Alberta
Alberta government should reform hospital funding to help shorten wait times
From the Fraser Institute
By Mackenzie Moir and Alicia Kardos
Other high-performing countries with universal health care (Australia, Germany, Switzerland) use “activity-based funding.” Under this model, hospitals receive funding based on the amount of care they provide.
Earlier this year, the Alberta Medical Association sounded the alarm on “rolling surgical outages,” patients diverted to other treatment sites, and the potential capping of services at major provincial hospitals. Unfortunately, the delays these problems create aren’t new to Albertans, as patients continue to face lengthy wait times.
According to the latest data, Albertan patients faced a median wait time of 33.5 weeks in 2022 for non-emergency medical treatment, a delay that was nearly six weeks longer than the national average, and three times longer than what patients in the province experienced in 1993 (when national estimates were first published).
When broken down, the wait in Alberta includes the first 16.4 weeks it takes for a patient to see a specialist after referral from their family doctor—then a second wait of 17.2 weeks to receive treatment after seeing that specialist. And these figures don’t account for the wait to see a GP in the first place, which is a significant issue in a rapidly growing province where remain without a family doctor.
Of course, we hear the predicable calls for more money. But in reality, spending more won’t get Albertans out of this problem. In a recent comparison of high-income countries with universal coverage, Canada (in 2021) was already one of the highest spenders on health care (as a share of their economy) while having some of the fewest doctors and hospital beds (after accounting for differences in population age among countries).
And when compared to nine other high-income countries in 2020, Canadians were found to have the longest waits for medical care. Specifically, Canadians were the least likely to report waiting under four months for non-emergency surgery (at 62 per cent) compared to higher-performing countries such as Australia (72 per cent), Switzerland (94 per cent) and Germany (99 per cent).
So what’s the solution?
In a word, reform. For example, Alberta could change the way it funds hospitals. Canada’s predominant approach is to provide hospitals a set amount of money each year, regardless of the level of services provided. This means that the money hospitals receive isn’t tied to the actual number of services they provide. This discourages hospitals from providing more care because each patient represents a drain on their budget rather than an opportunity.
In contrast, many other high-performing countries with universal health care (Australia, Germany, Switzerland) use “activity-based funding.” Under this model, hospitals receive funding based on the amount of care they provide. This creates a powerful incentive for hospitals to treat more patients, because each patient represents an opportunity for the hospital to earn more money.
Quebec decided in last year to fund all of its surgical procedures using this model, and now plans to expand the model to all hospital care by 2027/28. The Smith government has also taken some steps that lay the foundation for these types of reforms. This is good news for Albertans, if reform is actually on the way.
Across Canada, despite the availability of solutions, the status quo of long waits persists. Breaking from the past can be hard, but there may be hope on the horizon for patients in Alberta’s beleaguered and poorly performing health-care system.
Authors:
Alberta
Alberta Next Panel calls to reform how Canada works
From the Fraser Institute
By Tegan Hill
The Alberta Next Panel, tasked with advising the Smith government on how the province can better protect its interests and defend its economy, has officially released its report. Two of its key recommendations—to hold a referendum on Alberta leaving the Canada Pension Plan, and to create a commission to review programs like equalization—could lead to meaningful changes to Canada’s system of fiscal federalism (i.e. the financial relationship between Ottawa and the provinces).
The panel stemmed from a growing sense of unfairness in Alberta. From 2007 to 2022, Albertans’ net contribution to federal finances (total federal taxes paid by Albertans minus federal money spent or transferred to Albertans) was $244.6 billion—more than five times the net contribution from British Columbians or Ontarians (the only other two net contributors). This money from Albertans helps keep taxes lower and fund government services in other provinces. Yet Ottawa continues to impose federal regulations, which disproportionately and negatively impact Alberta’s energy industry.
Albertans were growing tired of this unbalanced relationship. According to a poll by the Angus Reid Institute, nearly half of Albertans believe they get a “raw deal”—that is, they give more than they get—being part of Canada. The Alberta Next Panel survey found that 59 per cent of Albertans believe the federal transfer and equalization system is unfair to Alberta. And a ThinkHQ survey found that more than seven in 10 Albertans feel that federal policies over the past several years hurt their quality of life.
As part of an effort to increase provincial autonomy, amid these frustrations, the panel recommends the Alberta government hold a referendum on leaving the Canada Pension Plan (CPP) and establishing its own provincial pension plan.
Albertans typically have higher average incomes and a younger population than the rest of the country, which means they could pay a lower contribution rate under a provincial pension plan while receiving the same level of benefits as the CPP. (These demographic and economic factors are also why Albertans currently make such a large net contribution to the CPP).
The savings from paying a lower contribution rate could result in materially higher income during retirement for Albertans if they’re invested in a private account. One report found that if a typical Albertan invested the savings from paying a lower contribution rate to a provincial pension plan, they could benefit from $189,773 (pre-tax) in additional retirement income.
Clearly, Albertans could see a financial benefit from leaving the CPP, but there are many factors to consider. The government plans to present a detailed report including how the funds would be managed, contribution rates, and implementation plan prior to a referendum.
Then there’s equalization—a program fraught with flaws. The goal of equalization is to ensure provinces can provide reasonably comparable public services at reasonably comparable tax rates. Ottawa collects taxes from Canadians across the country and then redistributes that money to “have not” provinces. In 2026/27, equalization payments is expected to total $27.2 billion with all provinces except Alberta, British Columbia and Saskatchewan receiving payments.
Reasonable people can disagree on whether or not they support the principle of the program, but again, it has major flaws that just don’t make sense. Consider the fixed growth rate rule, which mandates that total equalization payments grow each year even when the income differences between recipient and non-recipient provinces narrows. That means Albertans continue paying for a growing program, even when such growth isn’t required to meet the program’s stated objective. The panel recommends that Alberta take a leading role in working with other provinces and the federal government to reform equalization and set up a new Canada Fiscal Commission to review fiscal federalism more broadly.
The Alberta Next Panel is calling for changes to fiscal federalism. Reforms to equalization are clearly needed—and it’s worth exploring the potential of an Alberta pension plan. Indeed, both of these changes could deliver benefits.
Alberta
Alberta project would be “the biggest carbon capture and storage project in the world”
Pathways Alliance CEO Kendall Dilling is interviewed at the World Petroleum Congress in Calgary, Monday, Sept. 18, 2023.THE CANADIAN PRESS/Jeff McIntosh
From Resource Works
Carbon capture gives biggest bang for carbon tax buck CCS much cheaper than fuel switching: report
Canada’s climate change strategy is now joined at the hip to a pipeline. Two pipelines, actually — one for oil, one for carbon dioxide.
The MOU signed between Ottawa and Alberta two weeks ago ties a new oil pipeline to the Pathways Alliance, which includes what has been billed as the largest carbon capture proposal in the world.
One cannot proceed without the other. It’s quite possible neither will proceed.
The timing for multi-billion dollar carbon capture projects in general may be off, given the retreat we are now seeing from industry and government on decarbonization, especially in the U.S., our biggest energy customer and competitor.
But if the public, industry and our governments still think getting Canada’s GHG emissions down is a priority, decarbonizing Alberta oil, gas and heavy industry through CCS promises to be the most cost-effective technology approach.
New modelling by Clean Prosperity, a climate policy organization, finds large-scale carbon capture gets the biggest bang for the carbon tax buck.
Which makes sense. If oil and gas production in Alberta is Canada’s single largest emitter of CO2 and methane, it stands to reason that methane abatement and sequestering CO2 from oil and gas production is where the biggest gains are to be had.
A number of CCS projects are already in operation in Alberta, including Shell’s Quest project, which captures about 1 million tonnes of CO2 annually from the Scotford upgrader.
What is CO2 worth?
Clean Prosperity estimates industrial carbon pricing of $130 to $150 per tonne in Alberta and CCS could result in $90 billion in investment and 70 megatons (MT) annually of GHG abatement or sequestration. The lion’s share of that would come from CCS.
To put that in perspective, 70 MT is 10% of Canada’s total GHG emissions (694 MT).
The report cautions that these estimates are “hypothetical” and gives no timelines.
All of the main policy tools recommended by Clean Prosperity to achieve these GHG reductions are contained in the Ottawa-Alberta MOU.
One important policy in the MOU includes enhanced oil recovery (EOR), in which CO2 is injected into older conventional oil wells to increase output. While this increases oil production, it also sequesters large amounts of CO2.
Under Trudeau era policies, EOR was excluded from federal CCS tax credits. The MOU extends credits and other incentives to EOR, which improves the value proposition for carbon capture.
Under the MOU, Alberta agrees to raise its industrial carbon pricing from the current $95 per tonne to a minimum of $130 per tonne under its TIER system (Technology Innovation and Emission Reduction).
The biggest bang for the buck
Using a price of $130 to $150 per tonne, Clean Prosperity looked at two main pathways to GHG reductions: fuel switching in the power sector and CCS.
Fuel switching would involve replacing natural gas power generation with renewables, nuclear power, renewable natural gas or hydrogen.
“We calculated that fuel switching is more expensive,” Brendan Frank, director of policy and strategy for Clean Prosperity, told me.
Achieving the same GHG reductions through fuel switching would require industrial carbon prices of $300 to $1,000 per tonne, Frank said.
Clean Prosperity looked at five big sectoral emitters: oil and gas extraction, chemical manufacturing, pipeline transportation, petroleum refining, and cement manufacturing.
“We find that CCUS represents the largest opportunity for meaningful, cost-effective emissions reductions across five sectors,” the report states.

Fuel switching requires higher carbon prices than CCUS.
Measures like energy efficiency and methane abatement are included in Clean Prosperity’s calculations, but again CCS takes the biggest bite out of Alberta’s GHGs.
“Efficiency and (methane) abatement are a portion of it, but it’s a fairly small slice,” Frank said. “The overwhelming majority of it is in carbon capture.”

From left, Alberta Minister of Energy Marg McCuaig-Boyd, Shell Canada President Lorraine Mitchelmore, CEO of Royal Dutch Shell Ben van Beurden, Marathon Oil Executive Brian Maynard, Shell ER Manager, Stephen Velthuizen, and British High Commissioner to Canada Howard Drake open the valve to the Quest carbon capture and storage facility in Fort Saskatchewan Alta, on Friday November 6, 2015. Quest is designed to capture and safely store more than one million tonnes of CO2 each year an equivalent to the emissions from about 250,000 cars. THE CANADIAN PRESS/Jason Franson
Credit where credit is due
Setting an industrial carbon price is one thing. Putting it into effect through a workable carbon credit market is another.
“A high headline price is meaningless without higher credit prices,” the report states.
“TIER credit prices have declined steadily since 2023 and traded below $20 per tonne as of November 2025. With credit prices this low, the $95 per tonne headline price has a negligible effect on investment decisions and carbon markets will not drive CCUS deployment or fuel switching.”
Clean Prosperity recommends a kind of government-backstopped insurance mechanism guaranteeing carbon credit prices, which could otherwise be vulnerable to political and market vagaries.
Specifically, it recommends carbon contracts for difference (CCfD).
“A straight-forward way to think about it is insurance,” Frank explains.
Carbon credit prices are vulnerable to risks, including “stroke-of-pen risks,” in which governments change or cancel price schedules. There are also market risks.
CCfDs are contractual agreements between the private sector and government that guarantees a specific credit value over a specified time period.
“The private actor basically has insurance that the credits they’ll generate, as a result of making whatever low-carbon investment they’re after, will get a certain amount of revenue,” Frank said. “That certainty is enough to, in our view, unlock a lot of these projects.”
From the perspective of Canadian CCS equipment manufacturers like Vancouver’s Svante, there is one policy piece still missing from the MOU: eligibility for the Clean Technology Manufacturing (CTM) Investment tax credit.
“Carbon capture was left out of that,” said Svante co-founder Brett Henkel said.
Svante recently built a major manufacturing plant in Burnaby for its carbon capture filters and machines, with many of its prospective customers expected to be in the U.S.
The $20 billion Pathways project could be a huge boon for Canadian companies like Svante and Calgary’s Entropy. But there is fear Canadian CCS equipment manufacturers could be shut out of the project.
“If the oil sands companies put out for a bid all this equipment that’s needed, it is highly likely that a lot of that equipment is sourced outside of Canada, because the support for Canadian manufacturing is not there,” Henkel said.
Henkel hopes to see CCS manufacturing added to the eligibility for the CTM investment tax credit.
“To really build this eco-system in Canada and to support the Pathways Alliance project, we need that amendment to happen.”
Resource Works News
-
International2 days agoOttawa is still dodging the China interference threat
-
Agriculture8 hours agoEnd Supply Management—For the Sake of Canadian Consumers
-
Business2 days agoThere’s No Bias at CBC News, You Say? Well, OK…
-
Automotive2 days agoCanada’s EV gamble is starting to backfire
-
Digital ID6 hours agoCanadian government launches trial version of digital ID for certain licenses, permits
-
Alberta5 hours agoAlberta Next Panel calls to reform how Canada works
-
Business3 hours agoThe “Disruptor-in-Chief” places Canada in the crosshairs
-
International2 days ago2025: The Year The Narrative Changed


