After reiterating an old announcement about how awesome it is to have private delivery of public healthcare, and drastically increasing the baseline payment for those same surgeries, Danielle Smith says “the government must start somewhere” to reduce healthcare costs.
Somehow, in Danielle Smith’s world, that means doubling the costs and then inviting providers to “compete” to bring the same costs— that the UCP itself doubled— back down.
I can’t be certain this isn’t the stupidest thing I’ve had to think about under Danielle Smith’s leadership but it feels like it has to be in the top three.
UCP doubles payments for surgeries, says government “must start somewhere” to lower healthcare costs
This is a thing that happened this week.
In fairness, it’s likely just Danielle Smith and Adriana LaGrange’s latest brain fart designed to cover up the corruption in AHS procurement and the Ministry of Health, but it’s still the most illogical thing our elected officials have said in the past 72 hours.
As I was listening to 1/4 Health Minister Adriana LaGrange Tuesday talk about how giving public hospitals budgets they can rely on disincentivizes them from doing the work, I sort of spaced out and decided to go read articles written by people who have to rely on facts instead. I came across this quote from Danielle Smith which seems to be coming up more; "I believe actions speak louder than anything."
That was what she said in April 2023 when she was talking about a deal she signed with then Prime Minister Justin Trudeau to increase federal health transfers, but she’s also beginning to trot it out over her decision to hold a referendum on whether Albertans want to stay in Canada.
Unfortunately, I’ve been paying attention to the actions of the Danielle Smith-led UCP government has taken and they are entering 777 jet engine-levels of loud.
So. Let’s briefly review the steps the UCP has taken under Danielle Smith to… address healthcare costs.
The UCP has broken up the formerly centralized system of AHS into four separate silos. Where Alberta used to have one Minister of Health, we now have one for hospital services, one for mental health and addictions (new as of Jason Kenney’s term), and a third for preventative care. The fourth, assisted living and social services, which was formerly the Ministry of Seniors and Housing, which was previously the Ministry of Seniors, I believe. In any case, we definitely added one more Minister and their associated salary, and a second CEO to run the former AHS, as well as the associated staffing.
I don’t have a total cost, I just know that paying twice as many people to do the work costs more.
The UCP then created a Crown corporation at a cost of $2.3 billion to house “shared services”. Shared services that ostensibly already existed under the centralized AHS, but now costs $2 billion to set up under a legal entity that doesn’t have to tell the public anything.
Possibly related: Alberta’s healthcare budget also increased in 2026— by $2 billion.
It’s okay to feel like Danielle Smith is gaslighting us, because she is.
rUN gUvmeNt LikE a bIZneSs
My biggest issue with the UCP’s continuation of the healthcare dollars scam isn’t that these services are being privatized— they’re not— it’s that we’re using public dollars to subsidize profits by handing those services to private entities to deliver.
Remember the fiasco with the contracted company leaving Albertans in hotels alone to recuperate? Remember that they also didn’t pay their hotel bills. Probably because they underbid the contract and then couldn’t afford to provide the services, which is why private companies don’t provide those services already.
If the private/not-for-profit sector still has to rely on government funding to provide services then it’s not a private/not-for-profit enterprise; it’s just a public service that elected officials aren’t held accountable for delivering poorly.
As Alberta Surgical Group proved, these companies cannot manage the provision of the same services without being paid almost double for the same services in public facilities. Sure, some private companies bid below cost, but there’s no way they’re accepting that deal now that they know they could have been getting $8,000 per surgery instead of $3,000.
What we learned from former AHS CEO Athana Mentzelopolous’ statement of claim is that AHS had a cap on payments for less complex surgeries, at just over $4,000. Then we learned that costs associated with farming out surgeries through the Alberta Surgical Initiative (2019) had increased by 79 per cent in just six years, including a doubling of those costs under Danielle Smith in 2024.
A lot of attention was being paid to these skyrocketing costs but the UCP didn’t really have a good answer. Instead, after seeing that she and her governing party were getting pushed into a corner, Danielle Smith decided they needed to get a better idea of how much surgeries cost in public hospitals because it had to be more than the $4,000 AHS was paying.
Incredibly, the UCP found that surgeries performed in hospital should also be paid over $8,000.
Well golly gee! That number looks awfully familiar!
So far, the UCP’s privatization of surgical delivery has significantly raised the cost of those surgeries outside of hospitals and now they’re going to raise the cost of delivery inside public hospitals so they don’t look like it was all a scam to begin with. Or maybe we were drastically underfunding surgeries performed in hospital.
It’s okay to feel like the UCP is gaslighting us, because they are.
Ready, set, compete!
Now, after boosting funding for private delivery, and having to double funding for public delivery as well, Danielle Smith and Adriana LaGrange are now saying that hospitals need to find a way to compete— with the private entities our tax dollars are also funding— for patients.
And here’s the part where I’m just about to absolutely lose what little patience I have left because competition between publicly-funded services makes no sense.
It’s all coming from the same pool of money— our healthcare budget.
The same Minister of Health who approved a contract that increased the cost of individual surgeries performed at just one clinic in Edmonton, a guaranteed budget of more than $34 million to deliver fewer surgeries than could be performed in hospital for the same price, now says a guaranteed budget for hospitals to deliver surgeries disincentivizes them from performing those surgeries.
To what advantage? To whose?
There are no profit margins in public hospitals. There’s no shareholders, no dividends payable, no capital gains to be made. There’s no tax write-off that balances the books. No one is getting rich at public hospitals by not providing surgeries.
No one.
It’s a stupid argument from stupid people who think public services should somehow manage to deliver services at lower prices but are willing to fund private ownership at double the cost to do half as much work.
I can’t even make it sound less stupid. My new version of the serenity prayer is just this: “it’s okay to feel like the UCP is gaslighting us; because they are.”
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No One to Blame But the Mirror: Provinces, Not Equalization, Are Accountable for Healthcare
If you've waited hours in an ER or can't find a family doctor, you've likely heard your premier blame Ottawa and equalization. That story collapses under scrutiny.
1. Healthcare is provincial. The Constitution gives provinces exclusive authority over hospitals, delivery, and funding. When a province closes rural ERs or understaffs nurses, that's a provincial decision—own it.
2. The federal contribution is the cherry, not the cake. The Canada Health Transfer covers ~22% of costs with no strings attached. That share has grown. If wait times keep rising, the problem is provincial spending choices.
3. Equalization has nothing to do with healthcare. It's an unconditional payment to raise a province's revenue capacity to the national average—not a healthcare program. Equalization flows into general revenues. If a province cuts healthcare despite receiving equalization, it chose to spend that money elsewhere.
4. The tax-rate trap. Some provinces keep taxes artificially low, then claim poverty. Equalization guarantees capacity, not a subsidy for self-imposed tax cuts.
5. You vote for premiers on health. If you're angry about hallway medicine, your ballot can replace your provincial government. You have zero direct power over federal health transfers.
The bottom line: Ottawa hands over a generous cheque. Provinces control everything else. Equalization didn't fail you—your provincial government's priorities did.
I urge Alberta, Saskatchewan, and our MPs to drop the false blame game. And I urge Saskatchewan citizens: Enough is enough. No privatization necessary. We are the birthplace of universal healthcare in North America. Defend it. Expand it.
Calma, Calma. I got that advice one night in Cuba from one of Fidel’s former generals
The illogicality of this is as you say mind boggling. This is 1984 in real time.
This all is dead simple.
First we agree to pay for a broad range of health care via our taxes - done
Secondly we hire and empower capable institutional staff to oversee it, and no that’s not the sitting government doing the hiring.
Third the government , conservatives, keep their noses and their idiotology out of policy.
Fourth allow adequate funding and stop belittling labour be it cleaning staff to administration.
Fifth select group of interested engaged people to develop long term strategies around provision, funding and delivery of services. Again omitting any government interference
It’s that simple. The problem always has been the interference of government and now compounded by the fire sale to family and friends.
It’s not a business it’s an institution providing services to us.
Dani two things. A- you can’t run a government like a business that’s just bumper sticker talk. B- you have no experience- well in pretty much anything but grievance, rage and victimhood.
So let me help you through your latest iteration of abject stupidity
Finite number of staff, facilities and funding plus ageing population.
Telling staff they can take an extra job in the private sector. See point 1 finite staff already maximized.
Telling us competition between AHS and private sector when you are funding both is again off the scale ludicrous. I’ll be asking UofC to take back your economics degree.
Just to elaborate when you create the private sector you now create two more layers of bureaucracy and one layer of profit.
What you have done then is completely lost control over the whole. As costs rise do you think your provider will cinch his belt? Of course not.
Conversely as costs fall will they pass that along - of course not.
This is all before we talk about capitalization of machinery and tech.
While this isn’t the dumbest thing you’ve proposed it’s right up there.
Time to leave Dani, your goose is cooked