Alberta
Wait times down. Better EMS response times. Province releases results of 90 day Health Care Action Plan
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90-day HCAP update: Health care wait times dropping
Albertans are spending less time waiting for the medical care they need since the Health Care Action Plan (HCAP) was launched.
Alberta has the best front-line health care workers in the world, and Alberta’s government will work to have the right supports in place to ensure Albertans get the care they need when and where they need it. When Alberta’s HCAP was launched on Nov. 17, Alberta’s government identified four different areas on which it would work with Alberta Health Services to improve. After 90 days, Albertans are seeing improvements in all four areas.
“We are delivering on our promise to reduce wait times, add more front-line staff and keep Albertans updated on the progress we’re making. There is no one silver bullet to fixing our health care system, and change will take time. But positive change is happening, and Albertans are receiving better access to the level of care they need when and where they need it. We appointed Dr. John Cowell as official administrator to speed up improvements and make sure Albertans are getting high quality of care sooner and we are seeing some good, early results.”
Improving EMS response time
In an emergency, every minute counts and over the past three months, ambulances have been responding faster to emergency calls. Improved ambulance times means that Albertans are receiving the urgent care they need from highly skilled paramedics more quickly.
From November to the end of January, EMS response times for most urgent calls improved across the province in metro, urban, rural and remote areas. The decrease in EMS wait times across the province can be broken down to:
- 17 minutes in metro and urban areas, down from 21.8 minutes
- 19.2 minutes in communities with more than 3,000 residents, down from 21.5 minutes
- 34.9 minutes in rural communities with fewer than 3,000 residents, down from 36 minutes
- 57.5 minutes in remote communities, down from 63.9 minutes
In addition to improved EMS wait times, more ambulances have been available, meaning that red alerts, which indicate a lack of ambulance availability at a point in time, were substantially reduced in Edmonton and Calgary:
- Edmonton has seen a 92 per cent reduction in the number of alerts issued in January 2023 compared with January 2022.
- Calgary has seen a 60 per cent reduction over the same period.
The initiative to triage 911 calls to the most appropriate level of care has also played a role in ensuring paramedics are able to answer the most urgent calls. Since the program was launched in January, 1,600 callers with non-urgent conditions were transferred from 911 to Health Link registered nurses. Alberta’s government is pleased to see progress on its aim to reduce EMS wait times and will continue working to further decrease the amount of time an Albertan waits for an ambulance to arrive.
“The good news is wait times are trending in the right direction and Albertans are getting the care they need more quickly. More doctors, nurses and paramedics are available to help Albertans, and more help is on the way as Alberta continues to add front-line workers for ambulances, ERs and across the system.”
Reducing surgery wait times
Alberta’s government continues its work to reduce surgical wait times for Albertans. Part of a strong health care system is ensuring that Alberta patients are receiving their surgeries within clinically recommended times. Since November 2022, the number of patients waiting longer than the clinically recommended time has decreased by 9.4 per cent.
Alberta’s chartered surgical facilities are helping to reduce wait times and ensure Albertans are receiving the surgeries they need to improve their health and their quality of life. Nearly 7,000 more publicly funded surgeries were completed at chartered surgical facilities in January compared with November, a number that includes orthopedic and eye surgeries. As this work continues, AHS is focused on ensuring that those patients who have waited the longest for surgery are prioritized.
“I would like to thank our incredible front-line workers as well as our AHS leaders, who have worked extremely hard to identify and implement improvements to our health care system, with focus on our priority areas. We have emerged from an extremely challenging time, and I am optimistic that we will continue to see improvements that will benefit all Albertans whenever they need our care and support.”
Decreasing emergency room wait times and improving access to care
Alberta’s government is also encouraged to see that in January, more Albertans received care sooner when they visited emergency departments. Progress in lowering emergency department wait times has been seen in the two measures:
- Wait time to see a doctor in an emergency department decreased by almost 10 per cent provincially since November.
- Time spent in an emergency department for admitted patients has been reduced by about five per cent.
There is still work to be done to ensure Albertans have lower wait times in emergency rooms across the province, and Alberta’s government will continue to make policy and funding decisions to see those improvements. In January, the number of assessed patients waiting in the province’s top 14 hospitals for a continuing care space was 179, lower than the 218 patients in the 2018-2019 fiscal year, and also lower than the 253 patients waiting in November 2022. A number of changes have helped to spur progress on emergency department wait times from November to the end of January:
- AHS opened 255 new acute care beds (non-intensive care unit) across the province.
- More beds in continuing care facilities have been opened – freeing more hospital beds for urgent care: 55 new long-term care beds, 292 new designated supportive living beds and 38 new community addiction and mental health beds.
- Additionally, 36 new transition beds for people discharged from ERs in Edmonton who are experiencing homelessness will be opened this year.
Empowering health care workers to deliver health care
Alberta continues to hire more health care workers to support key areas. AHS is adding 420 more positions in emergency rooms, acute care, EMS and community care, on top of the nearly 400 front-line and support staff hired since November. If passed, Budget 2023 would provide $158 million for a new Health Workforce Strategy to make sure the province has the medical professionals needed and to improve the work environment.
Alberta is making good progress on increasing the number of highly skilled doctors, nurses, paramedics, nurse practitioners and other health allied professionals in the province:
- AHS added 800 registered nurses, licensed practical nurses and health care aides in 2022.
- Since 2019, AHS has added 5,800 front-line staff, including 1,800 registered nurses and 300 paramedics.
- AHS recruited 28 physicians to rural Alberta and added 278 more registered nurses, licensed practical nurses and health care aides since November.
- EMS added 39 front-line staff, including paramedics and emergency communications officers, over the last three months.
- 80 additional full-time paramedic positions are being recruited, and AHS is transitioning 70 current temporary full-time EMS positions to regular full-time.
- AHS is currently hiring 114 full-time nursing staff for emergency department teams to speed up EMS transfers and free up paramedics to respond to more calls.
Alberta
Alberta Income Tax cut is great but balanced budgets are needed
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By Kris Sims
The Canadian Taxpayers Federation is applauding the Alberta government for giving Albertans a huge income tax cut in Budget 2025, but is strongly warning against its dive into debt by running a deficit.
“Premier Danielle Smith keeping her promise to cut Alberta’s income tax is great news, because it means huge savings for most working families,” said Kris Sims, CTF Alberta Director. “Families are fighting to afford basics right now, and if they can save more than $1,500 per year thanks to this big tax cut, that would cover a month’s rent or more than a month’s worth of groceries.”
Finance Minister Nate Horner announced, effective this fiscal year, Alberta will drop its lowest income tax rate to eight per cent, down from 10 per cent, for the first $60,000 of earnings.
The government estimates this income tax cut will save the average Alberta worker about $750 per year, or more than $1,500 per year for a two-person working family.
Albertans earning less than $60,000 a year will see a 20 per cent reduction to their annual provincial income tax bill.
The budget also contained some bad news.
The province is running a $5.2 billion deficit in 2025-26 and the government is planning to keep running deficits for two more years.
Total spending has gone up from $73.1 billion from last budget to $79.3 billion this year, an increase of 8.4 per cent.
“If the government had frozen spending at last year’s budget level, the province could have a $1 billion surplus and still cut the income tax,” said Sims. “The debt is going up over the next few years, but we caught a lucky break with interest rates dropping this past year, so we aren’t paying as much in interest payments on the debt.”
The province’s debt is now estimated to be $82.8 billion for 2025-26.
Interest payments on the provincial debt are costing taxpayers about $2.9 billion, about a 12 per cent decrease from last year.
Alberta
Alberta 2025 Budget Review from the Alberta Institute
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The government has just tabled its budget in the Legislature.
We were invited to the government’s advance briefing, which gave us a few hours to review the documents, ask questions, and analyze the numbers before the official release.
Now that the embargo has been lifted, we can share our thoughts with you.
However, this is just our preliminary analysis – we’ll have a more in-depth breakdown for you next week.
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The 2025/26 Budget is a projection for the next year – what the government expects will happen from April 1st, 2025 to March 31st, 2026.
It represents the government’s best estimate of future revenue and its plan for expenditures.
In the budget (and in this email) this type of figure is referred to as a Budget figure.
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The actual final figures won’t be known until the 2025/26 Annual Report is released in the middle of next year.
Of course, as we’ve seen in the past, things don’t always go according to plan.
In the budget (and in this email) this type of figure is referred to as an Actual figure.
Importantly, this means that the 2024/25 Annual Report isn’t ready yet, either.
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Therefore, in the meantime, the Q3 2025/26 Fiscal Update, which has figures up to December 31st, 2024, provides a forecast for the 2024/25 year.
The government looks at the actual results three quarters of the way through the previous year, and uses those figures to get the most accurate forecast on what will be the final result in the annual report, to help with estimating the 2025-26 year.
In the budget (and in this email) this type of figure is referred to as a Forecast figure.
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Accurately estimating, and tracking these three types of figures is a key part of good budgeting.
Sometimes, the economy performs better than expected, oil prices could be higher than initially forecast, or more revenue may come in from other sources.
But, other times, there’s a recession or a drop in oil prices, leading to lower-than-expected revenue.
On the spending side, governments sometimes find savings, keeping expenses lower than planned.
Alternatively, unexpected costs, disasters, or just governments being governments can also drive spending higher than budgeted.
The best way to manage this uncertainty is:
- Be conservative in estimating revenue.
- Only plan to spend what is reasonably expected to come in.
- Stick to that spending plan to avoid overspending.
By following these principles, the risk of an unexpected deficit is minimized.
And if revenue exceeds expectations or expenses come in lower, the surplus can be used to pay down debt or be returned to taxpayers.
On these three measures, this year’s budget gets a mixed grade.
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On the first point, the government has indeed made some pretty conservative estimates of revenue – including assuming an oil price several dollars below where it currently stands, and well below the previous year’s predictions.
The government has also assumed there will be some significant (though not catastrophic) effects from a potential trade war.
If oil prices end up higher, or Canada avoids a trade war with the US, then revenue could be significantly higher than planned.
Interestingly, this year’s budget looks very different depending on whether you compare it to last year’s budget, or the latest forecast.
This year’s budget revenue is $6.6 billion lower than what actually happened in last year’s forecast revenue.
But, this year’s budget revenue is actually $600 million higher than what was expected to happen in last year’s budget revenue.
In other words, if you compare this year’s budget to what the government expected to happen last year, revenue is up a small amount, but when you compare this year’s budget to what actually happened last year, revenue is down a lot.
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On the second point, unfortunately, the government doesn’t score so well.
Expenses are up quite a bit, even though revenue is expected to drop.
According to some measurements, expenditures are increasing slower than the combined rate of population growth and inflation – which is the goal the government set for itself in 2023.
But, when other expenses like contingencies for emergencies are included, or when expenses are measured in other ways, spending is increasing faster than that benchmark.
This year’s budget expenses are $4.4 billion higher than what was actually spent in last year’s forecast expenses.
But, this year’s budget expenses are $6.1 billion higher than what was expected to happen in last year’s budget expenses.
Perhaps the bigger question is why is expenditure increasing at all when revenue is expected to drop?
If there’s less money coming in, the government should really be using this as an opportunity to reduce overall expenditures.
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On the third point, we will – of course – have to wait and see what the final accounts look like next year!
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Before we wrap up this initial analysis, there’s one aspect of the budget that is likely to receive significant attention, and that is a tax cut.
Originally planned to be phased in over the next few years, a tax cut will now be back-dated to January 1st of this year.
Previously, any income below about $150,000 was subject to a 10% provincial tax, while incomes above $150,000 attract higher and higher tax rates of 12%, 13%, 14%, and 15% as incomes increase.
Under the new tax plan, incomes under $60,000 would only be taxed at 8%, with incomes between $60,000 and $150,000 still paying 10%, and incomes above $150,000 still paying 12%, 13%, 14%, and 15%, as before.
Some commentators are likely to question the wisdom of a tax cut that reduces revenue when the budget is going to be in deficit.
But, the reality is that this tax cut doesn’t actually cost much.
We’ll have the exact figures for you by next week, but suffice to say that it’s a pretty small portion of the overall deficit, and there’s a deficit because spending is up a lot, not because of a small tax cut.
In general, lower taxes are good, but we would have preferred the government work towards a lower, flatter tax instead.
The Alberta Advantage was built on Alberta’s unique flat tax system where everyone paid the same low flat tax (not the same amount, the same percentage!) and so wasn’t punished for succeeding.
Alberta needs a plan to get back to a low flat tax, and we will continue to advocate for this at the Alberta Institute.
Maybe we can do better than just returning to the old 10% flat tax, though?
Maybe we should aim for a flat tax of 8%, instead?
That’s it for today’s quick initial analysis.
In next week’s analysis, we’ll break down the pros and cons of these decisions and outline where we might have taken a different approach.
In the meantime, if you appreciate our work and want to support more of this kind of independent analysis of Alberta’s finances, please consider making a donation here:
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