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Alberta

Bureaucratic shuffle not enough to fix health care in Alberta

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From the Fraser Institute

By Nadeem Esmail

Alberta Premier Danielle Smith spent a good portion of her yearend interviews discussing upcoming changes to the province’s health-care system including the shift from the single Alberta Health Services to multiple authorities each tasked with overseeing one area of the health-care system. But will the government pair this bureaucratic shuffle with reforms that will actually improve matters for Albertans?

Indeed, Albertans shouldn’t get too excited about reforms to the health-care system’s administrative structure. Back in 2008, Alberta Health Services replaced nine regional health boards, which themselves were amalgamated from 17 authorities created in 1994. Yet wait lists grew continuously over the entire period up to new record highs in 2023.

In 1993, a typical Albertan could expect to wait 10.5 weeks between GP referral and treatment by a medical specialist. By 2008, that wait time had increased to 18.5 weeks and now stands at a remarkable 33.5 weeks (longer than the national median wait of 27.7 weeks).

A lack of money is absolutely not to blame. On the contrary, Alberta’s provincial health-care spending ranked second-highest per person (after adjusting for age and sex) in 2021, while Canada nationally is a relatively high spender among universal health-care countries. At the same time, Canada ranks near the bottom for the availability of medical professionals, medical technologies and hospital resources. And Canadian patients suffer some of the longest delays for access to care in the developed world.

In other words, there’s much more wrong with health care in Alberta than the number of authorities overseeing the governmental system.

So what’s the solution?

Simply put, Alberta should learn from other countries that deliver more timely universal care with comparable spending such as Switzerland, Australia and Germany. For example, in 2020 (the latest year of available data) only 62 per cent of patients in Canada received elective care within four months compared to 72 per cent in Australia, 94 per cent in Switzerland and 99 per cent in Germany.

What do these countries do differently? They all have private competitive providers delivering universally accessible services within the public system, and payment for such care is based on actual delivery of services, known as “activity-based” funding.

Based on details released so far, the Smith government’s bureaucratic shuffle appears to bear little resemblance to these higher-performing approaches pursued abroad. In fact, it looks a lot like the provincial government working from the same old playbook, with another costly exercise to distract Albertans from the real problems in their health-care system. If that’s all this reform amounts to, then we can expect no real improvement for Albertans in need of care or the taxpayers who fund it.

On the bright side, there’s some hope that the Smith government is setting the stage for more meaningful reform. To move toward a higher-performing model with competitive patient-focused delivery, the government must first separate and clearly define the roles of the purchaser of health care and the providers of that care. If moving from one large health authority to multiple authorities is about more clearly defining government’s role as the purchaser and oversight authority for universal health care, with authorities and providers being transparently accountable for delivering timely quality care to patients, then Albertans may be on the road to shorter wait times and higher-quality health care.

But we’ll have to wait and see.

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Alberta

Provinces should be cautious about cost-sharing agreements with Ottawa

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From the Fraser Institute

By Tegan Hill and Jake Fuss

According to Premier Danielle Smith, Alberta will withdraw from the federal government’s dental care plan by 2026 mainly because the plan would duplicate coverage already provided to many Albertans (although she plans to negotiate unconditional funding in lieu of being in the program). Indeed, all provinces should be wary of entering into such agreements as history has shown that Ottawa can reduce or eliminate funding at any time, leaving the provinces holding the bag.

In the 1990s, for instance, the federal government reduced health and social transfers to the provinces amid a fiscal crisis fuelled by decades of unrestrained spending and persistent deficits (and worsened by high interest rates). Gross federal debt increased from $38.9 billion in 1970/71 to $615.9 billion in 1993/94, at which point debt interest costs consumed roughly $1 in every $3 of federal government revenue.

In response to this debt crisis, the Chrétien Liberal government reduced spending across nearly all federal departments and programs. Over a three-year period to 1996/97, health and social transfers to the provinces were 51 per cent ($41.0 billion) less than what the provinces expected based on previous transfers. In other words, the provinces suddenly got a lot less money from Ottawa than they anticipated.

This should serve as a warning for the provinces who may find themselves on the hook for Ottawa’s big spending today. In the case of dental care, an area of provincial jurisdiction, the Trudeau government has earmarked $4.4 billion  annually for the provinces on an ongoing basis. However, any change in federal priorities or federal finances could swing the financial burden from Ottawa to the provinces to maintain the program.

The current state of federal finances only heightens this risk to the provinces. The federal government has run uninterrupted budget deficits since 2007/08, with total federal debt climbing from $707.3 billion in 2007/08 to a projected $2.1 trillion in 2024/25. The current government—or perhaps a future reform-minded government focused on balancing the budget—could reduce transfers to the provinces.

The Trudeau government has committed to significant new funding in areas of provincial jurisdiction, but provincial policymakers would do well to understand the risks of entering into such agreements. Ottawa can unilaterally reduce or eliminate funding at any point, leaving provinces to either assume the unexpected financial burden through higher taxes or additional borrowing, or curtail the programs.

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Alberta

Just in time for Canada Day weekend! Crescent Falls ready to be enjoyed again

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The new staircase structure and viewing platform are among many upgrades that visitors can look forward to at the reopening Crescent Falls Provincial Recreation Area. (Credit: Alberta Parks).

The popular Crescent Falls Provincial Recreation Area reopens following a significant capital investment to improve visitor safety and experiences.

Crescent Falls Provincial Recreation Area is ready to welcome visitors back to enjoy one of the most remarkable, accessible waterfall viewing opportunities in Alberta. The upgrades at Crescent Falls will help improve the park’s visitor experience. Guests can expect expanded parking, improved access roads, trails and day use areas, new and improved viewing areas to take in the falls and upgraded safety measures, including signage and wayfinding.

The Provincial Recreation Area (PRA) is reopening over the July long weekend after being closed since 2023. Visitors will notice increased public safety upgrades through additions such as new parking lots, a new stair structure to access the lower falls, new pedestrian trails, a new vehicle bridge to access the camping area and a viewing platform to enjoy the Crescent Falls.

“We are thrilled to welcome visitors back to Crescent Falls Provincial Recreation Area in time for the Canada Day long weekend. These additions will help visitors to safely access and enjoy the area’s natural beauty. Parks are for people and Alberta’s government will continue to invest in high-quality outdoor recreation opportunities.”

Todd Loewen, Minister of Forestry and Parks

“Today marks a significant milestone for our community as we reopen the Crescent Falls Provincial Recreation Area following extensive upgrades. Our province is well known for its incredible natural beauty, and these improvements will make our backcountry more accessible and ensure that Albertans and those visiting our great province can continue to explore our stunning landscapes for years to come.”

Jason Nixon, MLA for Rimbey-Rocky Mountain House-Sundre
This project is part of an investment of more than $12 million to upgrade 13 sites along the David Thompson Corridor. The improvements at Crescent Falls will provide improved safety measures and better visitor access to and from popular tourist destinations in the area. Partners from Clearwater County, Rocky Mountain House and other organizations were critical in helping to move the upgrades forward. Clearwater County and its officials worked with Alberta Parks staff to advise on the upgrades needed around the area.

Alberta’s government is committed to reconciliation and acknowledges the significance of the land around Crescent Falls Provincial Recreation Area to the Stoney Nakoda First Nation. The completed upgrades reflect an ongoing commitment to creating more outdoor recreation opportunities while protecting the land’s natural and cultural values so it can be enjoyed by current and future generations.

“The Alberta Government’s reopening of Crescent Falls is a remarkable achievement for our region. This project not only enhances recreational opportunities, natural beauty and accessibility in our area but also means safer, more enjoyable visits for our citizens and visitors alike.”

Michelle Swanson, councillor, Clearwater County

“The Town of Rocky Mountain House is where adventure begins, and we are thrilled that Crescent Falls Provincial Recreation Area has reopened to the public in time for the summer adventure season. This is a wonderful day trip destination for visitors and residents alike setting out from Rocky Mountain House. The provincial investment has only improved its accessibility and safety, making it a must-see destination if you are in the area.”

Dale Shippelt, incoming deputy mayor, Rocky Mountain House

“Westward Bound Campgrounds is the proud facility operator of the Crescent Falls Provincial Recreation Area and we are very excited to see our campers and visitors return to its beauty. These upgrades will have a significant impact on enhancing guest satisfaction levels, providing unique and memorable camper and visitor experiences while providing a safe environment to enjoy spectacular scenery.”

Lonnie and Edena Earl, Westward Bound Campgrounds

This work is part of an ongoing commitment to creating more outdoor recreation and camping opportunities, building trails and facilities and ensuring Alberta’s provincial parks can be enjoyed by all Albertans.

Quick facts

  • The upgrades at Crescent Falls PRA include the following improvements:
    • Enlarging the existing parking area
    • Developing a new parking area for large RV vehicles
    • Upgrading the access roads down to the lower area
    • Installing a new pedestrian trail to the lower day use area
    • Installing a new vehicle crossing from the day use to the camping site
    • Upgrading and expanding the day use areas
    • Increasing signage
    • Installing additional toilets and bear-proof garbage bins
    • Developing a new stair structure to access the lower falls areas with a viewing platform
  • Enhancing safety features throughout the PRA. The upgrades were part of a significant capital investment of $12.3 million by Alberta’s government to address safety and experience opportunities in 13 key provincial recreation sites along the David Thompson Corridor. Along with Crescent Falls PRA, other sites that were upgraded include:
    • Bighorn Dam Recreation Area
    • The following 11 Public lands and parks sites:
    • Coliseum
    • Allstone
    • Abraham Slabs
    • Hoo Doo Creek
    • Coral Creek
    • Pinto Creek
    • Preachers Point
    • Cavalcade
    • Kinglet/Tuff Puff
    • Wildhorse
    • Owen Creek
  • Crescent Falls PRA is located 22 km west of Nordegg on Highway 11 and 6 km north on a gravel access road. Crescent Falls PRA has a first-come, first-served campground with 12 tent-only sites and 22 RV sites. The day use area includes multiple viewing platforms of the upper and lower falls and picnic tables with views of the river. Access to the lower day use area is available on a 0.8 km trail from the main parking area or, alternatively, from the Bighorn Canyon lookout via a 3 km trail. The lower day use area also has accessible-only parking stalls adjacent to the viewing platforms with an accessible vault toilet and picnic areas.

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