alberta governments lays the groundwork for substantial energy projects and infrastructure development over the next two-and-a-half decades. It is by all accounts a step forward, though, there’s debate about how large and meaningful that step actually is. There is, however, a fundamental flaw in the foundation of the agreement: it’s commitment to net zero in Canada by 2050.
The first point of agreement in the MOU on the first page of text states: “Canada and Alberta remain committed to achieving net zero greenhouse gas emissions by 2050.” In practice, it’s incredibly difficult to offset emissions with tree planting or other projects that reduce “net” emissions, so the effect of committing to “net zero” by 2050 means that both governments agree that Canada should produce very close to zero actual greenhouse gas (GHG) emissions. Consider the massive changes in energy production, home heating, transportation and agriculture that would be needed to achieve this goal.
So, what’s wrong with Canada’s net zero 2050 and the larger United Nations’ global goal for the same?
Let’s first understand the global context of GHG reductions based on a recent study by internationally-recognized scholar Vaclav Smil. Two key insights from the study. First, despite trillions being spent plus international agreements and regulatory measures starting back in 1997 with the original Kyoto agreement, global fossil fuel consumption between then and 2023 increased by 55 per cent.
Second, fossil fuels as a share of total global energy declined from 86 per cent in 1997 to 82 per cent in 2022, again, despite trillions of dollars in spending plus regulatory requirements to force a transition away from fossil fuels to zero emission energies. The idea that globally we can achieve zero emissions over the next two-and-a-half decades is pure fantasy. Even if there is an historic technological breakthrough, it will take decades to actually transition to a new energy source(s).
Let’s now understand the Canada-specific context. A recent study examined all the measures introduced over the last decade as part of the national plan to reduce emissions to achieve net zero by 2050. The study concluded that significant economic costs would be imposed on Canadians by these measures: inflation-adjusted GDP would be 7 per cent lower, income per worker would be more than $8,000 lower and approximately 250,000 jobs would be lost. Moreover, these costs would not get Canada to net zero. The study concluded that only 70 per cent of the net zero emissions goal would be achieved despite these significant costs, which means even greater costs would be imposed on Canadians to fully achieve net zero.
It’s important to return to a global picture to fully understand why net zero makes no sense for Canada within a worldwide context. Using projections from the International Energy Agency (IEA) in its latest World Energy Outlook, the current expectation is that in 2050, advanced countries including Canada and the other G7 countries will represent less than 25 per cent of global emissions. The developing world, which includes China, India, the entirety of Africa and much of South America, is estimated to represent at least 70 per cent of global emissions in 2050.
Simply put, the challenge of GHG emissions in 2050 is not in the industrial world but rather in the developing world, where there is still significant basic energy consumption using timber and biomass. A globally-coordinated effort, which is really what the U.N. should be doing rather than fantasizing about net zero, would see industrial countries like Canada that are capable of increasing their energy production exporting more to these developing countries so that high-emitting energy sources are replaced by lower-emitting energy sources. This would actually reduce global GHGs while simultaneously stimulating economic growth.
Consider a recent study that calculated the implications of doubling natural gas production in Canada and exporting it to China to replace coal-fired power. The conclusion was that there would be a massive reduction in global GHGs equivalent to almost 90 per cent of Canada’s total annual emissions. In these types of substitution arrangements, the GHGs would increase in energy-producing countries like Canada but global GHGs would be reduced, which is the ultimate goal of not only the U.N. but also the Carney and Smith governments as per the MOU.
Finally, the agreement ignores a basic law of economics. The first lesson in the very first class of any economics program is that resources are limited. At any given point in time, we only have so much labour, raw materials, time, etc. In other words, when we choose to do one project, the real cost is foregoing the other projects that could have been undertaken. Economics is mostly about trying to understand how to maximize the use of limited resources.
The MOU requires massive, literally hundreds of billions of dollars to be used to create nuclear power, other zero-emitting power sources and transmission systems all in the name of being able to produce low or even zero-emitting oil and gas while also moving to towards net zero.
These resources cannot be used for other purposes and it’s impossible to imagine what alternative companies or industries would have been invested in. What we do know is that workers, entrepreneurs, businessowners and investors are not making these decisions. Rather, politicians and bureaucrats in Ottawa and Edmonton are making these decisions but they won’t pay any price if they’re wrong. Canadians pay the price. Just consider the financial fiasco unfolding now with Ottawa, Ontario and Quebec’s subsidies (i.e. corporate welfare) for electric vehicle batteries.
Understanding the fundamentally flawed commitment to Canadian net zero rather than understanding a larger global context of GHG emissions lays at the heart of the recent MOU and unfortunately for Canadians will continue to guide flawed and expensive policies. Until we get the net zero policies right, we’re going to continue to spend enormous resources on projects with limited returns, costing all Canadians.
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