University of Calgary

Sustainable health care

April 14, 2009

The sustainability of health care in Canada

The long-term sustainability of Canada’s publicly funded provincial health care systems is under pressure from a wide variety of sources—an aging population, expensive technological advances, and expanding coverage that is pushing up against constraints on provincial government revenues. While Alberta has enjoyed the benefit of energy royalties, the volatility of this resource has been highlighted by the recent collapse in energy prices and the loss of upwards of $6 billion in royalties. Other provinces enjoy more stable sources of revenue, but are constrained in their health care choices by heavier tax burdens and larger public debt loads.

The challenge to any provincial government today is to satisfy the health needs of the current generation of taxpayers with current revenue and expenditures, and to ensure that those current burdens are not passed on to future generations

In their paper, The Fiscal Sustainability of Alberta’s Public Health Care System, Livio and Rosanna Di Matteo argue that “if spending requirements continue to grow at the pace of recent years ... Albertans will have to devote a rising share of their government program expenditures to public health care, be willing to accept a rising tax burden to pay for the increases and to maintain current program shares, or consider altering the mix of private versus public health care provision. ... a portfolio of policies that combines these solutions likely would be a pragmatic policy outcome."  

The School of Public Policy released the Di Matteo paper today. The Health Series is a collection of national research papers resulting from an initiative of the Institute for Advanced Policy Research (IAPR), within The School of Public Policy, with funding support from Alberta Health and Wellness. This is the third paper in the series.

To view the paper, visit

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