Last week, the UCP passed their final budget Albertans will see before voting in this spring’s provincial election. The government spent the days leading up to Budget Day trying to assure Albertans that health care would be taken care of. Premier Smith and her AHS administrator appointee, Dr. John Cowell even went so far as to declare that our health care system is no longer in crisis, a claim which was swiftly quashed by the people actually working on the front-lines of Alberta’s public health care.
But behind all the political boasting and rhetoric, how does this budget really stack up when it comes to Alberta's health care?
Health Care Funding
Despite big promises from the government for health care, with a closer look at the budget the math doesn’t add up: The 4.09% health care funding increase far from meets what is necessary to meet Alberta’s record inflation (6.4%) and population growth (3.03%). That means that they’re shorting Albertans $1.26 billion from what is needed just to keep our health care system running as it is now! Plus, new health care funding in Budget 2023 falls far short of the funding that is to be provided by the federal government, as result of the agreement in principle the Alberta government recently signed with Ottawa.
Paired with frozen funding in 2019 and 2020, and underfunding throughout the COVID-19 crisis, we aren’t even catching up, let alone keeping up. It is no wonder that our health care system is struggling under the pressure it’s facing.
What’s more, this funding far from makes up for the destruction the UCP government has already wreaked on our health care system, it doesn't make up for the four previous years of undermining and under-resourcing a system in crisis, it doesn’t make up for the millions of dollars in federal COVID-19 funding they left on the table or have refused to account for, and it certainly won’t bring back the family doctors and other health care workers we lost to burnout or to more supportive provincial governments.
But while health care continues to go underfunded, the Finance Minister spent his budget address bragging about their surplus budget. In reality, the government simply lucked out on another oil boom. And Danielle Smith also made sure there was room in the budget to give her own office and executive council a $3 million (23%) pay raise.
Since being elected, we’ve seen the UCP government pursue an aggressive agenda of health care privatization, including in our community labs, Emergency Medical Services, laundry & food services, ophthalmology, surgeries, seniors care, and home care—the list goes on. They even proposed an absurd scheme to send patients, along with their surgeons, to a for-profit clinics in British Columbia for their surgeries.
We saw more of the same in Budget 2023. But money promised to fund for-profit surgical centres or other private facilities is funding that isn’t going towards improving patient care. As Albertans have already seen, opening private, for-profit surgical centres doesn’t create more surgeons, nurses or anesthesiologists, it simply pulls them out of the public health care system. And as we’ve repeatedly seen before, when for-profit operators fail to profit, it’s our public health care system that is left to pick up the pieces.
The agreement in principle signed between the province and Ottawa last month will see billions in new federal funding provided to Alberta. But despite health advocates across the country’s repeated calls for strings-attached to ensure that new funding wouldn’t be put towards ongoing privatization efforts by provincial governments, funding was provided with no conditions. In fact, the federal government requires only 57 cents of every dollar actually go towards improving health care.
Between COVID-19 and continual inaction from our provincial government, our public health care system is in an urgent situation that requires urgent action to deal with the widespread short-staffing, worker burnout, and closures impacting our entire province. Yet, the provincial budget continues to accelerate this government’s failed privatization agenda, which is only further fragmenting the system, and worsening the dire short-staffing situation facing our public health care.
The government is continuing to privatize and downgrade care for seniors, following through on recommendations made in the Facility-Based Continuing Care review. This budget saw this government continue to erode higher-acuity long-term care (LTC) in favour of expanding the more lucrative and under-regulated home care and designated supportive living (DSL) facilities, with no plans to address any of the major issues that have resulted from decades of privatization.
Recent reports from the Auditor General showed just how badly we are failing Alberta’s seniors in long term care. Advocates have continued to call on the government to take action by adopting the new national long-term care standards, bringing back an independent Office of the Seniors Advocate, improving work conditions so that facilities aren’t relying on a low paid precarious workforce, and implementing paid sick days for all workers.
While the government accepted the Auditor General’s recommendations, the budget does nothing to fix the long-standing issues in seniors’ care. We need to address the infrastructure challenges, the chronic under-staffing, the reliance on a precarious workforce without job security, or benefits or paid sick days. We need to get seniors an advocate again. Ultimately, we need a plan to end Alberta’s approach to long term care which treats seniors as commodities, prioritizing profits over providing quality care.
Drug Poisoning Crisis
Albertans are continuing to die in record numbers, we know that each of these overdose deaths were avoidable with proper community supports. The government’s ideological push for a recovery-only approach to the drug poisoning crisis is continuing to fail us. They have already spent millions of dollars funding mainly for-profit facilities, with no accountability or transparency to the public.
Budget 2023 shows more of the same disregard for evidence, continuing to funnel hundreds of millions of dollars into expanding their abstinence based model, and ramping up the criminalization of people who use drugs, while cutting the programs and services that are most effective at preventing and reversing drug poisonings.
In the face of unprecedented death, this government continues to make it painfully clear which Albertans’ lives they value, and which they are more than willing to treat as collateral damage in their ideological political agenda.
Staffing & Capacity
While Danielle Smith has insisted that there’s no longer a crisis in Alberta’s health care system, the reality is that over 30 hospitals and health care facilities across the province are currently facing repeated temporary closures due to ongoing staffing shortages.
Though funding was provided to universities to educate and recruit doctors and nurses, nothing was provided to increase staffing for their health care colleagues in mental health and addictions, lab workers, diagnostic imaging, etc. In the meantime, health care workers across the province continue to suffer burnout whilst working short-staffed, meaning that any attempts to recruit workers will be moot unless we also have sufficient resources going to retain them. While long-term staffing strategies are needed, this remains an urgent situation that requires urgent action.
Danielle Smith was vocally critical of AHS’ ability to expand Alberta’s emergency health care system capacity during COVID-19, yet she has done nothing to meaningfully improve capacity in the short or long term. Decades of health care infrastructure neglect have meant that our deficit grows every year, keeping our hospitals running chronically at or over capacity, and overrunning our emergency medical services.
Edmonton hasn’t had a new hospital since the 1980s, and internal AHS documents show that Edmonton has been short 500 beds since 2016, projected to grow to 3,000 by 2036. But when it comes to the government’s major promises around capital projects like the Red Deer Hospital or a new South Edmonton Hospital, there are no timelines to get shovels in the ground, and the long-term capital plan in Budget 2023 doesn’t provide enough money to get these facilities built, let alone staffed. Albertans need to see a clear plan for getting these facilities built, and to ensure there's enough capacity to meet our province's growing health care needs.
Still, opening new health facilities, new hospital beds, or providing more ambulances is virtually meaningless without the team of specialized health care workers required to staff them. All while the government’s aggressive expansion of private, for-profit surgical facilities is siphoning much-needed health care workers like anesthesiologists out of the public system.
Patients and health care workers are tired of waiting for help that never comes. If the government was truly interested in improving access and trimming costs in our health care system long-term, they would invest in ensuring everyone has access to primary health care, and other initiatives that keep people out of the hospital and improve sustainability, including bringing back and retaining family doctors.
Addressing the Social Determinants of Health
We know that addressing the social determinants of health, the non-medical factors that influence health outcomes, is the best way to reduce strain on our system and keep Albertans healthy. Unfortunately, Budget 2023 doesn’t use that lens when setting priorities.
This year’s budget sees some increases to AISH (Assured Income for the Severely Handicapped), Alberta Seniors Benefit, and Income Support, and the re-indexing of these supports with inflation. However, this comes following years of cuts, freezes and deindexing, which means income support levels are still well below the poverty line!
As per the first Danielle Smith-appointed cabinet, Alberta no longer has a dedicated Ministry of Status of Women. Perhaps unsurprisingly then, Budget 2023 saw was no additional funding to expand specialized services for sexual assault survivors, despite growing demand, and waitlists currently at 15-16 months to access trauma counselling. Domestic violence shelters, which are operating over-capacity and underresourced, also saw their funding frozen.
Which should also come as no surprise, as Alberta no longer has a ministry dedicated to housing either. We saw no new budget funding dedicated to shelters or permanent supportive housing, despite the growing need. In the meantime, at least 239 unhoused people died in Calgary last year, and frostbite amputations hit 10-year high in Edmonton last winter, mostly among unhoused people.
We are in a housing crisis. From Lethbridge to Fort McMurray, housing is a top issues for communities, yet it saw almost no action in this budget.
What’s clear is that Budget 2023 is being offered to Albertans as a last-ditch effort to convince us to forget this government’s track record with health care and our other public services. This budget is harmful to our public health care system and isn’t what’s needed to keep Albertans healthy.
With a provincial election fast approaching, Albertans should be very concerned about what another four years of a Danielle Smith government would mean for the future of our health care, and whether or not they’ll be able to afford it.