Commentary

March 17, 2017

Albertans endure abysmal wait times despite 191% health-care spending increase over 15 years

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Another budget, another round of growth in health-care spending in Alberta.

The projected 3.2 per cent increase in health-care spending this year may sound reasonable at face-value since it’s generally in line with population growth and inflation. What’s missed is that not only does this not account for increased capital spending (such as new medical facilities), but this continued growth comes after years of staggering spending increases by consecutive governments.

In fact, over the last 15 years, Alberta’s provincial governments increased health-care spending by 191 per cent—faster than any other province in Canada, and almost double the growth of its economy over the same period. It’s no surprise then that health care now consumes a larger portion of both Alberta’s program spending and its economy than it did 15 years ago. Absent reforms, Albertans will likely continue to throw money at the problem while outcomes remain mediocre.

While the annual growth in spending is lower than it was through most of the 2000s, so is the province’s fiscal outlook. In such circumstances, governments are usually faced with a choice—decrease spending on health care, decrease spending on other programs, or risk higher taxes and digging the province into further debt. The $10 billion deficit projected this year gives us a hint about which way the government veered.

However, there’s another option that the government has been completely silent on—policy reform. Despite the rapid spending increases in the past, the Alberta’s health-care system still struggles to deliver adequate services. The most obvious manifestations of this failure are the long wait times Albertan patients have to endure for medically necessary treatment. Last year, it was estimated that the average wait between referral to treatment was 22.9 weeks—more than five weeks longer than 15 years ago. Clearly, the big spending increases during this period didn’t solve Alberta’s abysmal wait times.

Instead of continuing to pump money into the same system and hoping for different outcomes, it’s the perfect time for Alberta to look to the private sector to come aboard as a partner or alternative and institute the sort of patient cost-sharing policies commonly found in other universal health-care systems. Done correctly, neither of these policies would fundamentally alter the universal nature of the health-care system. Instead, the private sector would help take some pressure of the government, while the cost-sharing would help temper demand by reminding patients to use these scarce and expensive health-care resources responsibly.

To fully bring about such change, the province would admittedly need a little help from Ottawa. Luckily, it wouldn’t cost the federal government a dime. In fact, it only needs to do away with the restrictions imposed by the Canada Health Act that impede provincial governments from meaningfully experimenting with innovative policies that might help better deliver health care to patients in their provinces.

Unfortunately, neither the provincial nor federal government have indicated that they’re willing to follow the lead of other successful universal health-care systems in this regard—and so, we’re stuck with the status quo. More spending, more debt; same system, same problems.

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