EDMONTON—Danielle Smith nods along as she listens to the naturopath talk.
The naturopath is laying out her thoughts about cancer patients and how mainstream medicine deals with them. Smith agrees with her guest that medical practitioners don’t do enough to promote disease prevention and she says that when a person shows up at a hospital with Stage 4 cancer, they must consider “everything that built up before you got to Stage 4” because “that’s completely within your control.”
It’s a conversation from a podcast that Smith released in July 2022 as she was running to become the leader of the United Conservative Party and premier of Alberta. Critics would later say it was a glib way to talk about a complex disease that claims the lives of so many. Some of that criticism came from Smith’s fellow UCP leadership candidates, several of whom now sit in her cabinet.
But it is also one of several examples, observers say, of the unexpected and at-times confrontational approach Smith and some other conservatives seem to take, in the wake of the COVID-19 pandemic, with health and medical science.
The issue took the spotlight again this week, as a candidate with Smith’s United Conservative Party faced criticism of her own for suggesting that people who have heart attacks need to be held more responsible for their actions.
Critics see such remarks as a form of “magical thinking” — the kind of easy answers to complex problems that don’t hold up to scrutiny. Emerging from the COVID crisis at a time when trust in institutions and doctors has faltered, this thinking can resonate, they say. Increasingly coming from some conservative quarters, it’s a fusion of self-responsibility, institutional distrust and unscientific rhetoric that conservative politicians in and outside Alberta have been voicing.
It’s a shift some worry could have implications if Smith and the UCP win Alberta’s election next month, and are given a mandate to enact significant changes to the provincial health-care system. It could also fly in the face of Smith’s stated goal of fixing that system.
What happens when the person in charge of fixing the health system seems to be a skeptic?
Long before entering politics, Smith promoted controversial positions related to health.
In 2003, she penned a pro-smoking newspaper column promoting a controversial study suggesting that second-hand smoke didn’t contribute to developing cancer.
During the COVID pandemic, she hosted a popular talk-show in which she railed against public health measures being brought in and once promoted hydroxychloroquine as a treatment for the disease on social media.
When Smith ran to be UCP leader, she was supported by many conservatives in Alberta who had opposed public health measures, such as masks and vaccine mandates. Those supporters make up much of her base.
It’s part of a recent phenomenon on the political right, said Tim Caulfield, a health misinformation expert at the University of Alberta.
Politicians taking personal or unorthodox health-care stances isn’t new and, historically, it hasn’t been limited to conservatives. But the latest iteration of it has an “ideological theme,” Caulfield said, that seems to have mostly metastasized on the right.
He pointed to several people in the United States who got involved in politics: Dr. Mehmet Oz, the TV personality from the “Dr. Oz Show” and COVID measures critic, ran for a Senate seat. Robert F. Kennedy Jr., nephew of former president John F. Kennedy and a critic of COVID vaccines, is running for the Democratic presidential nomination in 2024. And a Wisconsin attorney general candidate, according to the Milwaukee Journal Sentinel, ran in 2022 on a platform to prosecute doctors who didn’t give Ivermectin to COVID patients.
“It certainly seems to be what’s happening in the United States, and you’re seeing hints of that here in Canada,” he said.
Recently, Chelsae Petrovic, the UCP election candidate for Livingstone-Macleod, prefaced a comment that would land her in trouble by saying “this might be political suicide” and then went on to suggest that people who have heart attacks need to be more accountable.
“Maybe the reason you had a heart attack was because you haven’t taken care of yourself,” Petrovic said on a recent podcast appearance.
“You’re extremely overweight, you haven’t managed your congestive heart failure, you haven’t managed your diabetes and there’s no personal accountability.
“But they come into the hospital and all of a sudden it’s everyone else’s problem but their own.”
She later issued a statement saying that her comments were taken out of context and that she should have “chosen better language.” Smith said she was glad Petrovic put out the clarifying statement.
John Church, a health policy expert and political scientist at the University of Alberta, said the comments were in line with some of what Smith herself has said in the past. On one hand, the candidate can say there’s an element of truth to her statement, but it’s also true that she’s “conflating what science tells us is a very complex situation.”
It “has to do with people who live in poverty, people who have certain genetic characteristics,” he said. “There are all kinds of factors involved in that that are beyond the control of the individual.”
To Caulfield, Petrovic is essentially saying that “this isn’t government responsibility; this is your responsibility,” which he said “is an ideological position.”
“It’s inaccurate from a scientific and public health perspective,” he added.
“One would hope that the health and science policies of a party were informed by the best science, by the emerging scientific consensus, and not by conspiracy theories and ideological spin.”
The problem, as he sees it, is that politicians are starting to stake out scientific positions with political flags.
People politicize vaccines, Ivermectin and masks by using them as wedge issues. As a politician, grounding your beliefs about health care in good science means that when evidence changes, you can change, said Caulfield. But “when you’re based on a conspiracy, when it becomes a baked-in ideological position, it becomes much more difficult to change as the evidence evolves.”
Where critics worry about the rubber hitting the road with Smith’s views is the provincial health-care system.
One of the top goals for Smith and the UCP is getting surgical wait times down and bolstering front lines facing staff shortages.
Lorian Hardcastle, a University of Calgary health law expert, said there are potential consequences to Smith pushing ideas not based on science if she wins a four-year term and goes on to make sweeping changes to the health-care system.
“If decisions around public versus private health care are made on a political or ideological basis, they will not be evidence-based and that will operate to the detriment of Albertans and will exacerbate health inequities,” she said.
One widely criticized idea that Smith is still promoting is that of health spending accounts for Albertans to use. It’s a potential move that Hardcastle said is “not evidence-based” and an idea put forward to “pander to voters.”
Smith, after becoming premier, changed her tune from her original idea — which was to make it so that people paid to see doctors using the accounts — to say that the accounts might only be used to pay for things outside the scope of public health insurance.
Hardcastle also said she worries that the rhetoric and policy stances from Smith could drive health-care workers away rather than attract them to a province where political leaders are “not making decisions that are evidence-based.”
On Tuesday, at a news conference where Smith pledged to maintain the public health system in Alberta and said no one will have to pay for medical services they need if she’s elected in May, Church said news photographers captured a telling image.
The photograph made the rounds on social media this week. It’s of a masked health-care worker draped in a white lab coat standing off to the side of Smith with her arms crossed and a sideways middle finger strategically placed, directed toward the premier delivering her remarks.
“It represents to me that Danielle Smith may be standing up and saying that she supports public health care, but health-care workers, I don’t think, are believing that for one minute,” said Church.
“You stand up and you say something in public enough and people might actually believe it. And you can say, ‘Well, no, we’ve said we’re supporting public health care, you know, look over here at what we said, don’t look over here at what we’re doing.’
“So, magical thinking.”