“Hi, I’m Danielle Smith, and I believe no one should ever have to pay out of pocket to see a family doctor.” So said Alberta’s premier in a 30-second pre-election video posted to the Internet on April 12, 2023.

The video continued, with Ms. Smith explaining in her chirpy, personable, reassuring public voice: “That’s why United Conservatives created the Public Health Care Guarantee. So every Albertan has confidence that they are always covered for the medical care they need. In Alberta, we’ve brought down surgical wait times, improved ambulance response, and are hiring thousands of new doctors, nurses, paramedics and other health workers. Our UCP team is improving health care for Albertans. So, together, let’s keep moving Alberta forward!”

In the background, an ethnically diverse group of friendly people, reassuring smiles on their faces, nod encouragingly in apparent agreement. Some readers will recognize among the happy faces former cabinet minister Kaycee Madu, who held the Justice, Labour, and Municipal Affairs portfolios in UCP governments despite some controversies along the way.

The video was posted on a website pumping the UCP’s “Public Health Care Guarantee.” 

“A UCP government will remain committed to ensuring Albertans have access to world-class health care, where and when they need it, through a publicly funded health care system,” the website promised. “Under a re-elected UCP government, no Albertan will ever have to pay for a doctor out of pocket.”

The statement continued with a canned quote for Ms. Smith: “‘I want to be clear: under the UCP’s Public Health Care Guarantee, we are committing to all Albertans that under no circumstances will any Albertan ever have to pay out-of-pocket to see their family doctor or to get the medical treatment they need,’ said UCP Leaders (sic) Danielle Smith. ‘It means that a UCP government, under my leadership, will not de-list any medical services or prescriptions now covered by Alberta Health Insurance. No exceptions.’”

According to a Postmedia report at the time, when Ms. Smith revived Jason Kenney’s widely mocked Canadian-Taxpayer-Federation-style health care guarantee gimmick she was reacting to voter skepticism about the government’s record on health care and what the reporter called “a growing tide of controversies.”

Obviously reassured, large numbers of Albertans, who polling consistently suggests take pride in their public health care system and want it to continue, voted for her UCP government in the May 29 election that year. 

Astonishingly, at least as of last night, that website and video remain online, where anyone can see them, although a UCP news release linked from the page has disappeared. I’d suggest you watch the video quickly, though. I imagine it won’t stick around for long. After all, it’s prima facie evidence of Ms. Smith’s and the United Conservative Party’s bad faith. 

For those promises have been broken. April 12, 2023, obviously, was then. This is now.

To quickly recap, in the fall of 2025, Ms. Smith’s Government imposed on most Albertans a $100 fee for COVID-19 vaccinations.

In December 2025, the UCP passed legislation allowing physicians to charge patients out of pocket for speedy care while continuing to bill the pubic health care system, sending those who can’t pay extra to the back of the line. It moved in the same law to create a private health insurance market, allow private-hospital operators, force public hospitals to compete for revenue, and add other measures that will increase costs for patients and lengthen wait times for those unwilling or unable to pay. 

In May this year, the UCP passed another law permitting private companies to charge patients without a physician’s referral for complex medical tests – a measure that can be expected to pull specialists and resources out of the public system and lengthen wait times even more for the rest of us. 

In June, the UCP introduced regulatory changes to allow the government to proceed this September with creating its planned two-tier health care system. As Friends of Medicare Director Chris Gallaway said then, “Telling Albertans to choose between cleaning out your retirement fund and waiting years in pain for a needed surgery is frankly insulting, and goes against the principles of equitability and universality on which our public medicare system is founded.” 

But while the changes are widely seen as violating the Canada Health Act, which creates nationwide public health care standards, so far Prime Minister Mark Carney and his health minister have sat on their hands. 

Last week, the UCP took another step toward U.S.-style private health care, publishing without the usual boastful press release Orders in Council that reclassify all preventive health testing services as non-insured extended health services.

To be fair, the cabinet orders are murky and unclear. But this very much sounds like the end of the promise the premier’s government would never delist medical procedures from public funding. 

All of which raises the question, did Ms. Smith really believe her re-election fairy tale in 2023, or was she deceiving us? 

Her record suggests she already planned to do exactly what she’s doing and successfully played Albertans for suckers. 

“My view is that the entire budget for general practitioners should be paid from Health Spending Accounts,” Ms. Smith said in a 2021 article for the University of Calgary’s School of Public Policy. “If the government funded the account to $375 a year, that’s the equivalent of 10 trips to a GP, so there can be no argument that this would compromise access on the basis of ability to pay.” 

At the time the paper was published, Ms. Smith was still the president of the Alberta Enterprise Group, a business advocacy organization with extensive ties to conservative parties. “We can no longer afford universal social programs that are 100 per cent paid by taxpayers,” she asserted in her rather unscholarly paper. “The only option is to allow people to use more of their own money to pay their own way and to use the power of innovation to deliver better services at lower cost.”

“Once people get used to the concept of paying out of pocket for more things themselves then we can change the conversation on health care,” she added. 

So as we can see, once she was premier – her election promises notwithstanding – Ms. Smith proceeded directly with the program she outlined in her 2021 private health care manifesto. 

Well, one of these days we’ll have another election, and despite all the distractions it might even be possible that health care becomes an issue once again.

So the important question is this: Will anybody believe her promises this time? 

They shouldn’t. But Alberta political history suggests they probably will.