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Opinion: Don’t blame immigration for Alberta’s health-care woes

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Alberta’s health-care system, like in every other province, is struggling with long wait times, overwhelmed ERs, a lack of medical technologies and a dearth of family practitioners—despite its high price tag. Recently, Premier Danielle Smith suggested that immigrants are putting pressure on the system, pointing the finger at Ottawa for some of Albertans health-care woes. But the health-care system was failing long before the rise in immigration.

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Let’s start with the money side of the equation. Canada has, since at least the early 2000s, consistently ranked among the top spenders on universal health-care in the developed world. And Alberta has consistently ranked as one of the top spenders in the country.

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And yet Albertans, and indeed all Canadians, have been getting little in return. In the early 2000s, Canada’s health-care system was already ranked as one of the less accessible in the developed world, and by the late-2010s had some of the longest wait times, worst access to medical technologies and fewest physicians. Again, this all predates the large growth in international immigration in the early 2020s.

While it’s undeniable that the recent large population increase had consequences including increasing the burden on an already overwhelmed health-care system, the immigrants are not the cause of the problem. The large population increase only made the health-care system’s existing failures more obvious.

Alberta’s health-care system has long cost more and delivered less in comparison with other universal health-care countries, and has long been unprepared for an expansion in the population or even the aging of the existing population. This is because of the policy choices of premiers Getty, Klein, Stelmach, Redford, Hancock, Prentice, Notley and Kenney. All these premiers embraced the Canadian model for health care dominated by government and delivered through bureaucratic monopolies.

Each of these past provincial governments showed steadfast loyalty to a failed set of health-care policies, rather than considering the health policies of the developed world’s top-performing universal health-care countries such as Australia, Switzerland, Germany and the Netherlands. These past governments also ignored the reality that the developed world generally was moving towards superior policy approaches and further away from the Canadian model.

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Premier Smith has started to move Alberta’s failing health-care system towards a higher-performing policy model. For instance, her government plans to soon pay hospitals in Alberta on a per-patient-treated basis, which encourages hospitals to treat more patients in a timelier fashion. Compare that to Alberta today where hospitals receive an annual budget from the government each year to care for patients, which makes each patient a cost for the hospital rather than a revenue source, and leaves very weak incentives to treat more patients or treat them more rapidly.

The premier also plans to allow Albertans to purchase some health-care privately, from physicians working in both the public and private systems. Again, this is the norm everywhere else in the developed world. No other developed country with universal health care prohibits privately purchased health care. And the overwhelming majority of these countries allow doctors to work in both public and private settings. There are many other important reforms to be made, but it’s at least a start.

The health-care system in Alberta is failing because of long-standing policies that currently guide it, not because of a sudden influx of immigrants. But while Premier Smith may be critiqued for blaming immigration, at least she recognizes there’s a problem and is doing something about it.

Nadeem Esmail and Tegan Hill are analysts at the Fraser Institute.

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