The Alberta government says it's too early to know whether hundreds of millions more in health transfers from Ottawa would actually increase health spending in the province.
Alberta stands to gain about $900-million a year if the federal government begins funding health care on a strict per-capita basis – money that would come from a single pot and thereby reduce the relative shares of each other province.
On Wednesday, however, a spokesman for Alberta Health Minister Fred Horne said in an e-mail, "It would be too speculative … to talk about future funding and how it might be used," because the new health deal hasn't been signed.
This raises the possibility that Alberta's windfall, coming at the expense of the nine other provinces, would replace the money the province pays from its own coffers for health care and not actually mean more dollars spent.
Alberta has a five-year funding deal with its health superboard, Alberta Health Services (AHS). It runs until then end of 2014-2015, the year the province would receive the first boost in federal cash from the new Canada Health Transfer deal.
Alberta currently puts $12.5-billion towards health care, or 84 per cent of its total cost, with Ottawa picking up nearly all the rest. No other province pays more of its own cash, per-capita, towards health care.
If Alberta gets more federal money, it could cut its own share, freeing up $900-million annually for other ministries.
"I don't know if [increased federal funding]would have a direct effect. AHS has got guaranteed funding," said Trevor Theman, a physician and chair of the Alberta College of Physicians and Surgeons.
"I suppose it would give the government a little bit of wiggle room."
Alberta has long sought change after agreeing in 2004 to a formula that, because of its wealth, paid it a lower per-capita transfer than other provinces.
The issue was a priority for Alberta Premier Alison Redford, who won her job in October and raised the issue with Prime Minister Stephen Harper, a fellow Calgarian, shortly after. The two leaders' governments now agree that health care funding should be strictly per-capita, regardless of provincial wealth.
"I consider that to have been a great success of our government," Ms. Redford said on Wednesday after returning from premiers meetings in Victoria.
Manitoba Premier Greg Selinger is leading a review focusing on, essentially, how Alberta's bigger share would affect the other provinces. Ms. Redford entered the Victoria meetings wondering whether her province may have a target on its back as a rich member of confederation clamouring for more cash.
"I'm not sure that would really come as a surprise to anyone in terms of what some people in Canada could think," Ms. Redford said on Wednesday. "But what we needed to do at that meeting – and what we were successful in doing – is having premiers acknowledge that per-capita funding for Canadians that's equal is a fundamental principle of Canadian health care. It may seem to some that this is an inequity, but it is actually correcting an inequity.
"I think, as opposed to Alberta having a bulls-eye on its back, it's actually seen as a leader in this area and that's what we'll bring to the table," she added.
The funding would come at a time when problems persist in Alberta's health system. It continues to struggle through the amalgamation of its health boards into AHS, a controversial move that has produced middling results.
Some in the province's health sector are divided over what more federal money should mean.
Any new federal cash shouldn't mean a reduction in a provincial share of health spending – an increase should be an increase, said David Swann, a physician and health critic for the Official Opposition Liberals. "You'd [otherwise]have to have a very good explanation," he said.
Others say cash won't solve Alberta's logjams and problems.
"I subscribe to some of the views of former AHS CEO Stephen Duckett, who would argue that some of the problem in Alberta isn't lack of funding – it's how we spend our money," Dr. Theman added. "I don't think there's a silver bullet. And if there is, it isn't money."