Alberta Premier Danielle Smith has officially asked the Canadian federal government for “latitude” as the province implements its controversial dual-practice healthcare model. The policy, which allows specialized physicians to offer both private and public services, has triggered widespread public protests and intense political debate over the future of Canada’s publicly funded healthcare system.
According to a report by the Edmonton Journal, Premier Smith confirmed that Alberta is actively negotiating with Ottawa to demonstrate that the new framework does not contravene the Canada Health Act. The federal government has historically penalized provinces that permit private billing for medically necessary services by clawing back federal healthcare transfer payments.
This report draws on information published by edmontonjournal.com.
A Major Shift in Provincial Healthcare
The new model, enacted under the Health Statutes Amendment Act 2025 (formerly known as Bill 11), officially took effect on Tuesday. Under the legislation, approved specialized physicians can divide their practice between the public system and private, out-of-pocket clinics. Crucially, the model excludes family doctors to prevent further strain on primary care, focusing instead on specific surgical specialties.
Premier Smith defended the transition, pointing to Quebec as a precedent where physicians can legally opt out of the public system to treat private patients. “It’s an active discussion, as always, with the federal government on the terms under which they will fund our healthcare, but we’ve asked them to give us some latitude to implement this model,” Smith told reporters during a press conference.
Safeguards and Oversight Under the Dual-Practice Model
To address concerns regarding the potential depletion of public healthcare resources, the provincial government has promised rigorous oversight. Premier Smith announced that approximately 400 physicians have already expressed an interest in participating in the dual-practice system.
Smith emphasized that doctors entering the program will not be permitted to reduce their existing public service commitments. “I’ll be making sure that there’s no hospital that does fewer surgeries next year than they did last year, and that’s the way that we hold it to account,” she stated, adding that participating physicians must maintain their current public sector workload.
While provincial officials confirmed earlier this year that there is no hard cap on the number of hours a dual-practice physician can work in the private sector, those limits will remain subject to professional practice standards established by the College of Physicians and Surgeons of Alberta (CPSA). Additionally, the provincial government has exempted all cancer-related and life-threatening conditions from the dual-practice model, ensuring they remain entirely within the publicly funded system.
Political Backlash and Public Mobilization
The implementation of the model has met with sharp resistance from public healthcare advocates and opposition politicians. On Tuesday, rallies were held across Alberta, organized by health coalitions urging federal members of Parliament to strictly enforce the Canada Health Act and block the provincial initiative.
Sarah Hoffman, the Alberta New Democratic Party (NDP) critic for hospital and surgical services, voiced strong opposition to the changes, arguing that the policy threatens the core principles of equitable healthcare access. “Those who can pay move to the front of the line, while everyone else waits even longer,” Hoffman said, accusing the governing United Conservative Party (UCP) of prioritizing private profits over public service delivery.
The Federal Funding Battle Ahead
The first surgeries under the new dual-practice model are scheduled to begin this fall. The program will initially cover specific surgical procedures approved by the CPSA, including orthopedics, minimally invasive general surgery, gynecology, ophthalmology, and ear, nose, and throat (ENT) surgeries.
The ultimate success of the model may depend on the outcome of Alberta’s negotiations with Ottawa. If the federal government determines that the dual-practice system violates the Canada Health Act’s accessibility provisions, Alberta could face significant financial penalties, setting up a major constitutional and economic showdown between the province and the federal government.