Alberta
MAiD In Alberta: Province surveying Albertans about assisted suicide policies
Alberta’s government is launching a public engagement to gather input about legislation and policies around assisted suicide, also referred to as medical assistance in dying (MAID).
Medical assistance in dying is a process that allows an eligible person to receive assistance from a medical practitioner in ending their life. To be found eligible, a person must be suffering from a serious and permanent medical condition.
Alberta’s government is reviewing how MAID is regulated to ensure there is a consistent process as well as oversight that protects vulnerable Albertans, specifically those living with disabilities or suffering from mental health challenges. An online survey is now open for Albertans to share their views and experiences with MAID until Dec. 20.
“We recognize that medical assistance in dying is a very complex and often personal issue and is an important, sensitive and emotional matter for patients and their families. It is important to ensure this process has the necessary supports to protect the most vulnerable. I encourage Albertans who have experience with and opinions on MAID to take this survey.”
In addition to the online survey, Alberta’s government will also be engaging directly with academics, medical associations, public bodies, religious organizations, regulatory bodies, advocacy groups and others that have an interest in and/or working relationship to the MAID process, health care, disabilities and mental health care.
Feedback gathered through this process will help inform the Alberta government’s planning and policy decision making, including potential legislative changes regarding MAID in Alberta.
“Our government has been clear that we do not support the provision of medically assisted suicide for vulnerable Albertans facing mental illness as their primary purpose for seeking their own death. Instead, our goal is to build a continuum of care where vulnerable Albertans can live in long-term health and fulfilment. We look forward to the feedback of Albertans as we proceed with this important issue.”
“As MAID is a federally legislated and regulated program that touches the lives of many Albertans, our priority is to ensure we have robust safeguards to protect vulnerable individuals. Albertans’ insights will be essential in developing thoughtful policies on this complex issue.”
The federal Criminal Code sets out the MAID eligibility criteria, procedural safeguards and reporting obligations. The federal government has paused MAID eligibility for individuals with a mental illness as their sole underlying medical condition until March 2027 to ensure the provincial health care systems have processes and supports in place. Alberta’s government does not support expanding MAID eligibility to include those facing depression or mental illness and continues to call on the federal government to end this policy altogether.
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.
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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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