Alberta
Bureaucratic shuffle not enough to fix health care in Alberta
From the Fraser Institute
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.
Author:
Alberta
Official statement from Premier Danielle Smith and Energy Minister Brian Jean on the start-up of the Trans Mountain Pipeline
Alberta
Protecting the right to vote for Canadian citizens: Minister McIver
Minister of Municipal Affairs Ric McIver issued the following statement in response to Calgary City Council’s vote to extend the right to vote to permanent residents:
“Yesterday, Calgary city council passed a motion advocating for permanent residents to be extended the right to vote in civic elections. Alberta’s government has been clear since the beginning: only Canadian citizens are able to vote in civic elections. That will not be changing.
“The Canadian Charter of Rights and Freedoms affirms the right of every Canadian citizen to vote and to run as a candidate. This right extends to voters in municipal, provincial and federal elections.
“Protecting our democracy is of the utmost importance. Our provincial election legislation, like the Local Authorities Elections Act, has also been clear since its inception that voting is a right of Canadian citizens.
“Alberta’s government is also ensuring that voting is accessible for more Albertans. The Municipal Affairs Statutes Amendment Act proposes to enable special ballot access for any voter who requests it, without having to provide any specific reason such as physical disability, absence from the municipality or working for the municipal election. The ministries of Seniors, Community and Social Services and Service Alberta and Red Tape Reduction are also making it easier for individuals to obtain the identification Albertans need for a variety of services, including the ability to cast a ballot.
“Our government will continue to protect the integrity of our elections and make sure voting is accessible for all Albertans who are Canadian citizens.”
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