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Alberta

Alberta government should reform hospital funding to help shorten wait times

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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.

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Alberta

The case for expanding Canada’s energy exports

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From the Canadian Energy Centre

By Deborah Jaremko

For Canada, the path to a stronger economy — and stronger global influence — runs through energy.

That’s the view of David Detomasi, a professor at the Smith School of Business at Queen’s University.

Detomasi, author of Profits and Power: Navigating the Politics and Geopolitics of Oil, argues that there is a moral case for developing Canada’s energy, both for Canadians and the world.

David Detomasi. Photo courtesy Smith School of Business, Queen’s University

CEC: What does being an energy superpower mean to you?

DD: It means Canada is strong enough to affect the system as a whole by its choices.

There is something really valuable about Canada’s — and Alberta’s — way of producing carbon energy that goes beyond just the monetary rewards.

CEC: You talk about the moral case for developing Canada’s energy. What do you mean? 

DD: I think the default assumption in public rhetoric is that the environmental movement is the only voice speaking for the moral betterment of the world. That needs to be challenged.

That public rhetoric is that the act of cultivating a powerful, effective economic engine is somehow wrong or bad, and that efforts to create wealth are somehow morally tainted.

I think that’s dead wrong. Economic growth is morally good, and we should foster it.

Economic growth generates money, and you can’t do anything you want to do in social expenditures without that engine.

Economic growth is critical to doing all the other things we want to do as Canadians, like having a publicly funded health care system or providing transfer payments to less well-off provinces.

Over the last 10 years, many people in Canada came to equate moral leadership with getting off of oil and gas as quickly as possible. I think that is a mistake, and far too narrow.

Instead, I think moral leadership means you play that game, you play it well, and you do it in our interest, in the Canadian way.

We need a solid base of economic prosperity in this country first, and then we can help others.

CEC: Why is it important to expand Canada’s energy trade?

DD: Canada is, and has always been, a trading nation, because we’ve got a lot of geography and not that many people.

If we don’t trade what we have with the outside world, we aren’t going to be able to develop economically, because we don’t have the internal size and capacity.

Historically, most of that trade has been with the United States. Geography and history mean it will always be our primary trade partner.

But the United States clearly can be an unreliable partner. Free and open trade matters more to Canada than it does to the U.S. Indeed, a big chunk of the American people is skeptical of participating in a global trading system.

As the United States perhaps withdraws from the international trading and investment system, there’s room for Canada to reinforce it in places where we can use our resource advantages to build new, stronger relationships.

One of these is Europe, which still imports a lot of gas. We can also build positive relationships with the enormous emerging markets of China and India, both of whom want and will need enormous supplies of energy for many decades.

I would like to be able to offer partners the alternative option of buying Canadian energy so that they are less reliant on, say, Iranian or Russian energy.

Canada can also maybe eventually help the two billion people in the world currently without energy access.

CEC: What benefits could Canadians gain by becoming an energy superpower? 

DD: The first and primary responsibility of our federal government is to look after Canada. At the end of the day, the goal is to improve Canada’s welfare and enhance its sovereignty.

More carbon energy development helps Canada. We have massive debt, an investment crisis and productivity problems that we’ve been talking about forever. Economic and job growth are weak.

Solving these will require profitable and productive industries. We don’t have so many economic strengths in this country that we can voluntarily ignore or constrain one of our biggest industries.

The economic benefits pay for things that make you stronger as a country.

They make you more resilient on the social welfare front and make increasing defence expenditures, which we sorely need, more affordable. It allows us to manage the debt that we’re running up, and supports deals for Canada’s Indigenous peoples.

CEC: Are there specific projects that you advocate for to make Canada an energy superpower?

DD: Canada’s energy needs egress, and getting it out to places other than the United States. That means more transport and port facilities to Canada’s coasts.

We also need domestic energy transport networks. People don’t know this, but a big chunk of Ontario’s oil supply runs through Michigan, posing a latent security risk to Ontario’s energy security.

We need to change the perception that pipelines are evil. There’s a spiderweb of them across the globe, and more are being built.

Building pipelines here, with Canadian technology and know-how, builds our competitiveness and enhances our sovereignty.

Economic growth enhances sovereignty and provides the resources to do other things. We should applaud and encourage it, and the carbon energy sector can lead the way.

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Agriculture

Growing Alberta’s fresh food future

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A new program funded by the Sustainable Canadian Agricultural Partnership will accelerate expansion in Alberta greenhouses and vertical farms.

Albertans want to keep their hard-earned money in the province and support producers by choosing locally grown, high-quality produce. The new three-year, $10-milllion Growing Greenhouses program aims to stimulate industry growth and provide fresh fruit and vegetables to Albertans throughout the year.

“Everything our ministry does is about ensuring Albertans have secure access to safe, high-quality food. We are continually working to build resilience and sustainability into our food production systems, increase opportunities for producers and processors, create jobs and feed Albertans. This new program will fund technologies that increase food production and improve energy efficiency.”

RJ Sigurdson, Minister of Agriculture and Irrigation

“Through this investment, we’re supporting Alberta’s growers and ensuring Canadians have access to fresh, locally-grown fruits and vegetables on grocery shelves year-round. This program strengthens local communities, drives innovation, and creates new opportunities for agricultural entrepreneurs, reinforcing Canada’s food system and economy.”

Heath MacDonald, federal Minister of Agriculture and Agri-Food

The Growing Greenhouses program supports the controlled environment agriculture sector with new construction or expansion improvements to existing greenhouses and vertical farms that produce food at a commercial scale. It also aligns with Alberta’s Buy Local initiative launched this year as consumers will be able to purchase more local produce all year-round.

The program was created in alignment with the needs identified by the greenhouse sector, with a goal to reduce seasonal import reliance entering fall, which increases fruit and vegetable prices.

“This program is a game-changer for Alberta’s greenhouse sector. By investing in expansion and innovation, we can grow more fresh produce year-round, reduce reliance on imports, and strengthen food security for Albertans. Our growers are ready to meet the demand with sustainable, locally grown vegetables and fruits, and this support ensures we can do so while creating new jobs and opportunities in communities across the province. We are very grateful to the Governments of Canada and Alberta for this investment in our sector and for working collaboratively with us.”

Michiel Verheul, president, Alberta Greenhouse Growers Association

Sustainable Canadian Agricultural Partnership (Sustainable CAP)

Sustainable CAP is a five-year, $3.5-billion investment by federal, provincial and territorial governments to strengthen competitiveness, innovation and resiliency in Canada’s agriculture, agri-food and agri-based products sector. This includes $1 billion in federal programs and activities and $2.5 billion that is cost-shared 60 per cent federally and 40 per cent provincially/territorially for programs that are designed and delivered by provinces and territories.

Quick facts

  • Alberta’s greenhouse sector ranks fourth in Canada:
  • 195 greenhouses produce $145 million in produce and 60 per cent of them operate year-round.
  • Greenhouse food production is growing by 6.2 per cent annually.
  • Alberta imports $349 million in fresh produce annually.
  • The program supports sector growth by investing in renewable and efficient energy systems, advanced lighting systems, energy-saving construction, and automation and robotics systems.

Related information

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