Five years ago, Alberta Premier Danielle Smith was already gaming out how to dismantle public medicare, discussing how to get the federal government “out of the business of health care.”

In an episode of a podcast she hosted in 2021 for right-wing think tank the Fraser Institute, she mused about how she could build a parallel for-profit system—even if it involved breaking Canada’s foundational health care laws.

“You can tell me if our starting point needs to be throwing out the Canada Health Act,” she told her guest, the Fraser Institute’s senior fellow on health policy Nadeem Esmail.

An independent legal opinion issued last week by a major law firm said Smith's legislation "clearly violates" the Health Act.

Yet Mark Carney's federal government has not intervened, despite pleas for months from health organizations, labour unions, and the NDP to use its powers, including financial penalties, to stop Alberta.

"Our government will always defend Canada's universal health care system," a spokesperson for the federal Health Minister told The Breach. He said the federal government would "closely assess the regulations associated with the bill."

Since taking office, however, the Carney government has broken one promise after another on the health-care file.

Health Canada saw its funding chopped by $1.3 billion in the 2025 budget. The federal government has stopped negotiating any new pharmacare agreements with provinces.

While the federal government hangs back on enforcing the Health Act, Alberta's privatization risks spreading across Canada.

On a 2021 podcast, the Alberta premier wondered aloud if privatizing health care would require breaking federal law. Despite learning the answer was ‘yes,’ she’s still going ahead with it

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