The Ledger Oldcorn Asked For
Alberta wants to charge temporary residents $1,900 for health care. A tax-paying refugee claimant, three kids in school and no provincial coverage, runs the audit the Western Standard asked for.
The Ledger Christopher Oldcorn Asked For
A response to the Western Standard column “Danielle Smith should charge temporary residents at least $1,900 for Alberta healthcare” — from one of the line items.
The setup, for anyone who missed it
On September 22, Premier Danielle Smith told a Calgary Chamber of Commerce audience what a health-care premium for temporary residents might cost. “I gave you the idea of what we’re looking at … $1,900 per person,” she said, pointing to the United Kingdom’s immigration health surcharge as her model. The government is weighing a range of $1,400 to $1,900, and has not said whether the fee would apply to temporary residents already living here or only to new arrivals.
The number is tied to Question 4 on the October 19 referendum, which asks Albertans:
“Assuming that all Canadian citizens and permanent residents continue to qualify for public health care and education as they do now, do you support the Government of Alberta charging a reasonable fee or premium to individuals with a non-permanent immigration status living in Alberta for their and their family’s use of the healthcare and education systems?”
A day later, the Western Standard’s Christopher Oldcorn published a column backing the idea. His case, in his own words:
“Public healthcare comes with a bill. When governments fail to collect enough to cover it, taxpayers pay more and patients wait longer. Premier Danielle Smith should press ahead with an annual healthcare premium of at least $1,900 for temporary residents. She should also publish the accounts behind it. Albertans deserve a policy that can survive scrutiny.”
His subhead adds the condition: “Smith must also show what the policy would collect — and how it would shorten waits.”
That last sentence is the first one in the piece I agree with completely and without qualification.
So let’s scrutinize it. I have two years of receipts.
Who is writing
I’m a temporary resident. Tax-paying, currently covered by the Interim Federal Health Program, and, per Statistics Canada’s own classification, one of the roughly quarter-million “non-permanent residents” Alberta counts when it builds the case for this fee. My wife and I landed here with our three children in the summer of 2024. Our third year began this past August: two full years behind us, still counted in that population without once being in the system it is supposedly protecting.
I have read the audit request. Here are my working papers, and a couple of exhibits from the family file.
Finding 1: The topline number doesn’t tie out
The premier’s justification, as reported by The Tyee: “For every $1 of taxes a guest worker generates, taxpayers are covering $10 in services.”
Economist Ben Atkinson ran that claim back through the government’s own source data and got $6.67, not $10. The gap wasn’t a rounding error. It was an $8.6 billion school construction budget folded into the “cost” column, a budget that hasn’t been spent yet. You can’t book a capital project you haven’t built as an operating expense you’ve already incurred. That isn’t immigration policy, it’s accounting, and it’s the kind of thing an audit is supposed to catch on page one.
Finding 2: The utilization data says the opposite of the premise
Non-permanent residents are 5.5% of Alberta’s population. They account for 1.27% of the province’s health costs, according to the same fact-check, using the government’s own CIHI-sourced figures. That is not a population straining the system. That is a population using it at roughly a quarter of its per-capita share.
NDP Leader Naheed Nenshi made the simpler version of the point when the $1,900 figure surfaced: “Her math doesn’t make sense either because, let’s remember, the temporary workers pay taxes.” If any other line item on the province’s books ran at this ratio, nobody would call it a crisis. They’d call it a healthy reserve.
Finding 3: Exhibit A — the queue that bars you from the thing it asks you to fund
Here is where the audit stops being abstract.
Refugee claimants are classified by Statistics Canada as non-permanent residents, the same bucket as work-permit and study-permit holders - altogether, these categories form the bucket feeding the figure Alberta cites to justify Question 4. Yet Alberta’s own rules are explicit: temporary residents, like refugee claimants are not eligible for coverage under the AHCIP while a claim is pending. They are directed to the federal program instead.
My family has been in that temporary residence queue for over two years. Two-plus years of being ineligible for the provincial coverage the province funds for everyone else, while being required to file and pay as taxpayers in that same province. (I’m not contesting the obligation. I’ve filed twice, and correctly so.) Sit with that structure for a moment: the people capable of contributing, who are already contributing, are held in a queue that bars them from the services their taxes help fund, on the theory that they are the ones straining the system. What’s being strained is the definition of “fair.”
What we’re on instead is the Interim Federal Health Program, and since May 1 we pay our own version of a premium: $4 for each eligible prescription, and 30% of the cost of other supplemental benefits. Nobody floated that number at a Chamber of Commerce lunch. It just started happening, quietly, to the same household now being told it may owe $1,900 more.
And that federal money isn’t hovering somewhere over Ottawa. Alberta’s own refugee care and billing page spells out the mechanism: the federal program “repays the cost of care to health-care providers, such as doctors, dentists, hospitals and pharmacies.” That is federal dollars landing in Alberta clinics, claim by claim, keeping exam rooms staffed and pharmacy shelves stocked. We are not draining those clinics. We are one of the reasons the lights stay on.
Finding 4: Exhibit B — the other invoice nobody waived
While all this was being sorted out, our three kids kept showing up to school. Every August for the last two years, including this past August at the start of year three, we have paid every mandated school fee in full. No waiver requested, none offered, none needed. Same registration costs, same supply fees, same everything as the family next door.
Meanwhile, the education half of the government’s cost case rests on a figure of roughly $12,000 per student, offered as evidence that families like ours are a drain, in the very years we were writing the cheque ourselves, in full, on time.
I don’t say this looking for sympathy. I say it because it’s the documentation an audit is supposed to want: not a sentiment, a receipt.
Finding 5: The actual crisis has a different cause, and it’s well documented
None of this is a mystery. Alberta’s own doctors have been saying so, loudly, for a while. The Alberta Medical Association’s 2026 State of Health Care report describes a widening gap between confidence in providers and confidence in the system’s ability to deliver timely care. Emergency physicians have described overcrowded ERs as “death zones” and asked for a declared state of emergency. One emergency doctor told The Canadian Press that Alberta is “trying to take care of a 2026 patient population with a bed-base of 1988.” And between 2014 and 2023, real per-capita hospital spending in Alberta fell by four per cent, the only large province where it did.
None of that shows up anywhere near a temporary-resident line item, because it isn’t one.
Finding 6: The people you’d bill are, in no small part, the people running the place
Here is the closing entry, and it’s an Alberta number before it’s anything else. In 2024, 36.0% of Alberta’s physicians were international medical graduates, up from 33.6% in 2015, and 12.7% of Alberta’s nursing workforce was internationally educated. That is the Canadian Institute for Health Information, on this province.
Zoom out and it gets starker: physicians and migration-health researchers writing in Healthy Debate note that newcomers make up 25 per cent of registered nurses and 37 per cent of physicians across Canada.
You cannot staff a health system with one wave of newcomers while charging admission to the wave standing in line behind them. At some point that stops being immigration policy and starts being an org chart problem.
The ask
Mr. Oldcorn, I’m not writing to dismiss your request. I’m writing because I ran it, with a household P&L that includes over two years of health-coverage limbo and three consecutive years of school fees paid in full. Not to prove a point, but because that is what showing up somewhere means.
The account doesn’t say what the referendum campaign says it says. It says a population that is statistically overcounted, provincially excluded, and quietly propping up the workforce and the school system is being asked to fund things twice: once through the taxes and fees it already pays in full, and once through a fee for services a meaningful share of us aren’t even eligible to receive.
You asked the premier to publish the accounts. I agree. Publish the whole ledger: the tax paid in, the AHCIP exclusion, the federal reimbursements landing in Alberta clinics, and the 36% of physicians this province depends on to keep those clinics open.
My family will be here, in the queue, in the classroom, in one of the doctor’s-office chairs we apparently haven’t been draining, with the receipts.
Brian Ssennoga writes, from Edmonton, Alberta on AI Governance & Policy, Family and newcomer life in Canada. This piece was also submitted as a letter to the Western Standard.
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