Alberta two-tier health system not comparable to European models, says report
Published 2:30 pm Friday, February 13, 2026
Alberta is trying to legitimize the creation of a private health insurance market for medically necessary care by falsely claiming its two-tier health care plan is comparable to western European and Australian models, says a report by the Canadian Centre for Policy Alternatives.
Senior researcher Andrew Longhurst said western European health systems do not allow doctors to work unrestricted in both the public system and private-pay market through a dual practice model, as Alberta is set to do.
Western European countries also have a greater commitment to public financing and regulation than Canadian provinces, he added.
“Where private insurance exists in (western European) countries, the insurance market is highly regulated. Insurers tend to be non-profits or effectively public — not private for-profit companies,” said Longhurst with Canadian Centre for Policy Alternatives (CCPA), who wrote Fact check: Alberta’s new two-tier system is not “European” health care.
Longhurst said Australia does come closer to Alberta’s new model, but at a cost: wait times for priority procedures remain much longer in Australia.
“Alberta is the first Canadian province to introduce two-tier legislation and encourage a private health insurance market for services covered under the Canada Health Act. This is a decisive shift towards U.S. health care based on greed and profit-taking, not “European” health care based largely on principles of social solidarity and universality,” said Longhurst, in a statement.
In another report by CCPA and Parkland Institute — The end of Canadian medicare? Alberta legislation opens the door to U.S. health care — researchers argue dual practice will violate the Canada Health Act, degrade the public system, and encourage doctors to focus on privately paid work which will increase public health care wait times and increase public health system costs.
Press secretary Madison McKee, with Primary and Preventative Health Services, said dual practice does not violate the Canada Health Act.
“The Act is silent on private practice operating outside the public system, and opt-out and dual-practice models in Alberta and other provinces have never been found to breach it. At the same time, the province is strengthening the public system and improving access for all Albertans, while allowing limited additional choice for some physicians and patients — subject to strict conditions to protect publicly funded services. Dual practice applies only to a limited range of scheduled surgeries. It does not apply to cancer care, other lifesaving treatments, or emergency services,” McKee said in a statement.
She said the debate is not actually about dual practice.
“It’s about whether we are willing to address long wait times, workforce shortages, and capacity challenges that patients experience every day. Maintaining the status quo won’t deliver more timely care, and Albertans deserve better,” McKee said.
Over 8,000 stories and comments from Albertans about the problems with Alberta’s health care system have been posted in the past three weeks as part of a Canadian Union of Public Employees (CUPE) Alberta online campaign and petition calling on Premier Danielle Smith to declare a health care state of emergency.
CUPE Alberta president Raj Uppal said over the last decade, Alberta’s population has increased by 37 per cent, but hospital beds have only increased by 13 per cent.
“Health care workers will move heaven and earth to help patients, but after years of UCP underfunding, they are limited in what they can do,” Uppal said.
Among those who posted comments at www.stateofemergency.ca was Christina, of Red Deer County, who said her mother was wasting away waiting for surgery.
“My mom is in the ER as I write this. She was in the waiting room for 8 hours and has been largely ignored for the next 8. She has desperately needed gallbladder surgery for a YEAR,” Christina wrote. “FUND OUR PUBLIC HEALTH CARE.”
Joanne, of Red Deer, warned that private for-profit healthcare is a serious problem.
“I had the terrible experience of working in a private hospital in the U.S. At orientation, when none of us could guess who were the most important people in the hospital, we were informed that it was the physicians because they brought in the money. I lasted 4 months before coming home. People waited until they were VERY ill before they came to hospital hoping they wouldn’t have to come because they couldn’t afford it,” Joanne wrote.
Public policy think tank SecondStreet.org, which is gathering signatures for its petition Patients Deserve Choice in Health Care that supports Canadians being able to choose between the public health system or paying for treatment at a non-government clinic, said it is false for CCPA to claim that dual practice opens the door to U.S. health care.
“What we can agree on is that strong guardrails are needed to ensure a robust public system that is complemented (rather than corrupted) by a private pressure valve. But Alberta’s government already understands this. Bill 11 (Health Statutes Amendment Act) includes language that empowers the Minister of Health to dictate the circumstances and conditions under which dual practice is permitted, including restricting the types of services offered,” said SecondStreet, in a statement.
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