Alberta gov’t mulls plan to allow doctors to work publicly, privately or both, according to reporting

Two-tiered health care is coming to Alberta, according to reporting from the Globe and Mail based on draft legislation obtained by that publication.

It’s been reported Alberta’s UCP government is considering legislative changes to permit doctors to work in both public and private health-care systems.

And the cabinet minister in charge of primary care says legislation is coming.

But Adriana LaGrange isn’t providing details at this time.

“I can’t speak to the specifics of legislation before it gets into the house, but I am always looking for opportunities to make sure that Albertans have increased access to the supports and the resources that they need,” LaGrange said at Alberta’s legislature on Tuesday.

“I’ll have more to share in a little while.”

LaGrange’s statement came as The Globe and Mail reported it had obtained documents discussing potential changes that would split physicians into three categories:

• the first would see doctors billing the province for patient care as usual;
• the second would see doctors quitting the public system and running private clinics; and
• the third would see doctors splitting their time between public and private models.

The third option would be a first in Canada.

“This is a major concern for publicly funded health care,” health policy professor Dr. Braden Manns told CTV News.

“This will cause waitlists to go up in the public system, and the only people that will benefit are those who are fortunate enough to have the money to pay.”

Manns worries the changes will result in doctors receiving more pay for fewer billed private hours, thereby giving them limited reason to continue in the public stream.

The Canadian Medical Association, which represents physicians across the country, also warned this could lead to Albertans waiting longer to see their family doctors.

“The evidence from around the world is clear: where a parallel private health system operates, both health outcomes and access to care are worse,” association president Dr. Margot Burnell said in a statement.

“Alberta’s private care plans may similarly weaken an already challenged public health system.”

Political pressure

Alberta NDP Leader Naheed Nenshi says the government is pushing “American-style medicine.”

He says the plan would only punish low-income Albertans.

During question period on Tuesday, Nenshi called on Premier Danielle Smith to call an election over the issue.

“Let me tell you what we will do: we are going to continue to create the very best environment for doctors and specialists to work here,” Smith responded.

This is not the first time a similar system has been proposed in Alberta.

Then-premier Ralph Klein floated the “Third Way” plan for health care in early 2006.

It also would have allowed doctors to work in public and private systems simultaneously.

But Klein’s idea didn’t make it off the ground 19 years ago—public outcry and protests led to a political backtrack soon after the system changes were announced.

Controversial call

Friends of Medicare is calling on the provincial government to focus on supporting public health care.

Chris Gallaway, the advocacy group’s executive director, said in a statement the government’s plan paves a path toward “two-tiered” health care, which, “if allowed to pass, would unequivocally bulldoze a path for American-style health care in Alberta.”

Gallaway questions how the potential changes keep Alberta in line with federal law governing how provinces provide health-care services as part of funding agreements with Ottawa.

Federal Health Minister Marjorie Michel’s office says Health Canada officials are engaging with the Alberta government to get a better understanding of the implications of the potential changes.

“We have a collaborative approach with all provinces and territories to ensure all Canadians continue to have equitable access to medically necessary care based on their medical needs, not their ability to pay,” a spokesperson for Michel said.

Proponents encouraged

The government’s plan drew praise from the Montreal Economic Institute, which pointed to Denmark, where the same public and private model is allowed.

Emmanuelle Faubert, an economist with the think tank, says Denmark’s model should be replicated.

“The Alberta government understands that universal and government-run are not synonymous,” Faubert said in the release.

“Successes abroad demonstrate this, and we are glad that Alberta is prepared to take an evidence-based approach to addressing the chronic wait times facing patients.”

With files by Jack Farrell with The Canadian Press