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.
Anyone who looks at the nightmare in the U.S. and still wants to privatize health care in Canada should immediately pack up and head over the border. We do not need privatization that will cause bankruptcy here in Canada. Anyone who likes what the U.S. is doing is free to go there but leave Canada alone.
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.
I’ll keep repeating myself, until Danny’s fever dream for healthcare privatization breaks.
If the private surgical suites are receiving twice the fee for hip/knee surgery as the public system, that means 50% fewer Albertans living with debilitating pain will get surgery in that year.
If 50% fewer Albertans get their surgery, that means they remain at risk of opioid addiction and overdose deaths. If they develop an opioid addiction, that means Danny’s donors can lock them up in their for profit, forced treatment centres. That is until locking innocent people up for profit is proven unconstitutional.
If locking up innocent people for profit is deemed unconstitutional Ms. Smith will just use the constitutional nuclear weapon known as the Notwithstanding Clause. She feels it's not used enough in this country.
It’s all about giving the already wealthy more opportunities to “invest” and have public money funnelled into their coffers.
- like they did when they privatized hospital laundry services and the trucking firm and the facility in Edmonton somehow related to a certain wealthy family -,got the contract.
Or the Taiwanese people they travelled to the Pacific Rim to urge to come to Alberta - and sold the then new large Chinook liquor store , for $25,000.00. Ditto the one in Airdrie, I was told by someone in the business.
And the Holy Cross Hospital - whole property, they closed and sold to two brothers who supported Klein’s party- for 4.4 , maybe it was 4.5 million. That’s it .
And that after they had just finished a 33 million dollar Reno on the special care nursery- that never got used. As I remember it.
The type of people in these so called conservative parties are -well -unspeakable .
They are ruthless, destructive, anti social, and now - willing to destroy the province of Alberta, the value we have in our homes and pensions, our whole way of life.
Their friends are friends of Trump. Trump and his rogue White House , are murderers. It’s plain to see. And I don’t think it’s just in a war situation.
I don’t know how we resist.
I would also wish Danielle Smith and any one of her cronies a very , very , very long wait in an Alberta emergency department. Maybe after a very long ambulance ride to an open emergency department.
Now, I'll admit that I am not a Healthdare Economist, but I have developed a simple, easy to understand formula to help explain the current situation with surgeries in Alberta.
This woman. The one with Dani Smith. What ever gave her any idea that she could tell Doctors and Nurses what to do. She is a glorified administrative assistant. When I went to NAIT to study Chemistry, I went one day to the administrative education building. They had fucking playing cards in a vending machine. I did not even know what playing cards were when I was at NAIT. Then I had an administrative person tell me they would be my boss one day. I told them that was bullshit. Almost all my bosses were professional engineers.
This piece of shit needs to be ran out. And release the corrupt care scandal report. We need to see if she should be jailed. These people are stealing from us and destroying our healthcare. Who voted for this shit? #UCP
Readers should realize that there is big money in health care and the grifters are always circling. The reason that they like UCP and PC governments is Because these parties have an ideological bias against public services. Despite evidence to the contrary, from all around the globe, they believe that for profit service providers are more “efficient”. And provide services at lower cost. My son who works in infrastructure says to me that there is not one example of a PPP, public private partnership, that comes in on time and on budget. Still the fantasy continues in the conservative brains. Think about the math, allow for a “reasonable” profit of 10%. That means the 8,000 surgery really costs 7,200. And 800 is going to the bottom line. Which is why the for profit medical business avoids complex cases. In a non-profit hospital the 8,000 goes to providing the surgery and care and the public part of the system picks up the messes made by the for-profit operations and the more complex care cases. The ministry of health supposedly has professional staff and advisory groups who can cost procedures and pay accordingly. But of course here we run into another conservative brain fart. Bureaucrats are unnecessary and just cost the system money. So get rid of them, move the decision making to non-accountable crown corporations and make sure your friends and funders are well introduced. Turkish aspirin anyone?
Wouldn’t the easiest political win for any party to have in Canada to look at any increase in private provision of health services and just claim the party responsible for this ‘want’s an American style healthcare system’ ?
I know in Australia and Britain to leave yourself open to being accused of wanting US style healthcare would be political suicide
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.
Anyone who looks at the nightmare in the U.S. and still wants to privatize health care in Canada should immediately pack up and head over the border. We do not need privatization that will cause bankruptcy here in Canada. Anyone who likes what the U.S. is doing is free to go there but leave Canada alone.
Well said.❤️🇨🇦💯
In the US, you can go bankrupt paying for healthcare treatments and still die. How is that acceptable to anyone living in Canada?
I agree 💯 that those who think that is okay can leave.
Kelly: Absolutely! You got 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
EXACTLY
Well said!!
I’ll keep repeating myself, until Danny’s fever dream for healthcare privatization breaks.
If the private surgical suites are receiving twice the fee for hip/knee surgery as the public system, that means 50% fewer Albertans living with debilitating pain will get surgery in that year.
If 50% fewer Albertans get their surgery, that means they remain at risk of opioid addiction and overdose deaths. If they develop an opioid addiction, that means Danny’s donors can lock them up in their for profit, forced treatment centres. That is until locking innocent people up for profit is proven unconstitutional.
Is this the Alberta we want?
If locking up innocent people for profit is deemed unconstitutional Ms. Smith will just use the constitutional nuclear weapon known as the Notwithstanding Clause. She feels it's not used enough in this country.
“I can’t even make it sound less stupid.” - if you decide to sell Substack tshirts, this will be the top seller.
It’s all about giving the already wealthy more opportunities to “invest” and have public money funnelled into their coffers.
- like they did when they privatized hospital laundry services and the trucking firm and the facility in Edmonton somehow related to a certain wealthy family -,got the contract.
Or the Taiwanese people they travelled to the Pacific Rim to urge to come to Alberta - and sold the then new large Chinook liquor store , for $25,000.00. Ditto the one in Airdrie, I was told by someone in the business.
And the Holy Cross Hospital - whole property, they closed and sold to two brothers who supported Klein’s party- for 4.4 , maybe it was 4.5 million. That’s it .
And that after they had just finished a 33 million dollar Reno on the special care nursery- that never got used. As I remember it.
The type of people in these so called conservative parties are -well -unspeakable .
They are ruthless, destructive, anti social, and now - willing to destroy the province of Alberta, the value we have in our homes and pensions, our whole way of life.
Their friends are friends of Trump. Trump and his rogue White House , are murderers. It’s plain to see. And I don’t think it’s just in a war situation.
I don’t know how we resist.
I would also wish Danielle Smith and any one of her cronies a very , very , very long wait in an Alberta emergency department. Maybe after a very long ambulance ride to an open emergency department.
Now, I'll admit that I am not a Healthdare Economist, but I have developed a simple, easy to understand formula to help explain the current situation with surgeries in Alberta.
Which will cost more?
PROVIDE SERVICE = X$$$
OR
PROVIDE SERVICE + PROVIDE PROFIT = X$$$
You're welcome...
PS: formula can be applied to any service. Utilities, insurance, etc.
May your rage be a magnet that pulls people back to a sanity that rids us of this ridiculousness.
I couldn’t help myself. Legitimately the most ignorant thing…
It’s a fair feeling and what’s best is that you’re doing something about it. Rage for rage’s sake will just eat you alive. This is sacred rage :)
This woman. The one with Dani Smith. What ever gave her any idea that she could tell Doctors and Nurses what to do. She is a glorified administrative assistant. When I went to NAIT to study Chemistry, I went one day to the administrative education building. They had fucking playing cards in a vending machine. I did not even know what playing cards were when I was at NAIT. Then I had an administrative person tell me they would be my boss one day. I told them that was bullshit. Almost all my bosses were professional engineers.
This piece of shit needs to be ran out. And release the corrupt care scandal report. We need to see if she should be jailed. These people are stealing from us and destroying our healthcare. Who voted for this shit? #UCP
Great essay Deidre!
Duh-duh-Dani and her fantasized private sector healthcare delivery shenanigans have been her particular idee fixe for over 20 years.
Of course she’s going to go all “aw shucks” and blow soothing smoke….
She’s like an insane terrier with a rat!
Readers should realize that there is big money in health care and the grifters are always circling. The reason that they like UCP and PC governments is Because these parties have an ideological bias against public services. Despite evidence to the contrary, from all around the globe, they believe that for profit service providers are more “efficient”. And provide services at lower cost. My son who works in infrastructure says to me that there is not one example of a PPP, public private partnership, that comes in on time and on budget. Still the fantasy continues in the conservative brains. Think about the math, allow for a “reasonable” profit of 10%. That means the 8,000 surgery really costs 7,200. And 800 is going to the bottom line. Which is why the for profit medical business avoids complex cases. In a non-profit hospital the 8,000 goes to providing the surgery and care and the public part of the system picks up the messes made by the for-profit operations and the more complex care cases. The ministry of health supposedly has professional staff and advisory groups who can cost procedures and pay accordingly. But of course here we run into another conservative brain fart. Bureaucrats are unnecessary and just cost the system money. So get rid of them, move the decision making to non-accountable crown corporations and make sure your friends and funders are well introduced. Turkish aspirin anyone?
Wouldn’t the easiest political win for any party to have in Canada to look at any increase in private provision of health services and just claim the party responsible for this ‘want’s an American style healthcare system’ ?
I know in Australia and Britain to leave yourself open to being accused of wanting US style healthcare would be political suicide