The drumbeat of referendum publicity has swept many problems under the rug in this province.

We’re in the midst of profound and dubious changes to services that Albertans depend upon.

In normal times, these would be top of mind. But the Oct. 19 vote, and the blizzard of news around it, doesn’t leave much breathing room.

Radical upheaval is bubbling, especially in health care.

The key points are:

• Health insurance changes that threaten higher costs for medications;

• A private surgery system that will bleed doctors from the public system;

• Explosive and controversial expansion of private surgery clinics;

• Radical restructuring of AISH.

Much of this came into full effect Sept. 1 with the implementation of Bill 11.

All of it — every step — is fully in line with Premier Danielle Smith’s determination to make Albertans pay for more of their own health care.

In the 2023 election, confronted with her earlier views on this subject, she pledged:

“You will never use a credit card to pay for a public health-care service.

“No Albertan will ever have to pay out of pocket to see their family doctor or to get the medical treatment they need.”

In the campaign Smith was forced to deal with what she’d written in a U of C policy paper two years earlier.

That paper reflects exactly what’s happening today.

“The fundamental rethink that needs to happen in health care is to create a patient-centered system,” Smith wrote.

“It has to be more than a slogan. It has to have buy-in on the part of practitioners and patients.”

And then, the kicker:  “It has to shift the burden of payment away from taxpayers and toward private individuals, their employers and their insurance companies.”

By “patient-centered system,” she clearly wasn’t talking about health care itself.

She meant costs would be centred on the patient.

That’s exactly what she’s done by shifting the payment order for medications that are also covered in part by employer insurance.

Health care now pays last, not first. Every analysis shows the government will pay less, the patients more.

The only way to argue that Smith kept her credit card promise is to say that nobody is forced to pay for private care.

You can always wait in line for your public appointment or procedure.

Just like I’m waiting for an MRI that’s finally scheduled — for 2028.

Or, like my friend who waited, waited some more, and finally opted for a private surgery — for $15,000.

Only a few months ago it was illegal for an Alberta doctor to perform a private surgery in the province. Some clinics flew surgeons in from other provinces to do this lucrative work.

That was a classic case of a rule that helped no one.

The solution, thanks to Bill 11, is that surgeons can move back and forth between private and public work.

But it’s no solution at all because it creates another enormous problem — the loss of public surgery time, due to an even more dire shortage of doctors caused by migration to private care.

On Thursday, senior Alberta physicians joined doctors across Canada in asking Prime Minister Mark Carney to intervene, saying the model violates the Canada Health Act.

“It is clear that the Alberta government is not going to change course and, therefore, we strongly recommend that you and the federal government step in an defend the principles of the Canada Health Act,” they wrote.

Then there’s AISH reform, which is causing enormous stress among the thousands of disabled people who must reapply for the benefit.

In one case, a person was refused because they have one leg amputated below the knee.

Above the knee would have been fine; below the knee, no AISH.

Then there’s the horrible case of the 18-year-old young man, confined to a wheelchair, unable to speak, requiring 24-hour care, whom the authorities ruled ineligible for benefits because he could work.

His mother went public. A moving video of this young man showed everyone that he couldn’t possibly be employed.

NDP MLA Marie Renaud said hundreds more AISH recipients are now being denied. Very few will be saved by a TV camera.

Finally, there’s the private surgery clinics, the scandal over procurement, and the long-awaited Auditor General’s report on this issue that hangs over Smith and the UCP.

When former auditor-general Doug Wylie ended his term on April 28, I was told the report was nearly ready for release. There were just a few loose ends to clean up.

Five months later, that crucial document still isn’t public.

But there’s plenty of referendum chaff to keep us distracted.

Don Braid’s column appears regularly in the Herald

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