Alberta Premier Danielle Smith's government has introduced controversial new health-care legislation that permits patients to pay for medical services directly or through personal insurance. While this might sound like a move toward privatization, experts argue the changes maintain the same centralized control that has plagued Canada's health system for decades.
What Bill 11 Actually Changes
Tabled on November 24, 2025, Bill 11 allows patients to pay out-of-pocket for medical care and enables doctors to charge outside the public queue. The legislation also permits health professionals to accept private payment during specified hours and locations, all under strict government oversight and monitoring.
The fundamental structure of Alberta's health care remains heavily regulated and centrally controlled, despite these apparent concessions to private payment options. As author Shawn Whatley notes in his National Post analysis, the system resembles "government announcing a new way for citizens to send mail — at higher cost, in a post office across the street."
Mixed Reactions and Historical Context
Advocacy groups like Friends of Medicare have strongly opposed the plan, labeling it "American-style two-tiered health care." The Canadian Medical Association has also expressed concerns, stating that evidence from other countries shows parallel private systems often lead to worse health outcomes and reduced access to care.
However, Whatley challenges this logic, comparing it to suggesting that "in regions where citizens own more umbrellas, rainfall and thunderstorms are worse." He argues that private options don't necessarily cause the problems in public systems.
The debate echoes the aftermath of the Supreme Court of Canada's 2005 Chaoulli decision, which struck down Quebec's prohibition on purchasing private health insurance. Despite initial fears, Colleen Flood, dean of Queen's University law school and medicare defender, correctly predicted the ruling wouldn't significantly alter Canada's health-care landscape.
Limited Impact on Core Problems
While Smith's announcement represents one of the most substantial health-care reforms attempted in Canada recently, the same problems inherent to central planning and rationing remain unresolved. The legislation does little to address the fundamental issues of wait times and service quality that affect actual patients.
Whatley suggests withholding applause until tangible improvements materialize. The reform may represent the biggest step possible within Canada's current political climate, but whether it will deliver meaningful change for Albertans seeking timely medical care remains uncertain.
The legislation continues Alberta's tradition of pushing health-care boundaries while navigating the complex political and constitutional constraints of Canada's medicare system. As implementation progresses, all eyes will be on whether this measured approach can deliver the improvements patients desperately need.
