Alberta Premier Danielle Smith and her provincial government are allowing physicians to bill both public and private insurers for certain surgical procedures [1].
This policy shift creates a dual-practice health-care model that critics argue establishes a two-tier system. The move marks a significant departure from traditional Canadian health-care norms by permitting doctors to operate within both the public and private sectors simultaneously [2].
According to the provincial government, the implementation of this model began in September 2024 [1]. Eligible doctors can now work in both systems, a change the government said will increase overall surgical capacity [2].
Officials said the primary goals of the policy are to reduce patient wait times and provide citizens with more choices regarding their medical care [2]. The government said that specific safeguards are in place to protect the existing public system from erosion [2].
Under the new framework, physicians who meet eligibility requirements can perform privately paid surgeries while maintaining their roles within the public system [1]. This allows patients with private insurance or the means to pay out-of-pocket to access certain procedures more quickly, a transition that has sparked debate over equitable access to care across the province [3].
While the government maintains that the public system remains the foundation of Alberta's health care, the dual-practice model allows for a parallel stream of delivery [2]. The province has not detailed the specific list of surgical procedures eligible for this dual-billing arrangement, but the framework is now active [1].
“Alberta is permitting doctors to perform privately-paid surgeries while remaining in the public system.”
This policy represents a fundamental shift in the administration of health care in Alberta. By allowing a dual-practice model, the province is testing whether private delivery can alleviate pressure on public infrastructure without compromising the quality of care for those who cannot afford private fees. If successful, it may serve as a blueprint for other Canadian provinces facing similar surgical backlogs, but it also risks creating a systemic divide where speed of treatment is determined by financial status.
