Alberta premier hopes for health reform payoff in 2025, regrets deferring tax cut

Alberta Premier Danielle Smith speaks to the Economic Club of Canada in Ottawa on Monday, Feb. 5, 2024. THE CANADIAN PRESS/Sean Kilpatrick

Alberta Premier Danielle Smith is eager to show that her government can finally put the pieces of a dismantled provincial health-care system back together again in the new year.

In a recent year-end interview, Smith said work that began in 2023 to create four new organizations in place of one health authority is almost complete, but there's still more to do.

“Next year, I think, will be the real proof of the new model,” she said.

Critics have said the restructuring would separate decision-making into silos, make the system more difficult for patients and workers to navigate, add layers of bureaucracy and fail to address the shortage of health-care workers and hospital beds.

Some of the biggest pieces to come together include getting everyone access to a family doctor and getting surgical wait times down to medically recommended time frames.

For Smith, it has been about identifying big problems and starting to fix them.

"That, to me, has been really rewarding," she said, pointing to the introduction of a new pay model for nurse practitioners, expanding the role of pharmacists and boosting the number of surgeries in private facilities.

Smith's United Conservative Party government was kept busy on a number of other fronts in 2024.

Smith highlighted "major progress" in tweaking electricity market rules to try to calm volatile prices and lower power bills, including by introducing a new default rate starting in January.

She also said Alberta had to contend with more than 1,200 wildfires, including one that devastated the mountain town of Jasper in July.

In the spring, Smith's government laid the groundwork for a new provincial police service and has committed an increasing amount of money toward sheriff-led projects, including beefing up security at Alberta's southern border with Montana.

The UCP also followed through with new regulatory hurdles to renewable wind and solar energy development.

And a provincial law unfurled partisan banners at the local level. In upcoming municipal elections in October, municipalities will be forced to hand count ballots, among other changes recasting the political landscape.

Smith has the unwavering support of the UCP. She garnered a resounding 91.5 per cent approval rating from party members in November, shortly after introducing a new Alberta Bill of Rights, which promises to protect the right to refuse vaccinations.

She continues to be buoyed by her near-constant legal and symbolic pushback against the federal Liberal government, perennially unpopular in Alberta, and her willingness to turn socially conservative proposals into government policy.

In that vein, the government also passed legislation restricting transgender medical care that now faces a court challenge.

The cost of Smith's health-care restructuring — estimated by the government to be $85-million — won't be the only line item squeezing Alberta's budget in the new year.

Billions of dollars have been promised over the next three years to build new schools, as classrooms burst at the seams.

About 250,000 public sector workers are still in collective bargaining talks with government employers.

All this as Finance Minister Nate Horner warns of the "real risk" of a deficit on the horizon, depending on whether the price of oil dips below budget projections.

Government forecasts don't take into account the effect of future policies, including 25 per cent tariffs threatened by incoming U.S. president Donald Trump.

As the Alberta government readies its 2025 budget, there is one billion-dollar regret that lingers in Smith’s mind.

“We probably should have brought the tax cut in our first budget,” Smith said.

That keystone election promise to save taxpayers hundreds of dollars a year beginning in 2023-24 may be fulfilled four years later.

“We did hear that that was something that disappointed the people who supported us,” said Smith.

"It may have been better for Albertans if we'd implemented and then found a way to be able to pay for it."

When she and Horner put it off, there was uncertainty with oil and gas prices, the Trans Mountain pipeline expansion project and population growth.

"We deferred it, but we sort of heard loud and clear that people needed that tax relief,” she said.

With the province’s population growing, income tax revenue has also inched upwards, from $15.1 billion in 2023-24 to a projected $16.5 billion in 2024-25.

Smith said that year-over-year increase came as a surprise.

She also pointed to Saskatchewan Premier Scott Moe, who has moved to implement a personal tax cut promised in the recent election campaign that delivered his Saskatchewan Party another majority government.

“Scott Moe learned the lesson that I learned, and he campaigned on a tax cut," Smith said.

Asked at what point her pending promise turns into a broken one, Smith said she's pleased to see many long-term revenue sources increasing, and the tax cuts are still on her agenda.

"That is giving the finance minister some comfort. I've asked him to look at ways to accelerate, so we'll find out at the end of February if he's been able to do that."

This report by The Canadian Press was first published Dec. 25, 2024.