Danielle Smith’s Mission to Dismantle Public Health Care

A video clip of Danielle Smith outlining how Alberta could privatize major public hospitals like the Peter Lougheed Centre, the Rockyview General Hospital and South Health Campus appeared on social media last week.

Speaking to a conference on “meeting the health-care challenge” on Oct. 23, 2021, a few days less than a year before she assumed office as Alberta’s premier, Smith laid out a plan to sever major public hospitals from Alberta Health Services and privatize them.

“You give money to Alberta Health insurance. It’s a separate entity. It’s a government entity, so it’s publicly administered,” she explained to her audience at the meeting of the “Economic Education Association,” a libertarian group. “They are forbidden from running any programs or any hospitals themselves.”

“Alberta Health Services becomes the contractor,” she continued, explaining how her plan would work after the creation of the new level of health-care bureaucracy she’d dreamed up with the apparent purpose of dismantling public health care.

She goes on: “Sure we can grandfather in their contract.”

At this point, you can almost hear Smith’s sly wink. “For now…. But then we would have the Health Quality Council of Alberta do us an auditor function, and tell us whether or not Alberta Health Services should continue running the Lougheed Hospital, or the Rockyview Hospital or South Campus, or any of the hundred hospitals that they currently run.”

It would seem from that remark that Smith, not yet premier, was pretty confident she could make the Health Quality Council of Alberta do her bidding on what conclusions to reach. (As premier, Smith appointed Dr. John Cowell, a former CEO of HQCA, as the sole administrator of AHS in November 2022.)

Smith continued: “If they can’t meet the terms that we want them to, we can do an RFP [request for proposal]. And then the Alberta Health insurance can give a different contract to a different group of doctors.”

“That is completely compliant with the Canada Health Act,” the soon-to-be premier claimed. “It’s a structure issue. And it’s a political will issue. And we’ve got neither of those, unfortunately, because I presented this to the health minister and they did not act on it.”

“Imagine if High River Hospital, which does most of the hernia operations, by the way, in Southern Alberta,” she said at another point, “What if they said, ‘You know what? We don’t need to be under the umbrella of Alberta Health Services. We’d like to charter directly with Alberta Health insurance, get our money directly’?”

This too would be possible with her new Alberta Health insurance bureaucracy, she asserted.

“They’re able to do a thousand hernias, to get paid on a per-patient basis for a thousand hernias. If they’re able to change their operations so they can do 2,000 hernia operations, then you allow them the funding to follow through.”

It’s hard to say how the United Conservative Party will try to spin this as not meaning what it obviously does, but one supposes that they will try, unless they’re lucky and media mostly ignores it. Right now, as alert readers are surely aware, the party and premier are busy spinning different remarks Smith made to a different audience, also in the fall of 2021.

Like many things Smith has said — and there are bound to be even more of these serial eruptions made by the premier when she was just a libertarian talk radio personality and market fundamentalist missionary now waiting to go off — this one has been sitting on the internet, hidden in plain sight.

A clip of Smith’s entire talk is online. But watch it quickly if you have a desire to hear what else she said. These things do tend to disappear when they become controversial.

In fact, we’re getting to the point where we’re not really talking about eruptions anymore, but a long running geological event on the scale, say, of Mount Pinatubo or Mount St. Helens.

Smith bloviated at the Economic Education Association health-care conference for more than an hour, so there’s more, of course. Here are a couple of additional points she made:

• “Just establish a health spending account with $350 for every single Albertan and tell them, ‘Your employer can match it. You can match it. You can put money in tax free. You can gift it to a friend or family member. If you don’t need it and you want to set up a charity.’”
• “Take Alberta Health Services out as the intermediary and we would see a proliferation of the kind of clinics that I was talking about, and the kind of telehealth services, and the kind of surgical services…. You need to give people the means to spend their own money on these types of services.”

If you’re wondering whether Smith really believes this stuff or was just saying what her audience wanted to hear, remember that she made many of the same points quite specifically when she ran for the leadership of the UCP last year.

Other speakers at the conference included Dr. Brian Day of the notorious Cambie Surgery Centre who recently lost his long legal fight to force provinces to allow private for-profit health care before the Supreme Court of Canada, People’s Party of Canada Leader Maxime Bernier and former MLA and current Alberta separatist Paul Hinman.