Today, the Alberta government released the 2026-27 budget with a $9.4 billion deficit following rhetoric that immigrants, temporary workers, and refugees are a drain on public services.
The provincial government is scapegoating migrant and newcomer communities for the government’s own lack of sound fiscal management. As other commentators have noted, the provincial government has not addressed the lack of alternative revenue sources like a sales tax, personal and corporate income tax increases or greater resource royalties.
Alberta is second-only to Ontario in population growth, adding nearly 600,000 people between 2021 and 2025. Immigrants and migrant workers make up part of this increase—and they pay taxes and contribute to the economy. It goes without saying that population growth requires governments to plan for the health care, education, and social services that residents rely on.
With Alberta’s health system in chaos, this analysis focuses attention on health care spending.
Health care spending: Where’s it going?
Budget 2026 increases the total health care spending from $32.5 billion to $34.4 billion—or by 5.8 per cent. However, due to the restructuring of Alberta health care into four different ministries, year over year comparisons are difficult.
The distribution of spending within the health care budget matters. Earlier this week, the Alberta government announced a 22 per cent increase in spending on doctors. It appears that this will fund increased compensation rather than increasing access to additional providers, such as family doctors and primary care providers.
The hospital and surgical services budget gets a $830 million increase—a 6.4 per cent bump. The provincial government has not made clear how much of this increase will go to for-profit health care providers. The budget adds $525 million to increase the number of surgeries over the next three years by 50,000, although the budget documents do not state whether this will be in public hospitals or for-profit facilities where procedures can be 57 to 133 per cent more expensive than the same procedures in public hospitals.
Also unclear is whether Alberta will prioritize the lowest complexity surgeries over more complex care, like cancer surgeries, where wait times have been increasing dramatically in recent years. The budget also does not explain what Alberta’s new two-tier system will mean for timely surgical care.
The health care component of the new assisted living and social services ministry is projected to see an increase of funding from $5.4 billion to $5.9 billion, but it remains unclear where these new dollars will go.
Primary care—the foundation of the health system—is projected to be cut from $1.597 billion to $1.569 billion or by 1.8 per cent. It is hard to reconcile the considerable jump in physician services spending with this cut in primary care.
Diagnostic, therapeutic, and other patient services will see an increase of three per cent, below the 5-6 per cent necessary to keep up with population growth, aging, and inflation.
While there are some notable increases in health care spending, the government’s decision to break (what used to be) Alberta Health Services into four separate health ministries makes analysis difficult. But the province’s policy directions suggest that Alberta is moving greater public funds into the hands of for-profit providers and investors.
Neither does Alberta’s overall health spending in this new budget address the longer term challenges in Alberta that have resulted from real spending cuts.
The Alberta budget follows a decade of real per capita hospital cuts
The Alberta budget provides little relief for the historical hospital funding crunch.
Between 2014 and 2023 (the most recent data available), provincial real per capita hospital spending in Alberta declined by four per cent from $2,252 to $2,169 (see the table below). Alberta was the only large province to experience real per capita spending cuts over these years. The other larger provinces—BC, Ontario, and Quebec—increased real per capita hospital spending over this period. The only other provinces that saw declines were P.E.I. and Newfoundland and Labrador. Alberta has been an outlier over the last decade. This budget continues to solidify that status.
While increasing hospital spending is not a panacea to addressing hospital overcrowding and severe strain, it is one of the most direct ways to increase hospital capacity, including beds and the required workforce.
Other health care improvements and public policy interventions—such as expanding seniors’ homes and community care, and addressing the social determinants of health (affordable housing, living wages, progressive taxation)—can help reduce hospital overcrowding, especially when low-income seniors have no community alternatives.
The Alberta budget does little to alleviate the challenges of patients who may not need an inpatient bed, but have no other safe alternatives to receive the appropriate level of care outside the hospital setting.
The Alberta budget follows a decade of massive growth in private long-term care spending
Access to long-term care is important for reducing hospital overcrowding and strain. Although long-term care cannot alleviate strain that is rooted in hospital undercapacity, it can play a role helping reduce emergency department and surgical wait times.
However, long-term care must provide appropriate care to meet patients’ needs, otherwise long-term care residents must be transferred back to hospital. The ownership of long-term care homes is also important: a large body of empirical evidence shows that public and non-profit long-term care homes, on average, provide higher quality care. This is because staffing levels and staffing mix tend to be better than for-profit-owned facilities where the profit motive encourages cutting corners on staffing—a key determinant of care quality.
Unfortunately, the Alberta budget does not provide a clear plan to address the lack of more cost-efficient public and non-profit long-term care beds in the province.
Increasing private, out-of-pocket spending on seniors’ long-term care care is one of the main indicators that the publicly funded system is not meeting the needs of Albertans. Private spending on long-term care has outpaced public long-term care investment.
From 2014 to 2023, per capita private spending increased by 267 per cent while public spending increased by only 38 per cent. Private spending comes in the form of out-of-pocket household and private insurance payments to obtain long-term care.
The shift to four separate health ministries makes analysis of Alberta’s health care spending more difficult—an issue that requires greater attention. For health care workers on the front lines and patients waiting for cancer care, Alberta’s budget offers more questions than answers.
