Alberta
Alberta taking back control of federal agreements
Alberta has introduced legislation requiring provincial entities to obtain approval before entering, amending, extending or renewing agreements with the federal government.
The introduction of the Provincial Priorities Act, 2024 will support Alberta’s government in pushing back against the federal government’s ongoing overreach into areas of provincial jurisdiction. Alberta’s government will ensure federal funding is aligned with provincial priorities, rather than with priorities contrary to the province’s interests. Under the legislation, agreements between the federal government and provincial entities, including municipalities, that have not received provincial approval would be invalid.
As an example, the federal government’s unrelenting and ideological push toward electric buses in Canadian cities including Calgary does not acknowledge mounting evidence of significant problems with their effectiveness during harsh Alberta winters. Alberta’s government believes the funds that Ottawa allocated for unreliable and impractical electric buses would have been better spent on Alberta priorities including strengthening the province’s economic corridors with improved roads and commuter rail, or advancing the province’s hydrogen strategy as an alternate clean-energy source for transportation.
If passed, the legislation would also support Alberta’s government in getting its fair share of funding when it comes to roads, infrastructure, housing and other priorities. Nowhere is this more apparent than in housing. In summer 2023, Alberta received only 2.5 per cent of the total $1.5 billion in federal housing funds, despite having 12 per cent of the country’s population and, by far, the fastest population growth.
The legislation would also work to prevent taxpayer dollars being wasted on duplicative programs like pharmacare and dental care when what the province really needs is envelope funding to expand existing provincial programs in these areas.
“It is not unreasonable for Alberta to demand fairness from Ottawa. They have shown time and again that they will put ideology before practicality, which hurts Alberta families and our economy. We are not going to apologize for continuing to stand up for Albertans so we get the best deal possible. Since Ottawa refuses to acknowledge the negative impacts of its overreach, even after losing battles at the Federal and Supreme Courts, we are putting in additional measures to protect our provincial jurisdiction to ensure our province receives our fair share of federal tax dollars and that those dollars are spent on the priorities of Albertans.”
Currently, the Government Organization Act requires intergovernmental agreements to be approved by the Minister of Intergovernmental Relations for Alberta government departments and some public agencies, such as Alberta Gaming, Liquor and Cannabis; Alberta Securities Commission; and Travel Alberta.
However, this requirement does not extend to all Alberta public agencies or broader public sector organizations including municipalities, public post-secondary institutions, school boards and health entities, which has created gaps that could result in federal agreements contradicting provincial priorities and investments. By introducing the Provincial Priorities Act, Alberta’s government is working to close those gaps.
Under the proposed legislation, provincial entities include Alberta public agencies and Crown-controlled organizations, as well as public post-secondary institutions, school boards, regional health authorities, Covenant Health, municipal authorities and housing management bodies.
“For years, the federal government has been imposing its agenda on Alberta taxpayers through direct funding agreements with cities and other provincial organizations. Not only does Alberta not receive its per capita share of federal taxpayer dollars, the money we do receive is often directed towards initiatives that don’t align with Albertan’s priorities. Albertans from all corners of the province expect our federal share of taxes for roads, infrastructure, housing and other priorities – not federal government political pet projects and programs in select communities.”
Currently, Quebec is the only other province or territory with similar legislation that requires provincial approval of intergovernmental agreements between a broad scope of public sector organizations and the federal government. During a federal-provincial-territorial meeting in November 2023, Premiers from across the country demanded that the federal government work with them, not around them when it came to agreements with municipalities. Additionally, the Premiers committed to exploring the need for provincial authorization on federal agreements.
Related information
From the Fraser Institute
On Monday, the Smith government announced that beginning next year it will change the way it funds surgeries in Alberta. This is a big step towards unlocking the ability of Alberta’s health-care system to provide more, better and faster services for the same or possibly fewer dollars.
To understand the significance of this change, you must understand the consequences of the current (and outdated) approach.
Currently, the Alberta government pays a lump sum of money to hospitals each year. Consequently, hospitals perceive patients as a drain on their budgets. From the hospital’s perspective, there’s little financial incentive to serve more patients, operate more efficiently and provide superior quality services.
Consider what would happen if your local grocery store received a giant bag of money each year to feed people. The number of items would quickly decline to whatever was most convenient for the store to provide. (Have a favourite cereal? Too bad.) Store hours would become less convenient for customers, alongside a general decline in overall service. This type of grocery store, like an Alberta hospital, is actually financially better off (that is, it saves money) if you go elsewhere.
The Smith government plans to flip this entire system on its head, to the benefit of patients and taxpayers. Instead of handing out bags of money each year to providers, the new system—known as “activity-based funding”—will pay health-care providers for each patient they treat, based on the patient’s particular condition and important factors that may add complexity or cost to their care.
This turns patients from a drain on budgets into a source of additional revenue. The result, as has been demonstrated in other universal health-care systems worldwide, is more services delivered using existing health-care infrastructure, lower wait times, improved quality of care, improved access to medical technologies, and less waste.
In other words, Albertans will receive far better value from their health-care system, which is currently among the most expensive in the world. And relief can’t come soon enough—for example, last year in Alberta the median wait time for orthopedic surgeries including hip and knee replacements was 66.8 weeks.
The naysayers argue this approach will undermine the province’s universal system and hurt patients. But by allowing a spectrum of providers to compete for the delivery of quality care, Alberta will follow the lead of other more successful universal health-care systems in countries such as Australia, Germany, the Netherlands and Switzerland and create greater accountability for hospitals and other health-care providers. Taxpayers will get a much better picture of what they’re paying for and how much they pay.
Again, Alberta is not exploring an untested policy. Almost every other developed country with universal health care uses some form of “activity-based funding” for hospital and surgical care. And remember, we already spend more on health care than our counterparts in nearly all of these countries yet endure longer wait times and poorer access to services generally, in part because of how we pay for surgical care.
While the devil is always in the details, and while it’s still possible for the Alberta government to get this wrong, Monday’s announcement is a big step in the right direction. A funding model that puts patients first will get Albertans more of the high-quality health care they already pay for in a timelier fashion. And provide to other provinces an example of bold health-care reform.
Nadeem Esmail
Senior Fellow, Fraser Institute
From the Montreal Economic Institute
Alberta’s move to fund acute care services through activity-based funding follows best practices internationally, points out an MEI researcher following an announcement made by Premier Danielle Smith earlier today.
“For too long, the way hospitals were funded in Alberta incentivized treating fewer patients, contributing to our long wait times,” explains Krystle Wittevrongel, director of research at the MEI. “International experience has shown that, with the proper funding models in place, health systems become more efficient to the benefit of patients.”
Currently, Alberta’s hospitals are financed under a system called “global budgeting.” This involves allocating a pre-set amount of funding to pay for a specific number of services based on previous years’ budgets.
Under the government’s newly proposed funding system, hospitals receive a fixed payment for each treatment delivered.
An Economic Note published by the MEI last year showed that Quebec’s gradual adoption of activity-based funding led to higher productivity and lower costs in the province’s health system.
Notably, the province observed that the per-procedure cost of MRIs fell by four per cent as the number of procedures performed increased by 22 per cent.
In the radiology and oncology sector, it observed productivity increases of 26 per cent while procedure costs decreased by seven per cent.
“Being able to perform more surgeries, at lower costs, and within shorter timelines is exactly what Alberta’s patients need, and Premier Smith understands that,” continued Mrs. Wittevrongel. “Today’s announcement is a good first step, and we look forward to seeing a successful roll-out once appropriate funding levels per procedure are set.”
The governments expects to roll-out this new funding model for select procedures starting in 2026.
* * *
The MEI is an independent public policy think tank with offices in Montreal, Ottawa, and Calgary. Through its publications, media appearances, and advisory services to policymakers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship.
Liberals Replace Candidate Embroiled in Election Interference Scandal with Board Member of School Flagged in Canada’s Election Interference Inquiry
RCMP memo warns of Chinese interference on Canadian university campuses to affect election
U.S. Experts Warn Canada Is Losing the Fight Against PRC Criminal Networks—Washington Has Run Out of Patience
WATCH: Massive Crowd for Historic Edmonton Poilievre Rally
-
2025 Federal Election24 hours ago
RCMP memo warns of Chinese interference on Canadian university campuses to affect election
-
2025 Federal Election2 days agoConservative Party urges investigation into Carney plan to spend $1 billion on heat pumps
-
Alberta1 day ago
Alberta takes big step towards shorter wait times and higher quality health care
-
2025 Federal Election2 days agoFifty Shades of Mark Carney
-
2025 Federal Election2 days agoCorporate Media Isn’t Reporting on Foreign Interference—It’s Covering for It
-
2025 Federal Election14 hours agoResearchers Link China’s Intelligence and Elite Influence Arms to B.C. Government, Liberal Party, and Trudeau-Appointed Senator
-
Business1 day agoTrump raises China tariffs to 125%, announces 90-day pause for countries who’ve reached out to negotiate
-
2025 Federal Election23 hours agoThe status quo in Canadian politics isn’t sustainable for national unity