Alberta
Provinces should be cautious about cost-sharing agreements with Ottawa
From the Fraser Institute
By Tegan Hill and Jake Fuss
According to Premier Danielle Smith, Alberta will withdraw from the federal government’s dental care plan by 2026 mainly because the plan would duplicate coverage already provided to many Albertans (although she plans to negotiate unconditional funding in lieu of being in the program). Indeed, all provinces should be wary of entering into such agreements as history has shown that Ottawa can reduce or eliminate funding at any time, leaving the provinces holding the bag.
In the 1990s, for instance, the federal government reduced health and social transfers to the provinces amid a fiscal crisis fuelled by decades of unrestrained spending and persistent deficits (and worsened by high interest rates). Gross federal debt increased from $38.9 billion in 1970/71 to $615.9 billion in 1993/94, at which point debt interest costs consumed roughly $1 in every $3 of federal government revenue.
In response to this debt crisis, the Chrétien Liberal government reduced spending across nearly all federal departments and programs. Over a three-year period to 1996/97, health and social transfers to the provinces were 51 per cent ($41.0 billion) less than what the provinces expected based on previous transfers. In other words, the provinces suddenly got a lot less money from Ottawa than they anticipated.
This should serve as a warning for the provinces who may find themselves on the hook for Ottawa’s big spending today. In the case of dental care, an area of provincial jurisdiction, the Trudeau government has earmarked $4.4 billion annually for the provinces on an ongoing basis. However, any change in federal priorities or federal finances could swing the financial burden from Ottawa to the provinces to maintain the program.
The current state of federal finances only heightens this risk to the provinces. The federal government has run uninterrupted budget deficits since 2007/08, with total federal debt climbing from $707.3 billion in 2007/08 to a projected $2.1 trillion in 2024/25. The current government—or perhaps a future reform-minded government focused on balancing the budget—could reduce transfers to the provinces.
The Trudeau government has committed to significant new funding in areas of provincial jurisdiction, but provincial policymakers would do well to understand the risks of entering into such agreements. Ottawa can unilaterally reduce or eliminate funding at any point, leaving provinces to either assume the unexpected financial burden through higher taxes or additional borrowing, or curtail the programs.
Authors:
Alberta
Early Success: 33 Nurse Practitioners already working independently across Alberta
Nurse practitioners expand primary care access |
The Alberta government’s Nurse Practitioner Primary Care program is showing early signs of success, with 33 nurse practitioners already practising independently in communities across the province.
Alberta’s government is committed to strengthening Alberta’s primary health care system, recognizing that innovative approaches are essential to improving access. To further this commitment, the Nurse Practitioner Primary Care Program was launched in April, allowing nurse practitioners to practise comprehensive patient care autonomously, either by operating their own practices or working independently within existing primary care settings.
Since being announced, the program has garnered a promising response. A total of 67 applications have been submitted, with 56 approved. Of those, 33 nurse practitioners are now practising autonomously in communities throughout Alberta, including in rural locations such as Beaverlodge, Coaldale, Cold Lake, Consort, Morley, Picture Butte, Three Hills, Two Hills, Vegreville and Vermilion.
“I am thrilled about the interest in this program, as nurse practitioners are a key part of the solution to provide Albertans with greater access to the primary health care services they need.”
To participate in the program, nurse practitioners are required to commit to providing a set number of hours of medically necessary primary care services, maintain a panel size of at least 900 patients, offer after-hours access on weekends, evenings or holidays, and accept walk-in appointments until a panel size reaches 900 patients.
With 33 nurse practitioners practising independently, about 30,000 more Albertans will have access to the primary health care they need. Once the remaining 23 approved applicants begin practising, primary health care access will expand to almost 21,000 more Albertans.
“Enabling nurse practitioners to practise independently is great news for rural Alberta. This is one more way our government is ensuring communities will have access to the care they need, closer to home.”
“Nurse practitioners are highly skilled health care professionals and an invaluable part of our health care system. The Nurse Practitioner Primary Care Program is the right step to ensuring all Albertans can receive care where and when they need it.”
“The NPAA wishes to thank the Alberta government for recognizing the vital role NPs play in the health care system. Nurse practitioners have long advocated to operate their own practices and are ready to meet the growing health care needs of Albertans. This initiative will ensure that more people receive the timely and comprehensive care they deserve.”
The Nurse Practitioner Primary Care program not only expands access to primary care services across the province but also enables nurse practitioners to practise to their full scope, providing another vital access point for Albertans to receive timely, high-quality care when and where they need it most.
Quick facts
- Through the Nurse Practitioner Primary Care Program, nurse practitioners receive about 80 per cent of the compensation that fee-for-service family physicians earn for providing comprehensive primary care.
- Compensation for nurse practitioners is determined based on panel size (the number of patients under their care) and the number of patient care hours provided.
- Nurse practitioners have completed graduate studies and are regulated by the College of Registered Nurses of Alberta.
- For the second consecutive year, a record number of registrants renewed their permits with the College of Registered Nurses of Alberta (CRNA) to continue practising nursing in Alberta.
- There were more than 44,798 registrants and a 15 per cent increase in nurse practitioners.
- Data from the Nurse Practitioner Primary Care Program show:
- Nine applicants plan to work on First Nations reserves or Metis Settlements.
- Parts of the province where nurse practitioners are practising: Calgary (12), Edmonton (five), central (six), north (three) and south (seven).
- Participating nurse practitioners who practise in eligible communities for the Rural, Remote and Northern Program will be provided funding as an incentive to practise in rural or remote areas.
- Participating nurse practitioners are also eligible for the Panel Management Support Program, which helps offset costs for physicians and nurse practitioners to provide comprehensive care as their patient panels grow.
Related information
Alberta
Province considering new Red Deer River reservoir east of Red Deer
Central Alberta reservoir study underway
Alberta’s government is moving forward a study to assess the feasibility of building a new reservoir on the Red Deer River to help support growing communities.
Demand for water from communities and businesses is increasing as more families, businesses and industries choose to live and work in central Alberta. The Red Deer River supplies water to hundreds of thousands of Albertans across the region and expanding water storage capacity could help reduce the risk of future droughts and meet the growing water demands.
Alberta’s government has now begun assessing the feasibility of building a potential new reservoir east of Red Deer near Ardley. A two-phase, multi-year study will explore the costs and value of constructing and operating the reservoir, and its impact on downstream communities, farmers and ranchers, and businesses.
“Central Alberta is a growing and thriving, and we are ensuring that it has the water it needs. This study will help us determine if an Ardley reservoir is effective and how it can be built and operated successfully to help us manage and maximize water storage for years to come.”
Reservoirs play a vital role in irrigation, drought management, water security and flood protection. Budget 2024 allocated $4.5 million to explore creating a new reservoir on the Red Deer River, at a damsite about 40 kilometres east of the City of Red Deer.
Work will begin on the scoping phase of the study as soon as possible. This will include reviewing available geotechnical and hydrotechnical information and exploring conceptual dam options. The scoping phase also includes meetings with municipalities and water users in the area to hear their views. This work is expected to be completed by December 2025.
“Reliable water infrastructure is essential for Alberta’s growing communities and industries. The Ardley reservoir feasibility study is a vital step toward ensuring long-term water security for central Alberta. As we assess this project’s potential, we’re supporting the sustainability of our economic corridors, agricultural operations and rural economy.”
“Water is essential to the agriculture industry and if the past few years are any indication, we need to prepare for dry conditions. A potential dam near Ardley could enhance water security and help farmers and ranchers continue to thrive in Alberta’s unpredictable conditions.”
Once that is complete, the feasibility study will then shift into a second phase, looking more closely at whether an effective new dam near Ardley can be safely designed and constructed, and the impact it may have on communities and the environment. Geotechnical and hydrotechnical investigations, cost-benefit analyses and an assessment of environmental and regulatory requirements will occur. The feasibility phase will also include gathering feedback directly from Albertans through public engagement. This work is expected to be completed by March 31, 2026.
Quick facts
- The Ardley dam scoping and feasibility study will be undertaken by Hatch Ltd., a Canadian multi-disciplinary professional services firm.
- Once the feasibility study is complete, government will assess the results and determine whether to pursue this project and proceed with detailed engineering and design work and regulatory approvals.
- Alberta’s government owns and operates several large reservoirs in the South Saskatchewan River Basin that help ensure sufficient water supply to meet demand from communities, irrigators and businesses, while also maintaining a healthy aquatic environment.
- Water stored at Gleniffer Lake, the reservoir created by Dickson Dam, helps supplement low winter flows along the Red Deer River and helps ensure an adequate water supply for Red Deer and Drumheller.
Related information
-
Business2 days ago
Ottawa’s avalanche of spending hasn’t helped First Nations
-
Business2 days ago
From ‘brilliant’ to ‘aghast’: Reactions to RFK Jr.’s nomination for HHS secretary run the gamut
-
Brownstone Institute1 day ago
The Most Devastating Report So Far
-
Business1 day ago
Carbon tax bureaucracy costs taxpayers $800 million
-
John Stossel23 hours ago
Green Energy Needs Minerals, Yet America Blocks New Mines
-
Health2 days ago
Canada’s public health agency still working to adopt WHO pandemic treaty: report
-
MAiD2 days ago
Over 40% of people euthanized in Ontario lived in poorest parts of the province: government data
-
ESG1 day ago
Can’t afford Rent? Groceries for your kids? Trudeau says suck it up and pay the tax!