Alberta
Free Alberta Strategy backing Smith’s Provincial Priorities Act
News release from Free Alberta Strategy
Premier Danielle Smith had a message for Ottawa last week.
Keep out.
On Wednesday, the Premier rolled out her latest weapon in the fight against federal intrusions into provincial jurisdiction.
If passed, Bill 18 – the Provincial Priorities Act – aims to align federal funding with provincial priorities, ensuring that said funding reflects Alberta’s interests.
The legislation stipulates that any agreements between the federal government and any provincial entities – including municipalities – must receive provincial approval to be considered valid.
Smith has already given it a nickname: “the stay-out-of-my-backyard bill.”
It’s an apt description of the legislation, especially considering that’s what the federal government has been doing for years – encroaching into Alberta’s jurisdiction.
The legislation shouldn’t come as a surprise to anyone.
We all know that most deals the Alberta government enters into with the federal government don’t work out for Albertans.
We end up paying more in federal taxes than gets spent in federal spending on the programs.
The programs come laden with restrictive conditions that undermine our autonomy, and are often detrimental to our ability to provide the services.
This is especially true with regard to the recent agreement between Ottawa and the provinces that allows the federal government to nationalize childcare.
The childcare agreement has come under heavy criticism due to funding shortfalls in the deal.
It also applies to housing, where despite Alberta accounting for 12% of the national population and experiencing the most rapid population growth, it received a mere 2.5% of the total $1.5 billion in federal housing funding last summer.
Jason Nixon, Minister of Seniors, Community and Social Services, is in charge of housing in Alberta – which is provincial jurisdiction.
On the latest rollout of conditional federal housing handouts, Nixon isn’t buying.
“We will not be bribed, with our own money, to increase the time it takes to get homes built with green energy that makes homes more expensive.”
The theory also applies to the federal government’s latest gambit – doing an end-around provincial negotiations and going directly to municipalities, who seem more interested in taking the money than the conditions attached.
Municipalities are provincial jurisdiction.
Bill 18 mandates that entities within Alberta’s jurisdiction, such as municipalities, universities, school boards, housing agencies, and health authorities, must seek the province’s approval before engaging in, modifying, extending, or renewing agreements with Ottawa.
Agreements between the federal government and provincial entities lacking Alberta’s endorsement will be deemed illegal under this legislation.
That’s Premier Smith’s message.
She’s had enough of it.
“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.”
Municipal Affairs Minister Ric McIver had additional thoughts:
“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.”
The Provincial Priorities Act is based on existing provincial legislation in Quebec – called “An Act Respecting the Ministère du Conseil executif” – which prohibits any municipal body from entering into or negotiating an agreement with the federal government or its agencies without express authorization from the Quebec government.
That’s right – the Quebec government has the same rule!
So, this boils down to the same argument we’ve been making for years – if Ottawa wants to step into our backyard, it must first seek Alberta’s approval.
Enough is enough – we won’t stand idly by as our interests are trampled upon.
It’s time for Ottawa to recognize Alberta’s autonomy and respect our right to determine our own future.
At the Free Alberta Strategy, we know that constant vigilance is necessary – for every fence we put up, the federal government tries to find a way around it.
We’ll continue to bring you information about what’s happening in Alberta’s backyard and fighting to keep Ottawa out.
The Free Alberta Strategy Team
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.
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