Alberta bill allows doctors to toggle between public and private pay for surgeries

EDMONTON — The Alberta government has tabled a bill that would open the door for surgeons to charge patients for privately delivered procedures while keeping a foot in the public system and billing taxpayers.

Premier Danielle Smith’s government previously suggested family doctors might be eligible, but they’re not included in the proposed legislation.

Surgical Services Minister Matt Jones says the bill is about offering flexibility to doctors, reducing wait times and giving Albertans the option to pay for procedures without having to travel out of province.

He told reporters Monday it would also help recruit and retain health workers in Alberta, countering criticism it will siphon professionals from the public system.

“Alberta is not an island. Alberta competes for health-care professionals all across Canada and North America,” he said.

The bill doesn’t cap private surgical costs for procedures like hip, knee or cataract surgeries, but the government promises to lay down guardrails to protect public health care.

That may include requiring doctors to perform a minimum amount of practice in the public system before expanding to offer private surgeries or restricting some specialties to public practice if shortages emerge.

Primary Health Minister Adriana LaGrange, who introduced the bill, said about 14 physicians in Alberta are currently opted out of the public system in favour of private practice. She said the new dual practice model would allow them to move back and forth without the red tape of a registration process that can take 18 months.

For now, LaGrange said, family doctors won’t be eligible to switch between the two.

“Our priority right now is to make sure that every person in Alberta is attached to a primary care provider,” she said.

Cancer and emergency surgeries would also only be offered through the public system, and private surgical facilities wouldn’t be able to charge patients for those operations.

Restrictions would come in regulations and not be written in the legislation, LaGrange said, so the government could make changes. “We need to be nimble,” she said.

Dr. Brian Wirzba, head of the Alberta Medical Association, which represents doctors, said success will depend on regulatory details, including how private delivery might be restricted.

Wirzba said the key is to make sure with any change, especially in surgery, that those in the public system are not left behind.

“We know the current system is leaving people behind,” Wirzba said. “This is not something that we should be rushing into.”

While the Opposition NDP has said the changes amount to “Americanizing” health care, LaGrange said they more closely reflect models from European countries.

NDP Leader Naheed Nenshi said people who can afford to pay will see their wait times go down.

“But the rest of us will see our wait times go up, unless there’s way more doctors, way more anesthetists, way more nurses, way more people doing the surgeries — and there is no plan for any of that,” he said.

Other changes under the bill mean private or employer-sponsored plans would first pay drug costs for Albertans, and the government-sponsored plan would pick up the remaining portion.

LaGrange said while it would be the payer of last resort, the government’s public prescription coverage would still serve as a safety net for those with no other coverage.

She said 76 per cent of Albertans have additional insurance, like plans offered through employers. LaGrange said she doesn’t think private insurers would adjust their coverage for Albertans in response to the legislation.

Government officials estimate the prescription coverage changes could save taxpayers between $35 million and $54 million per year.

Sarah Hoffman, the NDP’s critic for hospital and surgical health facilities, said that will result in insurance companies passing on the extra costs to those who pay into insurance plans.

“This is about government downloading $35 million or more onto ordinary Albertans,” she said.

Another proposed change would stop employers from cutting off coverage based on age, preserving coverage for those 65 and older who are still working.

The wide-ranging bill, if passed, would also pave the way for adding a personal health number to a driver’s licence or ID card next year.

This report by The Canadian Press was first published Nov. 24, 2025.

Lisa Johnson, The Canadian Press