In a week filled with significant political developments, Alberta's United Conservative Party government has proposed what could become the most substantial transformation of medical care delivery in modern Canadian history. While the province made headlines for multiple reasons, including the use of the notwithstanding clause and a critical auditor's report, it was the revelation of draft health care amendments that captured national attention.
The Three Pathways for Alberta Physicians
According to draft amendments to the Alberta Health Care Insurance Act obtained by The Globe and Mail, the provincial government is considering creating a hybrid health care model that would allow doctors to operate in three distinct ways. The proposed system would permit physicians to: bill the public system at government-set rates, establish completely private practices with self-determined fees, or maintain both public and private practices simultaneously.
The document, marked as draft 11 and dated November 5, represents a fundamental shift from the current Medicare framework that has defined Canadian health care for generations. While the government insists the changes would not require Albertans to pay out-of-pocket for essential medical services, critics argue the proposal effectively creates a two-tiered medical system.
Political and Professional Reactions
Maddison McKee, speaking for Primary and Preventative Health Services Minister Adriana LaGrange, emphasized the government's commitment to protecting public health care. "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," McKee stated, though observers noted the careful wording leaves room for interpretation.
The academic and medical communities responded with both concern and cautious interest. University of Calgary health policy professor Braden Manns didn't mince words: "This is definitely two-tiered medicine." Meanwhile, former University of Calgary medical school dean Jon Meddings offered a more nuanced perspective, noting that the current system discourages doctors from opting out of Medicare due to financial risk, while the hybrid model might allow physicians to "test the private waters without risking their entire income."
The Evidence From Other Jurisdictions
Premier Danielle Smith later promoted the model in a social media video, focusing specifically on surgical applications. However, health policy experts pointed to concerning precedents. André Picard of The Globe referenced a 1998 Manitoba study on cataract surgery wait times that found clinics offering both public and private services had wait times up to 13 weeks longer than those providing only publicly funded care.
"The more lucrative private cases always took precedence," Picard noted, adding that "there is little evidence" that allowing wealthier patients to pay for private care actually reduces public wait times.
Despite these concerns, some commentators argue that Canada's struggling health care system demands innovative solutions. Globe columnist Gary Mason wrote that "Alberta deserves credit for at least giving the public-private model a chance" to address a system "slowly crumbling under the weight of demand."
The proposed amendments remain in draft form and have not been formally introduced in the legislature. However, the mere existence of such detailed plans signals the Alberta government's willingness to challenge long-standing conventions in Canadian health care delivery, potentially setting a precedent that other provinces might follow.
