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Alberta

Alberta’s health funding reform offers hope for the rest of Canada

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This article supplied by Troy Media.

Troy Media By Michel Gagnon and Krystle Wittevrongel

Alberta’s shift to activity-based hospital funding could be the blueprint other provinces need to fix Canada’s ailing health-care system

Canada’s health-care system is broken, and most Canadians have given up hope it will improve. Delayed surgeries, overcrowded emergency rooms and long wait times have become the norm. But in Alberta, there is finally a reason to believe change is possible.

The Smith government has announced plans to overhaul hospital funding by introducing activity-based funding, a model where hospitals are paid based on the number and type of treatments they provide, rather than receiving a fixed annual lump sum.

Currently, Alberta uses global budgets: hospitals receive a set amount each year, usually based on the previous year’s volume, regardless of how many patients they end up treating. This rigid funding model limits hospitals’ ability to respond to growing demand and discourages efficiency. It’s a little like only stocking two lifejackets on a boat because two people fell in the water last time around. Under this system, patients become a financial burden, creating an incentive to ration care.

The Montreal Economic Institute has advocated for change since 2012. About a year ago, we urged Alberta to abandon global budgeting in favour of a model that lets money follow the patient. Activity-based funding does just that, rewarding hospitals for providing timely, efficient care rather than merely staying afloat within a fixed budget.

Other countries with universal health care have already embraced this approach. Canada remains a notable outlier among OECD nations. Australia adopted activity-based funding 30 years ago. Within a year, care volumes rose and wait times dropped by 16 per cent. Today, this model accounts for 87 per cent of hospital funding in Australia. In 2022, the median wait time for hip replacement surgery was 232 days in Alberta, compared to 175 days in Australia. Importantly, countries such as Australia and Sweden maintained universal access to care while adopting this system.

Closer to home, Quebec’s gradual shift to activity-based funding has also yielded encouraging results. After the province applied the change to MRIs, costs fell by four per cent and procedures increased by 22 per cent. In radiology and oncology, costs dropped by seven per cent while productivity rose by 26 per cent. Quebec now aims for full adoption by 2027-28, showing that meaningful change is possible within our public system.

These examples show that a better way is possible. Yet most provinces remain stuck in outdated funding models that reward bureaucracy over patient care. If Alberta and Quebec can move forward, so can others. The case for action is national, not just provincial.

Of course, no funding model is without its flaws. That’s why Alberta is taking a phased approach, beginning with a pilot program and consultations to make sure the system fits the province’s needs before the full rollout in 2026. The good news is Alberta doesn’t have to start from scratch. Countries like the United Kingdom, Norway, Sweden and Australia have already faced—and overcome—common challenges such as gaming the coding system (inflating or misclassifying treatments to receive higher payments) or favouring quantity over quality. With the right safeguards in place, hospitals can stay focused on delivering care, not just managing budgets.

Alberta’s move to activity-based funding gives patients something rare in Canadian health care: a real reason to hope for better. But this  opportunity shouldn’t be limited to one province. With its thoughtful approach and clear commitment to reform, Alberta is offering the rest of Canada a blueprint for fixing what’s broken. Other provinces should take notice—and follow its lead.

Michel Kelly-Gagnon is founding president, and Krystle Wittevrongel is director of research at the Montreal Economic Institute, a think-tank with offices in Montreal Ottawa and Calgary.

Troy Media empowers Canadian community news outlets by providing independent, insightful analysis and commentary. Our mission is to support local media in helping Canadians stay informed and engaged by delivering reliable content that strengthens community connections and deepens understanding across the country

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Alberta

Oil Sands are the Costco of world energy – dependable and you know exactly where to find it

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From Resource Works

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Canada’s secret energy advantage: long life, no decline

Frankly, Canadians should hold the oil sands in higher esteem. The more I see how the world really works, the prouder I am of this resource.

When Fatih Birol, Executive Director of the International Energy Agency, speaks, the world listens. His latest warning is blunt: decline rates are the elephant in the room for global energy.

Oil and gas fields almost everywhere face natural decline. Shale wells lose about 70 per cent of their output in the first year. Many conventional reservoirs also taper off, often in the range of 5 to 7 per cent annually, though actual decline rates vary widely depending on geology and field management. The result is that nearly 90 per cent of global upstream spending now goes simply to replacing lost supply.

Fatih Birol, Executive Director of the International Energy Agency, at right with the author in Winnipeg in 2017.

Birol estimates that it is taking about $500 billion a year just to keep the industry running in place. If that stopped, the world would lose the equivalent of Brazil’s and Norway’s combined production every year. That’s how steep the slope has become.

Which brings us to Canada’s quiet advantage. Our oil sands — especially the mining and upgrading projects in northern Alberta — don’t behave like shale. Once built, they produce steadily for forty years or more. No frantic drilling treadmill. No production cliff.

Oil sands insiders call this the “long life, no decline” advantage.

It may sound like inside baseball. But in energy economics, this distinction is huge. In fact, it’s so critical that one of the nation’s largest energy producers, Calgary’s Canadian Natural Resources, recently devoted an entire investor slide to it, spelling out the contrast between shale and oil sands. When a major company takes the trouble to educate even sophisticated investors, you start to suspect the point isn’t as widely understood as it should be.

 

Another underappreciated benefit of this advantage is what it makes possible on the decarbonization front. Because oil sands production is steady for decades, these assets provide a stable platform to deploy major emissions-reduction technologies — carbon capture and storage, small modular nuclear reactors, advanced heat recovery. These are not quick fixes; they require billions in upfront capital and long timelines to pay back. That kind of commitment makes little sense if your underlying resource base is collapsing year after year. Canada’s stability means we can make those big bets. When Prime Minister Mark Carney refers to “decarbonized oil”, some might dismiss that as magical thinking, but I’m pretty sure what he means is oil sands deposits that can be subject to long-term, intensive efforts to do all of these things – a luxury not available to those whose eggs are all in the drilling basket.

But there’s a bigger geopolitical conversation here. Surely if the United States wants to secure abundant oil in its own “backyard,” the logical step would be to ensure there is enough pipeline capacity from Canada. We’ve been here before with Keystone XL. The project became a political lightning rod, but the fundamental logic has not changed: the U.S. and their refineries will need reliable long-life oil for decades to come. Canada has it. The question is whether Washington is prepared to act in its own strategic interest.

That means the long life, no decline message is not just an investor presentation footnote. It’s a fact that needs to be recognized in Ottawa, in Washington, and across the Canadian public. In Ottawa, because policymakers must grasp that the oil sands are the crown jewel of Canada’s resource economy.

What Washington needs to keep front of mind is that Canada is not just a friendly neighbour — we are a cornerstone of North American energy security. Canadians, whose views have been shaped by years of opposition campaigns that tried to make us ashamed of the oil sands, seem to be open again to the possibility that energy is more complicated that polarized public debates often make out.

Frankly, Canadians should hold the oil sands in higher esteem. The more I see how the world really works, the prouder I am of this resource.

To understand in more detail what this long life, no decline phrase is all about, think of it this way. For decades, the global oil system has resembled hunting and gathering. Companies poke holes in the ground, chase short-lived wells, and then move on to the next patch. Technology has reduced the uncertainty, but the feel is still primitive — like a parent rushing to the corner store every night for a quart of milk. It works, but it’s expensive, unreliable, and not built for the long haul.

Canada’s oil sands are the opposite. They are the Costco of energy: a big-box supply that doesn’t run out after one trip. Instead of scrambling for the next well, the resource is completely known, concentrated in one place, and designed for decades of steady output. That allows entire communities, supply chains, railroads, and international ports to grow around it. The oil sands are less like hunting and more like a factory — stable, predictable, and always in stock.

If Costco can sell loyalty with a simple membership card, why can’t we brand Canada’s enduring energy advantage just as boldly?

Great observers of energy markets like Daniel Yergin and Anas Alhajji have hinted at this for years: decline is relentless, durable resources are rare, and those who hold them wield strategic power. The IEA’s latest report confirms it. Four out of five barrels of oil today come from fields already past peak. Nine out of ten cubic metres of natural gas come from the same category. The world isn’t just chasing new demand growth — it’s sprinting to replace what geology is taking away.

And indicators are that American oil producers sense the easy years of global oil dominance are fading fast. “The US shale business is broken,” said one executive recently, according to the Financial Times. “What was once the world’s most dynamic energy engine has been gutted by political hostility and economic ignorance.”

That’s why Canada’s message has to be clear and confident. This is not the time to downplay the value of our oil sands. It’s time to explain, unapologetically, that in a world of decline, Canada’s long-life, no-decline resources are indispensable.

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Alberta

Fact, fiction, and the pipeline that’s paying Canada’s rent

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From Resource Works

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Is the Trans Mountain a fake, like some say the moon landing was faked?

It’s hard to interpret otherwise a persistent claim being made in media by British Columbia’s premier, David Eby.

This week he said that Alberta is “not even using” the new Trans Mountain pipeline from Edmonton to Metro Vancouver.

Could that be true? We decided to look into it.

Here’s what we discovered.

Since May 2024 when the Trans Mountain expansion project was opened, Alberta oil has flowed steadily down the pipeline from its origin in a suburb of Edmonton.

Credible international news organizations have reported that the new pipeline is 85% full. Indications are that by the period 2027-28, it will reach as close to 100% full as it’s possible to.

The number of ship calls to the Westridge coastal loading facility in Burnaby is on track to reach 400 by the end of the year. This strongly supports the contention that Alberta oil is flowing through the pipeline.

https://www.statcan.gc.ca/o1/en/plus/8439-trans-mountain-pipeline-delivering

I often say Trans Mountain is “paying Canada’s rent,” and I mean it literally. Ottawa owns the pipeline through Trans Mountain Corporation, and it’s already sending more than a billion dollars a year back to the federal treasury in dividends, interest, and fees.

It’s also boosting export revenues by letting Alberta oil reach world markets instead of being trapped at a discount — raising royalties, taxes, and paycheques across the Prairies. And every tanker that sails from Burnaby keeps tug crews, port workers, and coastal suppliers in business. That’s real money flowing through the economy — the kind that actually pays the rent for Canada.

In total, Resource Works examined nine claims that would all need to be true if Premier Eby is telling the truth about the pipeline being empty:

Truth Test: “Alberta isn’t even using the pipeline we bought them last time.”

Category Claim or Implication Evidence / Data Source(s) Finding / Truth Rating
1. Pipeline utilization TMX is unused or empty. Trans Mountain reports 757,000 bpd throughput on an 890,000 bpd capacity system (≈ 85 %). Trans Mountain Q1 2025 Financial Results; Reuters (30 Jul 2025). ❌ False — pipeline is heavily used and approaching full capacity.
2. Export volumes Few or no shipments. 306 vessels loaded at Westridge Marine Terminal by Q2 2025 (~20–25 per month). Trans Mountain Q2 2025 Results; CER Market Snapshot (Sept 2025). ❌ False — consistent, large-scale exports are underway.
3. Financial returns No financial benefit to Canadians. $729 million returned to federal government YTD 2025; projected >$1.25 billion for year. Trans Mountain Q2 2025 Results. ❌ False — major positive fiscal returns already realized.
4. Shipper commitments No demand for pipeline capacity. 80 % of capacity contracted to long-term shippers; 20 % reserved for spot. S&P Global Commodity Insights (Feb 2025); CER Snapshot. ❌ False — demand is locked in by long-term contracts.
5. Operational timeline Project still inactive or delayed. Commercial service began May 1 2024; steady throughput growth each quarter. Trans Mountain Corporate Reports 2024–25. ❌ False — fully operational since 2024.
6. Regulatory data No verified data exist. Monthly throughput published by CER and Trans Mountain Corp. Canada Energy Regulator (CER Data Portal). ❌ False — independent regulators in fact consistently confirm the data.
7. Market impact No improvement to Alberta’s market access. WCS-Brent differential narrowed; Asia exports up sharply. CER Market Snapshot (Sept 2025); S&P Global 2025 report. ❌ False — there is clear evidence of improved market access.
8. Ownership context B.C. or Alberta “owns” the pipeline. Owned by Government of Canada via Trans Mountain Corporation. Finance Canada; Trans Mountain Corp. Ownership Statement. ⚠️ Misleading — federal ownership doesn’t mean Eby “bought Trans Mountain for Alberta.”
9. Provincial benefit analysis No benefit to B.C. or Alberta. Royalties, tax revenue, and employment gains in both provinces; marine services in B.C. TMX Economic Impact Assessment 2024; CER regional reports. ❌ False — both provinces gain fiscal and employment benefits.

Last year, on three occasions I visited the Westridge Marine Terminal, twice on tours of the land-based facilities and the third time from the water. Ships were docked at the terminal on all three occasions, and I was told by staff that they were being loaded.

I didn’t actually see any oil at the oil terminal, but…

I have to admit I did not actually see (or smell) any oil. But I’m also aware that it is very much in the interest of the Trans Mountain Corporation to never expose any oil to where it can be seen, touched or smelled, since this would result in stiff fines and other harsh repercussions.

At this point, I have to say that there is no supporting evidence whatsoever that Alberta is using the Trans Mountain pipeline as a moon landing style hoax for some nefarious goal. There is no sign of a massive fraud that required collaboration among energy regulators, Alberta oil producers, the pipeline company, the international business press, numerous federal ministers, trade union leaders, numerous environmental organizations that expend enormous efforts to try to curtail shipments of the oil that they say moves through the pipeline, and the many First Nations that have actively supported from and benefit from the project in its completed state.

Of course, I’m well aware there is a political context here. Since October 1, Premier Eby has been engaged in a war of words with Alberta Premier Danielle Smith. She announced that she is determined to see get built another new pipe from her province to a federally regulated port somewhere on the Pacific coast.

And to be clear, this isn’t about giving Alberta a free pass. Premier Smith isn’t blameless either — she’s been happy to turn complex national issues into provincial sound bites when it suits her. The difference is that Canada can’t afford leaders on either side of the Rockies who substitute theatre for truth.

Premier Eby is right when he says British Columbians should not be forced to give up opportunities because another province wants to do something. Labour market fears are legitimate as we’ve seen in the recent past. But when it comes to infrastructure and investment opportunities, time and again Canadians have learned the hard way that “a bird in the hand is worth two in the bush.” There is no guarantee that today’s opportunities, pushed away, will materialize again at any point in the future.

There’s also a public context. At no moment in recent times have British Columbia residents been more supportive of the idea of building more oil pipeline infrastructure. The following slide from a poll by Innovative Research Group (shared by pollster Greg Lyle at a recent event organized by Resource Works) is consistent with other findings:

Even without out this quite exceptional condition, the current situation deserves a vigorous public conversation. It also deserves the truthful use of information.

My final verdict is this: We can all be fully confident that the Trans Mountain Expansion is indeed 85 per cent full, that hundreds of tankers have already sailed, and that more than a billion dollars has flowed back to Canadians.

Bottom Line

The facts show a functioning, profitable national asset:

  • Operational since May 2024
  • 85% utilized and rising
  • Hundreds of ships exporting Canadian oil
  • Over $1 billion flowing back to the public purse from Trans Mountain – that’s even before counting the upstream employment and impacts

This Resource Works analysis is based on public reports from Trans Mountain Corporation (2024 & 2025), Canada Energy Regulator (2025), Statistics Canada, S&P Global Commodity Insights, and Reuters.

Stewart Muir, visting the Trans Mountain pipeline’s Westridge Marine Terminal.

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