BURST
Within the past four years, Premier Danielle Smith’s government has changed how health care is organized and funded in Alberta. She has moved forward with plans that would push tax dollars toward private delivery, a proposal that is fundamentally against the goals of the Canada Health Act .
One of the clearest signs of where Smith’s overhaul is headed is Bill 11 , the Health Statutes Amendment. The Canadian Medical Association has warned that the bill — which would allow doctors to run a dual-practice model, working in the public system but also charging patients privately for the same procedures — would undermine public care in the province.
In theory, this would reduce wait times. Doctors would treat publicly insured patients during the day, and privately paying patients after hours, getting more procedures performed without more public spending. Supporters argue that out-of-pocket costs and pressure on the system will ease, freeing up operating rooms and shortening waits for everyone else.
However, there is a flaw in the thinking — their logic assumes that health-care workers and operating rooms are unlimited.
Every hour a surgeon, nurse or specialist spends in a private clinic is an hour taken away from a public hospital. Rather than adding capacity, it does the opposite. Dual practice shifts resources toward those who can afford to pay, leaving the public system with more problems than before.
Worst of all, this shift is being paid for with public money. Alberta already uses tax dollars to pay private clinics that deliver insured surgeries, but this bill would make it easier to finance competition against a health-care system already on the brink of collapse.
When Smith broke Alberta Health Services into smaller agencies, she broke a system that other provinces looked to as a model. When you split one health authority into different agencies, you increase management costs, billing systems and bureaucracy. When you fragment these systems, it becomes more difficult to reassign staff, beds and equipment across the province where they are needed.
Despite a so-called “public health-care guarantee” from Smith’s government that Alberta Health Insurance would remain publicly funded, they are missing the real crisis: Alberta does not have enough doctors.
This shortage did not happen by accident. In 2020, the province used Bill 21 to give itself the power to unilaterally tear up its agreement with physicians, imposed new billing rules by law, cut compensation for longer and more complex visits, and capped how many patients doctors could bill in a day. The government said it needed cost control, but family doctors and rural clinics warned the changes would make their practices financially unstable.
Many responded by reducing hours, leaving the province or closing altogether.
Alberta Health Services has its flaws. But what is happening now is not reform, it is erosion. If the government is serious about protecting Medicare, it must stop harming the public system that makes it possible.
With more than 650,000 Albertans searching for a family doctor, the government should be focusing on increasing funding for medical school seats, or making it easier for international medical graduates to practise in Alberta.
Texas has done something similar with House Bill 2038 , to give IMGs provisional licences without U.S. residency. The focus should be on getting more doctors.
Right now, the government is building new lanes on a highway with no cars to fill them.
Muhammad Saim is a student researcher at the University of Calgary in the Cumming School of Medicine, with interests in public health and health equity.