Every province in Canada is struggling with its health-care system.

Although health spending has increased in every jurisdiction, waiting times for emergency and specialized services continue to climb while infrastructure and skilled labour shortages plague the systems. The root of the problem is within the Canada Health Act. While provinces are tasked with administering and delivering healthcare, federal legislation constrains the provinces in how they can operate. Premiers seeking reform must find ways to pursue changes without running afoul of the federal legislation.

Alberta Premier Danielle Smith has never made her intention to reform the health-care system a secret. She has mused about expanding private health-care provision options and setting up health-care savings accounts for citizens who may choose private or alternative medical options. That led to accusations of Smith wanting to privatize the public system, which is political blasphemy in Canadian politics. In the 2023 Alberta election, Smith was forced to repeatedly reiterate her commitment to a fully public health-care system.

With the pursuit of private care options off the table for now, Premier Smith has set her sights on reforming the health-care bureaucracy that operates as Alberta Health Services (AHS).

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