From the Fraser Institute

By Nadeem Esmail and Mackenzie Moir

Alberta’s health-care system may be set for another positive move away from the failed Canadian model. According to leaked draft legislation by the Smith government, Albertans may soon be able to access physician care in a parallel private sector, with physicians permitted to work in both the public and private systems.

The defenders of the status quo were of course quick to frame the approach as unique in Canada, arguing it would harm our universal system. While this potential change may put Alberta’s policies at odds with those of other provinces, it would more closely align with universal health-care systems everywhere else in the developed world. And most importantly, it will make for better access to health care for all Albertans.

First, it’s important recognize just how unusual Canada’s approach to privately-funded health care is compared to other high-income countries with universal health care.

In every one of the 30 other developed countries with universal health care, patients are free to seek services on their own terms with their own resources when the universal system is unwilling or unable to satisfy their needs. One reason may be to avoid long waiting lists, while others simply want to receive more personalized health-care services, meet a personal health need or access newer medical technologies and procedures.

In the majority of these countries, including those with high-performing systems such as Switzerland, the Netherlands, Germany and Australia, physicians are also permitted to work in both the public and private sectors.

Canada’s deviation, and Alberta’s, from this international norm has not served patients well. Despite having the highest health spending among the provinces in one of the most expensive universal health-care systems in the developed world, Albertans endure some of the worst access to health care and wait in some of the longest queues for treatment.

A central explanation for why Canadians spend more and get much much less is the lack of a private competitive alternative to the universal public system.

Again, a private option gives patients an option to select care the government is unwilling to provide, either in terms of timeliness or in ways that may be personally important to them. Faster access could allow some people to expedite a return to work and support their family, or to re-engage in important activities without needing to leave the province or the country as they currently must.

By moving people willing to pay for services out of the public queues, the government can help reduce the wait times for patients in the public queues. It’s not surprising that Canada has the longest waiting lists in the developed world given we’re the only country that prohibits privately-funded health care.

Arguments that the private sector will starve the public system of resources (including doctors and nurses) misunderstand what’s actually happening in Alberta today.

Currently, surgeons spend a good deal of time waiting for access to operating rooms or hospital beds for patients. Meanwhile, nurses are leaving the profession in large numbers. Canada also has unemployed medical specialists who could be employed if new opportunities arose. Allowing private access to care or previously unavailable medical resources would increase the total volume of services available to Albertans.

Even beyond this, the opportunity to earn more by working extra hours in a private clinic could encourage physicians to use some of their now non-working hours to treat patients privately. In this regard, the focus on allowing physicians to work in both public and private sectors is a well-informed policy choice that makes better use of Alberta’s existing medical workforce.

Finally, a private parallel option creates incentives for better service in the universal system through competition. Shackling patients to a government monopoly with no alternative choices results in a more expensive system and lower standard of care than would be available otherwise. When no one is permitted to deliver timelier patient-focused care, there’s no pressure created to do so anywhere else in the system. The outcome is obvious just from looking at how poorly the public system in Alberta performs despite its world-class price tag.

While this new leaked draft legislation may have the defenders of the status quo frantically racing to defend the current Canadian model, it promises a better health-care system for Albertans. This change will more closely align Alberta’s policies with those of every other universal health-care country in the developed world. More importantly, it will improve access to health care for all Albertans, and provide Albertans currently stuck with poor service an option to choose differently for themselves without a plane ticket.

Nadeem Esmail

Director, Health Policy, Fraser Institute

Mackenzie Moir

Senior Policy Analyst, Fraser Institute

From the Fraser Institute

By Tegan Hill and Elmira Aliakbari

On the campaign trail and after he became prime minister, Mark Carney has repeatedly promised to make Canada an “energy superpower.” But, as evidenced by its first budget, the Carney government has simply reaffirmed the failed plans of the past decade and embraced the damaging energy policies of the Trudeau government.

First, consider the Trudeau government’s policy legacy. There’s Bill C-69 (the “no pipelines act”), the new electricity regulations (which aim to phase out natural gas as a power source starting this year), Bill C-48 (which bans large oil tankers off British Columbia’s northern coast and limit Canadian exports to international markets), the cap on emissions only from the oil and gas sector (even though greenhouse gas emissions have the same effect on the environment regardless of the source), stricter regulations for methane emissions (again, impacting the oil and gas sector), and numerous “net-zero” policies.

According to a recent analysis, fully implementing these measures under Trudeau government’s emissions reduction plan would result in 164,000 job losses and shrink Canada’s economic output by 6.2 per cent by the end of the decade compared to a scenario where we don’t have these policies in effect. For Canadian workers, this will mean losing $6,700 (annually, on average) by 2030.

Unfortunately, the Carney government’s budget offers no retreat from these damaging policies. While Carney scrapped the consumer carbon tax, he plans to “strengthen” the carbon tax on industrial emitters and the cost will be passed along to everyday Canadians—so the carbon tax will still cost you, it just won’t be visible.

There’s also been a lot of buzz over the possible removal of the oil and gas emissions cap. But to be clear, the budget reads: “Effective carbon markets, enhanced oil and gas methane regulations, and the deployment at scale of technologies such as carbon capture and storage would create the circumstances whereby the oil and gas emissions cap would no longer be required as it would have marginal value in reducing emissions.” Put simply, the cap remains in place, and based on the budget, the government has no real plans to remove it.

Again, the cap singles out one source (the oil and gas sector) of carbon emissions, even when reducing emissions in other sectors may come at a lower cost. For example, suppose it costs $100 to reduce a tonne of emissions from the oil and gas sector, but in another sector, it costs only $25 a tonne. Why force emissions reductions in a single sector that may come at a higher cost? An emission is an emission regardless of were it comes from. Moreover, like all these policies, the cap will likely shrink the Canadian economy. According to a 2024 Deloitte study, from 2030 to 2040, the cap will shrink the Canadian economy (measured by inflation-adjusted GDP) by $280 billion, and result in lower wages, job losses and a decline in tax revenue.

At the same time, the Carney government plans to continue to throw money at a range of “green” spending and tax initiatives. But since 2014, the combined spending and forgone revenue (due to tax credits, etc.) by Ottawa and provincial governments in Ontario, Quebec, British Columbia and Alberta totals at least $158 billion to promote the so-called “green economy.” Yet despite this massive spending, the green sector’s contribution to Canada’s economy has barely changed, from 3.1 per cent of Canada’s economic output in 2014 to 3.6 per cent in 2023.

In his first budget, Prime Minister Carney largely stuck to the Trudeau government playbook on energy and climate policy. Ottawa will continue to funnel taxpayer dollars to the “green economy” while restricting the oil and gas sector and hamstringing Canada’s economic potential. So much for becoming an energy superpower.