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Alberta

Province says improving primary health care system will take pressure off emergency care

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Strengthening health care: Improving access for all

Alberta’s government is stabilizing and strengthening primary health care across the province so that everyone can access care when and where they need it.

Primary health care is the first point of contact Albertans have with the health care system, and includes health professionals such as family doctors, nurse practitioners and pharmacists.

Last fall, health care leaders, Indigenous partners and experts from across Canada and around the world came together to form advisory panels as part of the Modernizing Alberta’s Primary Health Care System (MAPS) initiative. The panels identified immediate, medium- and long-term improvements to strengthen Alberta’s primary health care system.

Alberta’s government will begin moving forward on the recommendations in the final report to improve access to primary health care for all Albertans. The recommendations will be implemented through a phased approach, with several moving forward immediately, followed by medium- and longer-term improvements that will enhance community-based primary health care across Alberta.

“Today marks an important step in the work I am undertaking to enhance primary care as the foundation of our health care system. The Modernizing Alberta’s Primary Health Care System (MAPS) reports clearly identify the challenges our system is facing, and their release signals this government’s commitment to take immediate and ongoing action to support and stabilize primary health care in our province. I look forward to the ongoing work of implementing needed changes with our health care partners and providers.”

Adriana LaGrange, Minister of Health

Several immediate actions are being taken, all of which are consistent with recommendations from the panels. These actions are critical to ensuring Albertans have better access to health care when and where they need it. Alberta Health continues to work toward implementing recommendations over the medium and long term.

“The MAPS recommendations represent a huge leap forward for our primary health system – strengthening and clarifying governance, community involvement, and recognizing the importance of integrated team-based care that allows Albertans to access primary care from the most appropriate team member at the right time, in the right place. This is how we can ensure equitable access to care across our province.”

Dr. Janet Reynolds, co-chair, MAPS strategic advisory panel

Strengthening primary health care

Alberta’s government is acting immediately on recommendations to improve primary health care and increase Albertans’ access to the medical care they need, including:

  • Creating a primary health care division within Alberta Health.
  • Allocating $57 million over three years to provide family doctors and nurse practitioners with support to help manage their increasing number of patients. Each provider has the potential to receive up to $10,000 annually.
  • Working with the Alberta Medical Association to create a task force to recommend a new payment model for family physicians that encourages comprehensive primary care – where a patient has a regular family doctor who they develop a long-term relationship with and who works with them to ensure all their health care needs are met.
  • Developing a memorandum of understanding with the Alberta Medical Association to collaborate on a transition to a new physician compensation model, modernize primary care governance and enable family doctors to spend more time with patients and less time on paperwork and immediately stabilize primary care.
  • Expanding online mental health services, allowing doctors to bill for virtual mental health checks and therapy, and compensating them for extra time spent with patients virtually.
  • Ensuring doctors get paid if patients can’t prove insurance coverage, reducing administrative burden. This is known as “good faith” claims.
  • Introducing a payment system that will support nurse practitioners to open their own clinics, take on patients and offer services based on their scope of practice, training and expertise. Nurse practitioners have completed graduate studies ensuring that they are properly trained to examine patients, provide diagnoses and prescribe medication.

“We know that a strong primary health care system is foundational for better health care for Albertans, and that starts with access to a family physician and a team of dedicated providers. Primary care requires dedicated planning, resourcing and coordination. We are pleased to join the task force and believe continued collaboration and immediate action will bring us closer to our collective vision.”

Dr. Noel DaCunha, president, Alberta College of Family Physicians

“The Nurse Practitioner Association of Alberta is elated to see the newly released MAPs report, which provides direction for primary care reform and includes the full integration of nurse practitioners. The Government of Alberta is taking a significant and essential step in improving access to primary care for Albertans. This announcement is a win-win for Albertans and nurse practitioners, as it recognizes the valuable contributions of NPs delivering high-quality care for Albertans and their ability to decrease the stress on the health care system. We are excited about the future of primary care in Alberta.”

Dr. Susan Prendergast, president, Nurse Practitioner Association of Alberta

“These actions are welcome news for rural Alberta. Ensuring Albertans have access to health care professionals when and where they need it is essential. This work will help to solve some of the unique challenges for rural Albertans by encouraging health professions to practise in rural parts of the province.”

Martin Long, parliamentary secretary for rural health

Strengthening Indigenous health care

Indigenous Peoples face many barriers to access appropriate health care. To support better health outcomes, the government will build more meaningful connections with Indigenous leaders and communities to identify improvements that reflect the unique nature of their communities. Immediate actions include:

  • Creating an Indigenous health division within Alberta Health.
  • Creating a $20-million fund for Indigenous communities to design and deliver innovative primary health care services and projects.
  • Creating an Indigenous patient complaints investigator and Elders roster to investigate incidences of racism during the delivery of health care and provide culturally safe support to Indigenous patients throughout the patient complaint process.
  • Investing in a community-based Indigenous patient navigator program to support Indigenous peoples throughout their health care journey.

“It is unacceptable that Indigenous Peoples continue to face so many barriers when accessing primary health care. It is crucial that all First Nations, Métis and Inuit peoples have equitable access to community-based primary health care that is culturally safe, respects their unique needs and is free of racism. These immediate actions will help us achieve that goal.”

Rick Wilson, Minister of Indigenous Relations

“The panel’s recommendations provide a clear and stable pathway to create a safe, culturally appropriate primary health care system that includes Indigenous people as partners and leaders at every stage of the development, governance and delivery of health care services. The best solutions exist within our respective communities, tailored for our unique needs and priorities. The commitments made today are an important first step toward improving health equity for Indigenous Peoples, regardless of where they live in Alberta.”

Naa Taoyi Piita Wo Taan, Dr. Tyler White, CEO, Siksika Health Services and co-chair, MAPS Indigenous Primary Health Care Advisory Panel

Quick facts

  • Advisory panels were established through MAPS in fall 2022 to identify primary health care improvements in the short term and over the next 10 years.
  • Final reports from the panels were submitted in spring 2023.
  • The strategic advisory panel final report contains 11 recommendations to refocus the system around primary health care with an emphasis on:
    • access to team-based care
    • integration between primary health care and community care
    • a foundation of a coordinated and accountable primary health care system
  • The Indigenous advisory panel final report contains 22 recommendations under five themes:
    • improve health equity for Indigenous Peoples
    • address Indigenous racism in health care
    • build culturally safer primary health care and an Indigenous workforce
    • create system innovation and support community capacity
    • Indigenous ownership, stewardship, design and delivery of health care services
  • Budget 2023 allocated $125 million over three years to implement recommendations from MAPS.
  • The next step will be to further engage with health care partners, including Indigenous communities, to implement these immediate priorities and the broader MAPS recommendations.

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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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