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Alberta

Pharmacist-led clinics improve access to health care: Lessons from Alberta

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News release from the Montreal Economic Institute

In Canada, 35 per cent of avoidable emergency room visits could be handled by pharmacists.

Emulating Alberta’s pharmacist-led clinic model could enhance access to primary care and help avoid unnecessary emergency room visits, according to a new study from the Montreal Economic Institute.

“Pharmacists know medication better than anyone else in our health systems,” explains Krystle Wittevrongel, senior public policy analyst and Alberta project lead at the MEI. “By unlocking their full potential in prescribing and substituting medications, Alberta’s pharmacist-led clinics have helped avoid tens of thousands of unnecessary emergency room visits.”

Pharmacists in Alberta have the largest prescribing authority in the country, including the ability to prescribe schedule one drugs with special training.

Unlike in Ontario and Manitoba, Alberta pharmacists are authorized to substitute prescribed medications, which can help address issues such as adverse reactions caused by interaction with other treatments.

The study explains that this can help reduce pressure on hospitals, as prescription-related issues account for more than 10 per cent of emergency room visits.

Alberta’s first pharmacist-led clinic, in Lethbridge, sees between 14,600 and 21,900 patients per year since opening in 2022.

It is expected that there will be 103 such clinics active in the province by the end of 2024.

The researcher also links the success of the pharmacist-led clinic model in Alberta to pharmacists’ expanded scope of practice in the province.

Among other things, Alberta pharmacists are able to order and interpret lab tests, unlike their counterparts in British Columbia, Ontario, and Newfoundland and Labrador.

A 2019 peer-reviewed study found that pharmacists could handle 35 per cent of avoidable emergency room visits in Canada.

“By enabling pharmacists to play a larger role in its health system, Alberta is redirecting minor cases from emergency rooms to more appropriate facilities,” said Wittevrongel. “Just imagine how much faster things could be if pharmacists could take care of 35 per cent of the unnecessary load placed on Canada’s emergency rooms.”

The MEI study is available here.

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The MEI is an independent public policy think tank with offices in Montreal and Calgary. Through its publications, media appearances, and advisory services to policy-makers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship. 

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Alberta

Federal taxes increasing for Albertans in 2025: Report

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From the Canadian Taxpayers Federation

By Kris Sims 

The Canadian Taxpayers Federation released its annual New Year’s Tax Changes report today to highlight major tax changes in 2025.

The key provincial tax change expected for Alberta is a reduction in the income tax rate.

“The Alberta government promised to reduce our lowest income tax bracket from 10 down to eight per cent and we expect the government to keep that promise in the new year,” said Kris Sims, CTF Alberta Director. “The United Conservatives said this provincial income tax cut would save families about $1,500 each and Alberta families need that kind of tax relief right now.

“Premier Danielle Smith promised to cut taxes and Albertans expect her to deliver.”

Albertans will see several federal tax hikes coming from Ottawa in 2025.

Payroll taxes: The federal government is raising the mandatory Canada Pension Plan and Employment Insurance contributions in 2025. These payroll tax increases will cost a worker up to an additional $403 next year.

Federal payroll taxes (CPP and EI tax) will cost a worker making $81,200 or more $5,507 in 2025. Their employer will also be forced to pay $5,938.

Carbon tax: The federal carbon tax is increasing to about 21 cents per litre of gasoline, 25 cents per litre of diesel and 18 cents per cubic metre of natural gas on April 1. The carbon tax will cost the average household between $133 and $477 in 2025-26, even after the rebates, according to the Parliamentary Budget Officer.

Alcohol taxes: Federal alcohol taxes will increase by two per cent on April 1. This alcohol tax hike will cost taxpayers $40.9 million in 2025-26, according to Beer Canada.

Following Budget 2024, the federal government also increased capital gains taxes and imposed a digital services tax and an online streaming tax.

Temporary Sales Tax Holiday: The federal government announced a two month sales tax holiday on certain items like pre-made groceries, children’s clothing, drinks and snacks. The holiday will last until Feb. 15, 2025, and could save taxpayers $2.7 billion.

“In 2025, the Trudeau government will yet again take more money out of Canadians’ pockets with payroll tax hikes and will make life more expensive by raising carbon taxes and alcohol taxes,” said Franco Terrazzano, CTF Federal Director. “Prime Minister Justin Trudeau should drop his plans to take more money out of Canadians’ pockets and deliver serious tax relief.”

You can find the CTF’s New Year’s Tax Changes report HERE.

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Alberta

Fraser Institute: Time to fix health care in Alberta

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From the Fraser Institute

By Bacchus Barua and Tegan Hill

Shortly after Danielle Smith was sworn in as premier, she warned Albertans that it would “be a bit bumpy for the next 90 days” on the road to health-care reform. Now, more than two years into her premiership, the province’s health-care system remains in shambles.

According to a new report, this year patients in Alberta faced a median wait of 38.4 weeks between seeing a general practitioner and receiving medically necessary treatment. That’s more than eight weeks longer than the Canadian average (30.0 weeks) and more than triple the 10.5 weeks Albertans waited in 1993 when the Fraser Institute first published nationwide estimates.

In fact, since Premier Smith took office in 2022, wait times have actually increased 15.3 per cent.

To be fair, Premier Smith has made good on her commitment to expand collaboration with the private sector for the delivery of some public surgeries, and focused spending in critical areas such as emergency services and increased staffing. She also divided Alberta Health Services, arguing it currently operates as a monopoly and monopolies don’t face the consequences when delivering poor service.

While the impact of these reforms remain largely unknown, one thing is clear: the province requires immediate and bold health-care reforms based on proven lessons from other countries (e.g. Australia and the Netherlands) and other provinces (e.g. Saskatchewan and Quebec).

These reforms include a rapid expansion of contracts with private clinics to deliver more publicly funded services. The premier should also consider a central referral system to connect patients to physicians with the shortest wait time in their area in public or private clinics (while patients retain the right to wait longer for the physician of their choice). This could be integrated into the province’s Connect Care system for electronic patient records.

Saskatchewan did just this in the early 2010s and moved from the longest wait times in Canada to the second shortest in just four years. (Since then, wait times have crept back up with little to no expansion in the contracts with private clinics, which was so successful in the past. This highlights a key lesson for Alberta—these reforms are only a first step.)

Premier Smith should also change the way hospitals are paid to encourage more care and a more patient-focused approach. Why?

Because Alberta still generally follows an outdated approach to hospital funding where hospitals receive a pre-set budget annually. As a result, patients are seen as “costs” that eat into the hospital budget, and hospitals are not financially incentivized to treat more patients or provide more rapid access to care (in fact, doing so drains the budget more rapidly). By contrast, more successful universal health-care countries around the world pay hospitals for the services they provide. In other words, by making treatment the source of hospital revenue, hospitals provide more care more rapidly to patients and improve the quality of services overall. Quebec is already moving in this direction, with other provinces also experimenting.

The promise of a “new day” for health care in Alberta is increasingly looking like a pipe dream, but there’s still time to meaningfully improve health care for Albertans. To finally provide relief for patients and their families, Premier Smith should increase private-sector collaboration, create a central referral system, and change the way hospitals are funded.

Bacchus Barua

Director, Health Policy Studies, Fraser Institute

Tegan Hill

Director, Alberta Policy, Fraser Institute
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