Today’s political weather forecast: Ill winds that blow no good will begin throughout Alberta on Wednesday.

Mr. Stelmach’s health minister, Ron Liepert, in 2012 (Photo: David J. Climenhaga).

After that, conditions will get worse.

Wednesday is when Premier Danielle Smith has promised us her health minister will present a plan to cabinet to “decentralize,” “reform,” “reconfigure,” or whatever, Alberta Health Services.

Call it what you will, the conventional wisdom in health care is that the chaos the Smith Government now proposes to sow is exactly the last thing our frayed and battered health care system needs. As is usually the case when actual experts are doing the predicting, the conventional wisdom is right. 

The United Conservative Party doesn’t care, though – its leaders have has bigger fish to fry. 

So never mind the positive spin you’re sure to hear. Everybody in this province understands that whatever the scheme Adriana LaGrange hands to cabinet says, it will have the potential to unleash a catastrophe in public health care in Alberta as severe as the battering the province’s health system took from the global coronavirus pandemic that began in 2020 and continues to this day.

Alberta Premier Danielle Smith (Photo: Alberta Newsroom/Flickr).

This includes, unquestionably, the people who cooked up the plan for Ms. LaGrange, whatever it turns out to be, who are presumably hoping to create the kind of situation modern disaster conservatives use to undermine public services in their unrelenting quest for the financialization of everything. 

But something is going on this time beyond the usual neoliberal shenanigans to create conditions in which privatization and similar “reforms” can be justified.

Indeed, as we have recently seen, Ms. Smith is willing to move her privatization agenda to the back burner, or even drop it entirely for a spell, in the face of political necessity like that created by the privatization-induced collapse of medical lab services in Calgary.

Whether she would be willing or able in similar circumstances to move away from her anti-AHS agenda in the face of a public backlash – especially at the risk of alienating the party’s radical and increasingly powerful Take Back Alberta faction – remains to be seen.

Regardless, for the Smith Government, its plans for AHS represent a new front in the ideological civil war within the conservative movement in Alberta and Canada. 

Alberta Health Minister Adriana LaGrange (Photo: Alberta Newsroom/Flickr).

If she is really proposing to move ahead with effectively dismantling Alberta’s province-wide public health agency – or to divest it of key functions it has held since it was established such as cancer treatment, mental health, addictions services, community health, and long-term care – the Smith Government will be intentionally destroying one of the signal achievements of the Progressive Conservative government that ruled Alberta from 1971 until 2015. 

For, try as they might, the UCP can’t blame Alberta Health Services on the NDP – although the NDP does deserve credit for keeping it together and running smoothly under health minister Sarah Hoffman’s clear-eyed leadership from 2015 to 2019. 

When the Progressive Conservatives created the largest integrated health care system in Canada in the spring of 2009, Premier Ed Stelmach and his health minister, Ron Liepert, may have merely been trying mainly to solve a political problem caused by the inconvenient power of the Calgary Health Region’s leadership.

NDP health minister Sarah Hoffman in 2016 (Photo: David J. Climenhaga).

Still, over the past 14 years AHS has matured into a success story from which Alberta has benefitted significantly. 

By the start of the pandemic, AHS had the lowest administration costs of any health care system in Canada, according to a comparative study by the respected Canadian Institute of Health Information.

And Alberta’s response to COVID-19 was more effective than almost anywhere else in North America thanks to the size and purchasing power of AHS and the capability of leaders like former CEO Verna Yiu – who was later fired by former UCP premier Jason Kenney in a craven attempt to save his sorry ass from the same vaccine conspiracy theorists who now dominate the party he founded.

Mr. Stelmach and Mr. Liepert didn’t just pull AHS out of thin air, of course. The PC government of Ralph Klein had centralized health care delivery into large health regions, and then reorganized them again into larger regional agencies, principally as a cost-saving measure. 

Former AHS CEO Verna Yiu (Photo: David J. Climenhaga).

But this trend to technocratic conservatism with incremental privatization has now been confronted by the desire for a revolution in the neoliberal revolution by Take Back Alberta, the radical UCP faction inspired by Christian nationalism, bitter opposition to public education and inclusive schools, and president Donald Trump’s four years of misrule in the United States. 

Ms. Smith, beholden to TBA for her hold on power and sharing its leaders conspiracy-minded distrust of vaccines and faith in quack COVID remedies, appears enthusiastic to go along.

TBA cadres – resentful about the inconvenience of public health measures during the pandemic, steeped in false conspiracy theories about vaccines and Christian nationalist dogma, and now poised to complete their takeover of the party at its annual general meeting next month in Calgary – want “reforms” of AHS that will make enforceable public health measures impossible in Alberta.

Of course, Ms. Smith’s claim her plans will make health care more responsive to local wishes may apply to abortion services in rural hospitals, but you can be assured this will not extend to wearing surgical masks in urban ones as COVID-19 spreads again. 

American television producer Rod Serling (1924-1975), best known for his anthology television series, The Twilight Zone (Photo: CBS Television, Public Domain).

Indeed, considering some of their leaders’ rhetoric, it’s not outside the realm of possibility TBA dreams of a day when life-saving vaccines can be banned entirely in Alberta.  

Arguably, these extremists despise progressive Conservatives like Mr. Stelmach more than they hate the Liberals in Ottawa and the NDP Opposition in Edmonton, both of which they risibly label as “communist.”

Mr. Stelmach, by the way, remains actively involved in public health care, as chair of the board of Covenant Health, the province-wide organization of publicly funded Catholic health care employers set up in the same time frame as AHS. 

UCP strategists may now try to leave politically disengaged voters with the impression their party is a continuation of the PC coalition that successfully and mostly popularly ran Alberta from Peter Lougheed’s election in 1971 until Rachel Notley’s NDP finally broke its grip on power. 

But the reality is quite different. Under Ms. Smith, her separatist office manager and Svengali Rob Anderson, and TBA’s shadowy leadership, the UCP has become a sort of political subculture – Leninist in strategy and Christian nationalist in objectives – as determined to wipe out the accomplishments of previous Conservative governments as to attack Liberals and New Democrats.

It may be true that a house divided against itself cannot stand, but it can make a godawful mess when it starts to fall apart. 

Recall that episode of The Twilight Zone where a mean little kid controlled everything and everyone in a small Ohio town and sets about, as Rod Serling put it, moving an entire community back into the dark ages? 

Welcome to Alberta, where mean little kids are in charge and there’s nothing you can do about it. This is the Twilight Zone!

Join the Conversation


  1. What’s old is new again, but I do wonder what this reorganization will look like. Danielle Smith has been calling for the disintegration of AHS since she jumped into the Wildrose Party leadership back in 2009, but the government has become accustomed to centralized control that allows them to dismiss the entire board or CEO (or board and CEO) on a whim. I can’t imagine a government, even one as radical as Smith’s, to give up that power.

    1. How much vengeance for COVID is enough, for the radical right? I have never seen a group so bent on cutting off their nose to spite their own face. Parker fancies himself the Bannon (or maybe DeSantis?) of Alberta, pulling strings and fomenting hatred. Regardless, it’s clear he’s never had an original thought in his life. Doppelgängers indeed.

  2. David, another frightening article from you! I think you should make sharing your posts on (Twitter) and FB possible so that the word about this dreadful government can be more easily spread. Voters have to know how bad she’s becoming!

    1. Actually DJC normally shares his posts on his own ‘X’ feed. You can also share them yourself on FB or ‘X’ using the share function in whatever web browser you read him on.

  3. According to The Breakdown, they are reducing the amount they pay to pharmacists for giving covid vaccinations, from $25 to $18 right now and to $13 next April.

    1. Yes they are cutting reimbursement by 40% as of this past Sunday. They announced it Friday late afternoon. Reimbursement goes down another 25% next year down to the levels the NDP government had previously set (decrease of 30% at the time). The UCP basically kicked pharmacists in the gut. Nice thank you for the front line work we did and do in the pandemic. I’d stop giving vaccines as we can’t now cover costs, but I’m in a remote rural area so I feel I have a responsibility. Pharmacists are tired of working for free because of our sense of responsibility and patient care.

      1. Well, I thank you for doing your essential work giving out vaccinations and helping to reduce the deadly effects of Covid-19.

  4. The Liberal turned Reformer, Ralph Klein, had fully intended to get private for profit healthcare in Alberta. His cuts to the public healthcare system in Alberta were so bad, that people nearly lost their lives, or they lost their lives, because of it. Hospitals were improperly maintained, or demolished, and so many nurses were given pink slips. Danielle is intent on copying Ralph Klein, whom she admired so much. Covid-19 numbers are going up, and this will further strain things, but the UCP doesn’t care. It will be a rough four years.

    1. Back when PM Brian Mulroney was negotiating the Free Trade Agreement with the US, the Americans were trying to gain access for the For Profit medical industry. Access was not granted but I have observed a slow and gradual slide in that direction which makes me wonder if there was so some sort of `back door entrance and a deliberate action by our governments to create problems by underfunding our health care system. I believe it was back in the Chretien/Paul Martin days that the feds dumped about 40-50% of the federal portion of health care costs onto the provinces then claimed they balanced the budget. Whatever is going on at AHS, I really didn’t like the idea that AHS was getting advice from the World Economic Forum (WEF) for COVID solutions. If you think I am crazy I suggest you Google the Medical Advisor to WEF, Dr Houval Noah Harari and see what he is all about. As far as I am concerned AHS needs a shakeup, reorganization and to thin out the number of management people in relation to the number of front line workers. What we have now is not working, just look at ambulance service and emergency line ups.

  5. Read in the news the other day that the Premier of NFLD requested former residents of the province move back home. They needed the workers. If Smith goes ahead with dismantling health care in Alberta, NFLD may see a lot of people returning. It may also cause others to not move to Alberta. Yes, the housing is less expensive and yes there are lots of jobs but if you have to pay for your own health care you could go bankrupt, not to mention die. If seniors die, and they voted for Smith and her gang, its their own fault. Its just kids die also and they didn’t get to vote. When you dismantle health care the rate of dealth amongst pregnant women and those who have just given birth along with their babies have a much higher rate of .death.
    Perhaps Smith’s quest to dismantle health care is a round about way of dealing with the lack of housing. when the population is dying faster than normal, there is more housing available. Of course those good old bible bounders will think its o.k. because they’re going to a “better place”.
    Smith might have “borrowed”Huckabee’s play book, who knows what goes on in Smith’s mind.
    Having seen Smith speak on the news, here in B.C., sometimes I have the impression she just is out of her league and not playing with a full deck. Perhaps its something in the drinking water.

    1. e.a.f., I now seriously doubt that what goes on in Danielle Smith’s head can be described as thinking.

      Smith is a libertarian by attitude, and a neocon Trumpist Republican by politics. She’s a conspiracy-theorist wack job. In a CBC interview, Smith quoted a former staffer who told her she has “no crazy radar”—and she seems proud of it. She has a whim of iron and a brain of bean curd.

      I’m convinced that Danielle Smith is driven not by rational thought, but by emotion. She seems to decide what she wants based on how she FEELS, then looks for excuses for her feelings. The more bizarre the excuses, the harder she flaunts them.

      The brief Wikipedia bio at says she has two university degrees, in English and economics. She’s apparently never been employed as an economist, unless briefly (and as a junior intern) at the Fraser Institute. Certainly nothing she learned at the U of C taught her how to think.

  6. A reminder of what it was like under the smaller regions: A relative needed care in the big city. The relative was labelled a “non-resident” and put at the bottom of a waiting list. This supposed “non-resident” had lived in Alberta all her life, but was treated as if she’d come from another province or even another country.

    Care was not based on need or equality for all Albertans, but on fiefdoms. Each fiefdom set its own priorities. The one I used to live in chose diabetes as its favorite cause. Accordingly, there was no care available in the region for people with heart conditions because the budget did not prioritize heart health. “Get diabetes” should have been the region’s motto.

    1. Thanks Abs, we needed this warning. Smith will try to return us to the “good” ol’ days. In addition to underfunding, understaffing, chaotic management and worsening morale (how much lower can it get?), we’ll now have a health care system that Balkanized. Yay. Every manager for himself. Battlin’ business units everywhere.

  7. What could go wrong, when the people behind the greatest poisoning of freedom and democracy loving Canadian children in Canadian history, are in charge of peoples health?

    1. I’m sure the folks of Fort Whooping Cough Up will be happy to have more ways to kill their children with impunity.

  8. It ought to be ironic, but somehow it just seems inevitable. The only good decision by the Old Tories was the accidental improvement of Alberta’s health care system. Ron Liepert didn’t mean to do that, he just wanted to kick out a noisy rival. Since then, the only time there HASN’T been chaos in our hospitals was during the NDP interregnum.

    Danielle Smith will be a textbook study in how not to run a Canadian province. She’d be much more suitable for governorship of an American red state. Anybody want to start a GoFundMe page to send Danielle, Rob, Barry and David to Alabama?

    1. There wasn’t chaos in hospitals, but under the NDP there were massive cuts to pharmacist services. They vilified us and lied to the public about the cuts.

    1. Lars: I don’t accept the preposition of that sentence. Joke. It’s been fixed. DJC

  9. Four more years of this, and worse. Thanks Notley for announcing a rise in taxes during an election campaign. What the hell was the NDP thinking? As a result we have this. Oh, and thank you rural voters [that’s sarcasm].

  10. Hello CovKid
    Tempting, isn’t it. The problems, I think, include B C is more willing to ignore corruption than AB, and the cost of housing in B C makes Alberta look inexpensive. However, if Smith brings in pay-as-you-go healthcare, then, any province will look better than Alberta.
    When we lived in Houston, a neighbour and daughter were in an auto collision. The cost , after taking into consideration free and discounted care because the neighbour worked at a hospital plus the amount paid by insurance, the neighbour’s cost was $380,000 U S. That would be somewhere around $700,000 Cdn to-day. U S-style health care, no thanks.

  11. “privatization-induced collapse of medical lab services in Calgary”

    It wasn’t privatization that caused the lab issues in Calgary.
    Lack of previous capital investment by CLS/APL before privatization (no new collection sites in many years), the switch to Connect Care, staff shortages, and taking hospital collection capacity out of the system, all while post-pandemic patient volume increased. Perfect storm.

    As to everything else, these UCP clowns are going to be literally the death of us. Looking at moving to BC.

  12. Daniel Smith is said to be considering making all new wheelchairs and mobility scooters be coal fired to save on health care costs!!

  13. Yet more signs that the UCP are broken. Someone should tell PP that they are the broken ones not Canada.

  14. This must be the part where Alberta’s unfolding dark comedy takes the turn of become a Saw movie.

    Danielle Smith makes a proposal … want to play a game?

    The CPP is Justin Trudeau’s pension plan and it’s Woke AF. So, how about an Alberta style pension plan, where the funds are invested in good ole Alberta stuff…like oil…and more oil…and nat gas?

    Or, you can have public healthcare, that doesn’t try to deny you the availbility of vaccines, or doctors, or hospitals, or medical staff.

    Now, here’s the catch … you have to have one with the other. But even then, there’s no guarantee that you will get what you think you’re getting. Danielle Smith’s reality is kind of like that.

    If you go for, in a fit of emotionalism, the APP and its sketchy investment strategy, for the sake of owning PMJT, you may have proven that you’re willing, by default, to go for a broken public healthcare system.

    Albertans will be the stupidest people alive if they play this game.

    1. Financial Times just did an article on their analysis of banking decisions, insurance trends and how quickly nations and cities around the world are electrifying. The result of the study was they are suggesting the peak USE of oil will begin becoming apparent in about a decade. That means the oil Alberta produces will be reduced because fewer and fewer markets will want to take it. At that point, Alberta’s fortunes will begin a long and inevitable decline. Who will you blame then?

      1. First, who funded the study. Second, no matter what Western countries do to try and wean off oil, what really matters is what China and India do. If they don’t care about it, then oil will be around for a long time. Not saying that’s good, just saying some of it is out of our control.

  15. I feel the ongoing conservative obsession about the size and structure of AHS indicates one or both of two things. First, that they have no clue about how to really fix health care, but they need to appear to be doing something, so they go through the motions. Second, that they have no interest in fixing health care, so they need a good distraction.

    Over the last several decades, we have had decentralized systems with hospital boards, various in between systems with regional bodies and now a more centralized system. However, the fundamental problems with health care in Alberta persists throughout all of these, which leads me to believe the structure is not the problem.

    I get the current effort by the provincial government to try sell a more decentralized system as a cure for those problems isn’t based so much on reality or evidence, but more as a way to try satisfy a block of voters that the current UCP wants to try keep happy – an anti COVID restriction, mostly rural group. I suspect the implicit message is that creating some smaller more rural health regions, will lead to or allow approaches that are more friendly towards this group.

    There are two dangers from this approach. The first is that it might work as planned. The second is that the promise of improvement in health care will not materialize by decentralization. Our current premier should know from past history that promising improvement in health care and failing to deliver it is a recipe for future political peril or disaster.

    Our current conservative leaders are like addled monkeys that can’t seem to learn to resist touching the third rail. Yet again, they risk getting a very nasty shock from it.

  16. I haven’t yet seen whatever document or plan LaGrange has come out with, but I’m not optimistic. Every time there’s been a major reorganization of Alberta’s health care system, it has gone through a long period of upheaval and uncertainty, as everyone in management from the CEO on down to front-line managers gets new roles, new responsibilities, new reporting structures and new budget allocations. At the point of care, clinical staff like nurses and allied health professionals do the day to day, providing care to patients as they always do, but suddenly they don’t know who’s in charge. Meanwhile, physicians — most of whom are not actually “staff” but instead have “privileges” to practice in hospitals and other AHS facilities — find themselves not knowing who to talk to when they have questions or concerns, and usually take it out on the first staff member they encounter regardless of whether they have the authority to address their concerns (speaking here from bitter firsthand experience).

    Where this really hits hard, though, is on anything that requires medium- to long-term planning. Every time there’s a restructuring, there ensues a prolonged period of what I call “decisional inertia”, lasting anywhere from a year to 18 months, and sometimes longer, depending on the scope of the restructuring. For example, restructuring the organizational chart of a regional health authority was less disruptive than the initial regionalization of the early 1990s, or the RHA mergers of the early 2000s. The creation of AHS created a longer period of decisional inertia, and the constant turmoil — from the firing of the “I’m eating my cookie” CEO to the later firing of the entire AHS Board — that characterized its first few years of existence meant that this phenomenon persisted longer than it should have.

    Eventually, some stability was found and the organization began to be able to actually make some progress on key initiatives. Now, though, we can expect more uncertainty and more upheaval.

    Typo alert: paragraph 17, in discussing the abrupt firing of Verna Yiu, the text refers to “UPC premier Jason Kenney”. Of course he’s not a bar code, but [former] UCP Premier.

  17. I would love to see the information from the link you posted
    By the start of the pandemic, AHS had the lowest administration costs of any health care system in Canada, according to a comparative study by the respected Canadian Institute of Health Information.
    but I can’t open it. It drives me crazy when I se UCP apologists who accuse NDP of bloating AHS administration with their appointees.

  18. They’ve delayed these cuts for a few months:

    “It would’ve caused a huge problem because of the fact that pharmacies had already planned for the next couple of months — our outreach clinics, our long-term care clinics, and all the other things that are going into providing COVID vaccinations this season,” Howden said.
    “It’s a lot of staffing. It’s a lot of supplies. It’s a lot of administrative time to organize these clinics and document everything properly we had planned based on a certain reimbursement and all of a sudden they were cutting that reimbursement significantly.”
    The Alberta Pharmacists’ Association said Alberta Health introduced the changes with no advanced warning and that the elimination of the funding will have an impact on patient care.

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