Alberta plans hybrid healthcare model, allowing optional private choices

Alberta is poised to revolutionize healthcare with a new model that would allow doctors to work in both the public and private systems at the same time, according to leaked draft legislation.

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Alberta is poised to revolutionize healthcare with a new model that would allow doctors to work in both the public and private systems at the same time, according to leaked draft legislation. This groundbreaking shift, a first in Canada, directly addresses the crisis of long wait times and poor access by finally opening the door to private-sector solutions.

The Globe and Mail reported that draft amendments, dated November 5, would create three categories of physicians, including a new class of “flexibly-participating” doctors allowed to bill privately while working in the publicly funded system. The draft also outlines new disclosure requirements for private billing and establishes government authority to restrict which services may be offered outside the public stream.

The “flexibly-participating” physicians would reportedly not be required to notify the government which specific services they intend to offer publicly versus privately.

The Globe and Mail also reported that the draft creates distinct streams of fully public physicians, fully private physicians and a new category of doctors who may choose on a case-by-case basis whether to bill the public system or charge patients privately.

The potential legislation would also require doctors providing privately billed care to give patients written disclosure of costs, confirm the service may be available at no charge in the public system, and obtain written consent before proceeding.

The documents come as pressure for systemic reform grows nationwide.

Recent polling and research from Canadian think tanks show rising interest in private healthcare options, especially among younger Canadians.

A Fraser Institute study highlighted the differences between healthcare in Canada and Switzerland, which has integrated private healthcare into its public system.

In Switzerland, 85.3 per cent of patients waited less than two months for a specialist appointment in 2022, compared to 48.3 per cent of Canadians.

In Canada, the waiting does not end once an appointment is booked; the median interim period peaked at 30 weeks last year.

“Ultimately, it is increasingly clear that the status quo in health policy is not sustainable in Canada,” the study reads. “In order to improve access to care for the population, Canadian decision makers should consider introducing some competition in the provision of hospital care based on conclusive international experiences, such as that of Switzerland.”

While provinces and territories are responsible for the administration and delivery of health services, the Canada Health Act is federal legislation that establishes principles to follow. It does not prevent provinces or territories from allowing private healthcare providers if they do not implement extra billing or user charges.

While Canada spends 11.5 per cent of its GDP on healthcare, Switzerland spends only slightly more at 11.9 per cent. Despite this, Switzerland has 4.6 doctors per thousand people compared to 2.8 per thousand people in Canada, meaning Switzerland has 64 per cent more doctors available.

Only 56 per cent of Canadians report being satisfied with their healthcare system, compared to 94 per cent of Swiss patients.

A national survey conducted in late May found that 36 per cent of Canadians believe the healthcare system would function better under private operation, with support reaching 50 per cent among those aged 18 to 34.

The poll found that nearly one-third of Canadians are open to reducing federal healthcare spending to address government debt — an increase from the previous year.

Significant wait-list backlogs have also pressured the government for reform. SecondStreet.org recently reported that almost 75,000 Canadians died on surgical and diagnostic wait lists between 2018 and 2024, with tens of thousands more avoiding the system entirely due to delays.

With Alberta’s draft legislation not yet introduced in the legislature, it remains unclear when the UCP government plans to unveil the bill or whether changes will be made before its presentation. However, the document reported by The Globe and Mail signals the most significant shift toward private-sector participation ever contemplated in a Canadian province.

As governments across the country face worsening access, mounting wait times and growing public demand for alternatives, the coming legislative debate in Alberta is set to become a major national flashpoint in the future of Canadian healthcare.