The Alberta legislature passed the Health Statutes Amendment Act (No. 2) on December 18, 2025. This Act establishes “dual practice,” allowing physicians to both bill the government for publicly funded patient care and charge patients privately for the same medically necessary, publicly insured services. In practice, this would create a two-tiered health care system. It also opens the door for private insurance companies that are eager to profit from Canadian patients.
Dual practice has not been permitted in Canada because of its negative impacts on access to care. There is no convincing evidence that private-pay health care reduces overall wait times. In countries such as Australia and the United Kingdom, wait times remained unchanged or even increased after parallel private-pay systems were introduced. The Cambie Surgeries Corporation trial at the British Columbia Supreme Court reviewed evidence and testimony over four years and ultimately concluded that “there is clear evidence that wait times would not improve with the introduction of duplicative private health care.”
Taking Action
August 17, 2026 - CDM's Letter to the Prime Minister's Office
Canadian Doctors for Medicare sent a letter to the Prime Minister and the Minister of Health regarding Alberta's Health Statutes Amendment Act, 2025 (No. 2). Since our previous letter, sent on March 3, 2026, this legislation has evolved from enacted law into increasingly entrenched policy.
Every week of federal inaction allows dual practice, extra-billing, user charges, and private payment infrastructure to become more deeply embedded in Alberta's health system. Alberta's two-tier health care law will undermine equitable access, contravene the Canada Health Act, exacerbate health workforce shortages, and set a dangerous national precedent.
The Prime Minister has a direct responsibility to uphold the Canada Health Act and to protect equitable access to health services for every person in Canada. Further consultation with Alberta about half-measures that attempt to mitigate the harms will not meet the moment. We urge the federal government to act immediately and decisively:
1. Apply mandatory, dollar-for-dollar deductions to the Canada Health Transfer for user-charges and extra-billing. The Canada Health Act requires automatic, mandatory deductions for extra-billing and user-charges whenever enrolled physicians—including those who are “flexibly participating” —charge patients for any medically required services. Your government should commit publicly and in writing to take dollar-for-dollar deductions from Alberta's Canada Health Transfer for every dollar billed to patients for medically required.
2. Initiate a Section 14 notice of concern without delay. Send formal notice to Alberta under s. 14 of the Canada Health Act, setting out the ways in which the Health Statutes Amendment Act, 2025 (No. 2) fails to satisfy the criteria of the CHA. Seek any additional information you need from the province through bilateral discussions and then provide a report to the province and to the public within 90 days of sending your notice of concern.
3. Publicly and immediately urge Alberta to pause implementation of dual practice while a formal s. 14 review is underway, and make clear that continued implementation during that period will lead to mandatory deductions for user-charges and/or extra-billing whenever any enrolled patient pays privately for insured health services provided by a flexibly participating physician, irrespective of whether Alberta considers those services to fall outside the CHA.
March 3, 2026 - National Letter to the Prime Minister and Minister of Health
Signed and endorsed by 23 national and provincial organizations
On March 3, 2026, Canadian Doctors for Medicare has sent a letter to the Prime Minister and the Minister of Health expressing concern about Alberta’s Health Statutes Amendment Act (No. 2), introduced as Bill 11. The letter has been signed and endorsed by a coalition of 23 national and provincial health and labour organizations. Check out the letter at the bottom of the page or by clicking here.
Press Conference on Parliament Hill: Doctors and health care advocates concerned about Alberta’s two-tiered health care legislation
On March 5, 2026, CDM organized a press conference on Parliament Hill with the Canadian Health Coalition, the Canadian Medical Association and Alberta-based physician Dr. Braden Manns. Click here to watch the press conference recording. Prime Minister Mark Carney and Minister of Health Majorie Michel have an urgent duty to act and enforce the Canada Health Act so that patients across Canada are protected from private charges for medically-necessary care.
We are asking the federal government to:
- Conduct a formal Canada Health Act compliance review of Alberta’s Health Statutes Amendment Act, 2025 (No. 2);
- Urge the Government of Alberta to pause implementation of Health Statutes Amendment Act, 2025 (No. 2) while its impacts are assessed by Health Canada’s legal team and independent national experts;
- Use the full range of federal tools available, including discretionary penalties permitted under the CHA.