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Alberta

Alberta takes big step towards shorter wait times and higher quality health care

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From the Fraser Institute

By Nadeem Esmail

On Monday, the Smith government announced that beginning next year it will change the way it funds surgeries in Alberta. This is a big step towards unlocking the ability of Alberta’s health-care system to provide more, better and faster services for the same or possibly fewer dollars.

To understand the significance of this change, you must understand the consequences of the current (and outdated) approach.

Currently, the Alberta government pays a lump sum of money to hospitals each year. Consequently, hospitals perceive patients as a drain on their budgets. From the hospital’s perspective, there’s little financial incentive to serve more patients, operate more efficiently and provide superior quality services.

Consider what would happen if your local grocery store received a giant bag of money each year to feed people. The number of items would quickly decline to whatever was most convenient for the store to provide. (Have a favourite cereal? Too bad.) Store hours would become less convenient for customers, alongside a general decline in overall service. This type of grocery store, like an Alberta hospital, is actually financially better off (that is, it saves money) if you go elsewhere.

The Smith government plans to flip this entire system on its head, to the benefit of patients and taxpayers. Instead of handing out bags of money each year to providers, the new system—known as “activity-based funding”—will pay health-care providers for each patient they treat, based on the patient’s particular condition and important factors that may add complexity or cost to their care.

This turns patients from a drain on budgets into a source of additional revenue. The result, as has been demonstrated in other universal health-care systems worldwide, is more services delivered using existing health-care infrastructure, lower wait times, improved quality of care, improved access to medical technologies, and less waste.

In other words, Albertans will receive far better value from their health-care system, which is currently among the most expensive in the world. And relief can’t come soon enough—for example, last year in Alberta the median wait time for orthopedic surgeries including hip and knee replacements was 66.8 weeks.

The naysayers argue this approach will undermine the province’s universal system and hurt patients. But by allowing a spectrum of providers to compete for the delivery of quality care, Alberta will follow the lead of other more successful universal health-care systems in countries such as Australia, Germany, the Netherlands and Switzerland and create greater accountability for hospitals and other health-care providers. Taxpayers will get a much better picture of what they’re paying for and how much they pay.

Again, Alberta is not exploring an untested policy. Almost every other developed country with universal health care uses some form of “activity-based funding” for hospital and surgical care. And remember, we already spend more on health care than our counterparts in nearly all of these countries yet endure longer wait times and poorer access to services generally, in part because of how we pay for surgical care.

While the devil is always in the details, and while it’s still possible for the Alberta government to get this wrong, Monday’s announcement is a big step in the right direction. A funding model that puts patients first will get Albertans more of the high-quality health care they already pay for in a timelier fashion. And provide to other provinces an example of bold health-care reform.

Nadeem Esmail

Senior Fellow, Fraser Institute

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Alberta

Alberta can’t fix its deficits with oil money: Lennie Kaplan

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This article supplied by Troy Media.

Troy MediaBy Lennie Kaplan

Alberta is banking on oil to erase rising deficits, but the province’s budget can’t hold without major fiscal changes

Alberta is heading for a fiscal cliff, and no amount of oil revenue will save it this time.

The province is facing ballooning deficits, rising debt and an addiction to resource revenues that rise and fall with global markets. As Budget 2026 consultations begin, the government is gambling on oil prices to balance the books again. That gamble is failing. Alberta is already staring down multibillion-dollar shortfalls.

I estimate the province will run deficits of $7.7 billion in 2025-26, $8.8 billion in 2026-27 and $7.5 billion in 2027-28. If nothing changes, debt will climb from $85.2 billion to $112.3 billion in just three years. That is an increase of more than $27 billion, and it is entirely avoidable.

These numbers come from my latest fiscal analysis, completed at the end of October. I used conservative assumptions: oil prices at US$62 to US$67 per barrel over the next three years. Expenses are expected to keep growing faster than inflation and population. I also requested Alberta’s five-year internal fiscal projections through access to information but Treasury Board and Finance refused to release them. Those forecasts exist, but Albertans have not been allowed to see them.

Alberta has been running structural deficits for years, even during boom times. That is because it spends more than it brings in, counting on oil royalties to fill the gap. No other province leans this hard on non-renewable resource revenue. It is volatile. It is risky. And it is getting worse.

That is what makes Premier Danielle Smith’s recent Financial Post column so striking. She effectively admitted that any path to a balanced budget depends on doubling Alberta’s oil production by 2035. That is not a plan. It is a fantasy. It relies on global markets, pipeline expansions and long-term forecasts that rarely hold. It puts taxpayers on the hook for a commodity cycle the province does not control.

I have long supported Alberta’s oil and gas industry. But I will call out any government that leans on inflated projections to justify bad fiscal choices.

Just three years ago, Alberta needed oil at US$70 to balance the budget. Now it needs US$74 in 2025-26, US$76.35 in 2026-27 and US$77.50 in 2027-28. That bar keeps rising. A single US$1 drop in the oil price will soon cost Alberta $750 million a year. By the end of the decade, that figure could reach $1 billion. That is not a cushion. It is a cliff edge.

Even if the government had pulled in $13 billion per year in oil revenue over the last four years, it still would have run deficits. The real problem is spending. Since 2021, operating spending, excluding COVID-19 relief, has jumped by $15.5 billion, or 31 per cent. That is nearly eight per cent per year. For comparison, during the last four years under premiers Ed Stelmach and Alison Redford, spending went up 6.9 per cent annually.

This is not a revenue problem. It is a spending problem, papered over with oil booms. Pretending Alberta can keep expanding health care, education and social services on the back of unpredictable oil money is reckless. Do we really want our schools and hospitals held hostage to oil prices and OPEC?

The solution was laid out decades ago. Oil royalties should be saved off the top, not dumped into general revenue. That is what Premier Peter Lougheed understood when he created the Alberta Heritage Savings Trust Fund in 1976. It is what Premier Ralph Klein did when he cut spending and paid down debt in the 1990s. Alberta used to treat oil as a bonus. Now it treats it as a crutch.

With debt climbing and deficits baked in, Alberta is out of time. I have previously laid out detailed solutions. But here is where the government should start.

First, transparency. Albertans deserve a full three-year fiscal update by the end of November. That includes real numbers on revenue, expenses, debt and deficits. The government must also reinstate the legal requirement for a mid-year economic and fiscal report. No more hiding the ball.

Second, a real plan. Not projections based on hope, but a balanced three-year budget that can survive oil prices dropping below forecast. That plan should be part of Budget 2026 consultations.

Third, long-term discipline. Alberta needs a fiscal sustainability framework, backed by a public long-term report released before year-end.

Because if this government will not take responsibility, the next oil shock will.

Lennie Kaplan is a former senior manager in the fiscal and economic policy division of Alberta’s Ministry of Treasury Board and Finance, where, among other duties, he examined best practices in fiscal frameworks, program reviews and savings strategies for non-renewable resource revenues. In 2012, he won a Corporate Values Award in TB&F for his work on Alberta’s fiscal framework review. In 2019, Mr. Kaplan served as executive director to the MacKinnon Panel on Alberta’s finances—a government-appointed panel tasked with reviewing Alberta’s spending and recommending reforms.

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Alberta

IEA peak-oil reversal gives Alberta long-term leverage

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This article supplied by Troy Media.

Troy MediaBy Rashid Husain Syed

The peak-oil narrative has collapsed, and the IEA’s U-turn marks a major strategic win for Alberta

After years of confidently predicting that global oil demand was on the verge of collapsing, the International Energy Agency (IEA) has now reversed course—a stunning retreat that shatters the peak-oil narrative and rewrites the outlook for oil-producing regions such as Alberta.

For years, analysts warned that an oil glut was coming. Suddenly, the tide has turned. The Paris-based IEA, the world’s most influential energy forecasting body, is stepping back from its long-held view that peak oil demand is just around the corner.

The IEA reversal is a strategic boost for Alberta and a political complication for Ottawa, which now has to reconcile its climate commitments with a global outlook that no longer supports a rapid decline in fossil fuel use or the doomsday narrative Ottawa has relied on to advance its climate agenda.

Alberta’s economy remains tied to long-term global demand for reliable, conventional energy. The province produces roughly 80 per cent of Canada’s oil and depends on resource revenues to fund a significant share of its provincial budget. The sector also plays a central role in the national economy, supporting hundreds of thousands of jobs and contributing close to 10 per cent of Canada’s GDP when related industries are included.

That reality stands in sharp contrast to Ottawa. Prime Minister Mark Carney has long championed net-zero timelines, ESG frameworks and tighter climate policy, and has repeatedly signalled that expanding long-term oil production is not part of his economic vision. The new IEA outlook bolsters Alberta’s position far more than it aligns with his government’s preferred direction.

Globally, the shift is even clearer. The IEA’s latest World Energy Outlook, released on Nov. 12, makes the reversal unmistakable. Under existing policies and regulations, global demand for oil and natural gas will continue to rise well past this decade and could keep climbing until 2050. Demand reaches 105 million barrels per day in 2035 and 113 million barrels per day in 2050, up from 100 million barrels per day last year, a direct contradiction of years of claims that the world was on the cusp of phasing out fossil fuels.

A key factor is the slowing pace of electric vehicle adoption, driven by weakening policy support outside China and Europe. The IEA now expects the share of electric vehicles in global car sales to plateau after 2035. In many countries, subsidies are being reduced, purchase incentives are ending and charging-infrastructure goals are slipping. Without coercive policy intervention, electric vehicle adoption will not accelerate fast enough to meaningfully cut oil demand.

The IEA’s own outlook now shows it wasn’t merely off in its forecasts; it repeatedly projected that oil demand was in rapid decline, despite evidence to the contrary. Just last year, IEA executive director Fatih Birol told the Financial Times that we were witnessing “the beginning of the end of the fossil fuel era.” The new outlook directly contradicts that claim.

The political landscape also matters. U.S. President Donald Trump’s return to the White House shifted global expectations. The United States withdrew from the Paris Agreement, reversed Biden-era climate measures and embraced an expansion of domestic oil and gas production. As the world’s largest economy and the IEA’s largest contributor, the U.S. carries significant weight, and other countries, including Canada and the United Kingdom, have taken steps to shore up energy security by keeping existing fossil-fuel capacity online while navigating their longer-term transition plans.

The IEA also warns that the world is likely to miss its goal of limiting temperature increases to 1.5 °C over pre-industrial levels. During the Biden years, the IAE maintained that reaching net-zero by mid-century required ending investment in new oil, gas and coal projects. That stance has now faded. Its updated position concedes that demand will not fall quickly enough to meet those targets.

Investment banks are also adjusting. A Bloomberg report citing Goldman Sachs analysts projects global oil demand could rise to 113 million barrels per day by 2040, compared with 103.5 million barrels per day in 2024, Irina Slav wrote for Oilprice.com. Goldman cites slow progress on net-zero policies, infrastructure challenges for wind and solar and weaker electric vehicle adoption.

“We do not assume major breakthroughs in low-carbon technology,” Sachs’ analysts wrote. “Even for peaking road oil demand, we expect a long plateau after 2030.” That implies a stable, not shrinking, market for oil.

OPEC, long insisting that peak demand is nowhere in sight, feels vindicated. “We hope … we have passed the peak in the misguided notion of ‘peak oil’,” the organization said last Wednesday after the outlook’s release.

Oil is set to remain at the centre of global energy demand for years to come, and for Alberta, Canada’s energy capital, the IEA’s course correction offers renewed certainty in a world that had been prematurely writing off its future.

Toronto-based Rashid Husain Syed is a highly regarded analyst specializing in energy and politics, particularly in the Middle East. In addition to his contributions to local and international newspapers, Rashid frequently lends his expertise as a speaker at global conferences. Organizations such as the Department of Energy in Washington and the International Energy Agency in Paris have sought his insights on global energy matters.

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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