Paul Kershaw
TROY MEDIA
Alberta Premier Jim Prentice primed the electorate for spending reductions in his 2015 budget by emphasizing that Alberta spends $1,300 more per person than the national average. What he didn't tell us is how this average breaks down by age.
The bulk of Alberta's 2015 spending will be delivered through healthcare ($18.9 billion), education ($7.5 billion), post-secondary ($5.8 billion) and human services ($4.2 billion). Of this money, approximately $17,129 is budgeted for each of the half million Albertans age 65 and over. By contrast, the budget spends $7,489 for each of the 2.6 million Albertans under 45.
At these rates, Alberta allocates $2,000 more per senior than Saskatchewan, the next most generous province; and $6,000 more than B.C. However, it spends less than Saskatchewan per younger citizen, and only moderately more than B.C.
Alberta doesn't spend more on average. It spends more on retirees.
Medical care is at the heart of this pattern. Data show that approximately 41 per cent of the $18.9 billion healthcare budget will go to services and procedures for the 11.5 per cent of the population age 65 and over. This adds up to more than the entire K-12 budget; a third more than the entire post-secondary budget; and nearly double the human services budget.
Such health spending might be fine if Albertans were getting bang for the buck, because we want the best for our aging parents and grandparents. Alas, evidence shows Canadians spend more on medical care than many other rich countries, but get only middling or below average access to doctors, CT scans, MRIs and patient satisfaction. All the while, doctors get above average remuneration.
In response, Alberta is the first province not to increase annual medical spending in some time. This change will make many of us anxious, because we cherish healthcare. So we must remain vigilant about the effects on seniors' access to care for their chronic conditions.
If there are problems, we should give further attention to Alberta's new healthcare levy, which will raise 3 per cent of the health budget. It's important to focus on revenue sources for the aging population's medical care because we have not done so historically. As citizens aged 65 and over grew from 9 per cent of Canada's population in 1976 to 15 per cent today, governments added $32.5 billion in annual medical care spending for this age group. But governments did not increase revenue to pay for it.
Instead, governments held post-secondary spending relatively constant since 1976, even though twice as many young people pursue this extra education to compete for jobs. Similarly, governments didn't build a child care system, even though young Alberta women increased their labour force participation by 42 per cent.
Although trade-offs like these persist into the 2015 budget, we don't have to cut important services for seniors to escape them. Other reallocations are possible, or we can listen to the 92 per cent of Albertans who supported some kind of tax increase in the government's pre-budget consultation.
The Premier listened somewhat, raising various taxes by $1.5 billion - one third from fuel tax increases. Since the government brags that Alberta will still maintain the lowest taxes on gas and diesel in the country, there remains room to think seriously about advice from the Ecofiscal Commission.
Supported by Suncor Energy, and championed by Preston Manning, the Commission urges governments to raise revenue less from income taxes and more from systems that put a price on pollution. From a generational perspective, it's time Albertans think about this option.
Because we've spent decades raising medical care spending for the aging population without collecting additional revenue, we now have less to invest in younger generations. By pricing pollution, Alberta could ease the squeeze that younger citizens face from larger student debts and child care fees that cost more than university. And it could do so while reducing environmental debts left primarily to younger Canadians, their kids, and the children they still want to have, because the province relies so heavily on resource extraction to pursue economic prosperity.
Dr. Paul Kershaw is a policy professor in the UBC School of Population Health, and founder of Generation Squeeze