No premier in living memory has had the courage to take the political gamble of pursuing systemic reform when it comes to health care. That may all change with Alberta Premier Danielle Smith as she boldly has staked her political career on tackling the provincial health-care system. Rest assured every premier in Canada will be watching Smith’s gamble closely. If she succeeds, we may see provinces pursuing systemic change across the country.
Canada’s universal health-care system has long been a symbol of national pride. It is also considered to be a sacred cow by many. We have woven the system into the fabric of our national identity, and woe betide the politician who may dare to challenge the status quo. Governments have tinkered around the edges of the system, but they rarely will try anything beyond pumping more money into it.
Canada’s current model of universal health care is unsustainable, though few leaders will dare to point that out. While spending on health care has dramatically increased in every province over the last decade, the performance of the system continues to lag. Waiting lists are growing for every service, from specialists to family doctors to emergency treatment. Knowing the system provides universal “free” coverage is of the coldest of comforts if you die while waiting to get into it. Something has to give.
It is a big gamble. If health-care performance continues to decline despite Smith’s reforms, she could very well lose the election over it. She is going all-in with her wager.
With such a short timeline to work with, it isn’t surprising that Smith is hitting the ground running. She began by firing Alberta’s Chief Medical Officer Dr. Deena Hinshaw. Next, she dismissed the entire Alberta Health Services board of directors and replaced them with a single administrator. She is getting rid of the old guard to be able to implement reforms without dealing with opposition from people heading up the system.
Reactions from Smith’s political opponents have been swift, and predictable. NDP leader Rachel Notley is accusing her of adding chaos to the system, while union leaders imply Smith plans to privatize the system and force people to pay out of pocket for care. Those have been the stock responses from defenders of the status quo for years as they work to raise fears that citizens may lose health-care coverage if any changes are made to the system. Those tactics are losing political efficacy, as people are finding themselves unable to get timely care under the current layout.
The true elephant in the room is the potential expansion of private health-care options within the universally funded system. While serving as the leader of Alberta’s official opposition and during her role as a talk radio host, Smith has never made a secret of her support for exploring the expansion of private care options within the public system. This is where every politician faces their most heated opposition in Canada when proposing health-care reforms. They are immediately accused of wanting to Americanize the system, and the spectre of people being turned away from care for lack of personal funds is raised.
Premier Smith has put her neck on the line and isn’t showing any signs of being willing to back down.
If Smith’s reforms are a success, she will win re-election next May. It will embolden premiers across the country to pursue similar changes in their provinces as their own systems and budgets are overburdened. If the reforms fail, Smith’s tenure as premier will be measured in months rather than years. Alberta will be the petri dish for health-care reforms.
The battle is sure to be fierce as it may lead to a domino effect of change for the entire country. Smith’s campaign may be provincial, but it will have national implications.
