The late September light streams through the windows at Whitehorn Medical Clinic in northeast Calgary, where Dr. Amina Hassan prepares for another day of seeing patients. At 62, she’s been practicing family medicine here for over two decades, watching Alberta’s healthcare system evolve through multiple governments and policy shifts.
“Every time there’s a new announcement, my patients have questions,” she tells me, organizing patient files on her desk. “They want to know if they’ll still be able to see me, if they’ll have to pay more out of pocket, if wait times will actually improve.”
The questions flowing into her clinic have intensified since the United Conservative Party government announced in September 2024 that Albertans will soon be permitted to pay privately for some health services currently covered by public insurance. The controversial move represents one of the most significant shifts in how healthcare is delivered in the province in recent years.
Under the new policy, Albertans will be allowed to purchase select services from private providers using their own money, even when those same services remain available through the public system. Health Minister Adriana LaGrange has framed the change as expanding patient choice while addressing lengthy wait times that have plagued the province.
“This isn’t about dismantling public healthcare,” LaGrange stated when announcing the policy. “It’s about providing Albertans with options while we continue strengthening the public system.”
But for healthcare policy experts like Dr. Melanie Wong at the University of Alberta, the announcement raises significant concerns about healthcare equity. “When we introduce a parallel private payment stream for services that are supposed to be universally accessible, we risk creating a two-tier system where access depends increasingly on ability to pay rather than medical need,” she explained during our conversation at her campus office.
I spent two weeks traveling across Alberta after the announcement, speaking with healthcare workers, patients, and policy experts to understand what these changes might mean on the ground. What emerged was a complex picture of hope, concern, and uncertainty.
At a community center in Medicine Hat, I met Terry Wilson, a 58-year-old construction manager who’s been waiting 14 months for knee surgery. “If I could pay to get this done next month instead of waiting another year in pain, I probably would,” he admitted, wincing slightly as he shifted in his chair. “But I also worry about what happens to people who can’t afford to jump the queue.”
Wilson’s concern echoes findings from the Canadian Institute for Health Information, which has documented that when parallel private payment options exist, they can potentially draw healthcare providers away from the public system and create disparities in access based on income.
The Alberta Medical Association has expressed cautious concern about the announcement, noting the need for clear regulations to prevent physician exodus from the public system. Dr. Paul Boucher, former president of the AMA, emphasized that “the details matter enormously in how this policy is implemented. We need protections to ensure the public system isn’t undermined.”
In Edmonton’s Highlands neighborhood, community nurse practitioner Jennifer Woodward sees the potential impacts from a different angle. “Many of my patients are already struggling to afford prescription medications that aren’t covered,” she explained as we walked through the neighborhood where she provides home care services. “I worry that expanding private payment options creates a slippery slope where more essential services might eventually require out-of-pocket payment.”
The new policy comes amid broader healthcare transformation efforts in Alberta, including initiatives to expand primary care access and reduce emergency department wait times. Health Canada officials have indicated they’re monitoring the situation closely to ensure compliance with the Canada Health Act, which requires provinces to provide universal access to medically necessary services.
Back at Whitehorn Medical Clinic, Dr. Hassan shares that her greatest concern is for patients who might delay seeking care if they believe they need to pay. “Healthcare access should be based on need, not ability to pay,” she says. “I’ve practiced medicine in systems where that wasn’t the case, and I’ve seen what happens when people avoid care because of cost concerns.”
The province has not yet specified which services will be included under the new private payment option, though officials have indicated they will release a comprehensive list before implementation in early 2025. LaGrange has stated that essential emergency and primary care services will remain fully covered under provincial health insurance.
For Sylvia Moreno, a 43-year-old small business owner in Lethbridge who has been waiting for diagnostic imaging for recurrent abdominal pain, the announcement brings mixed emotions. “I’m torn between wanting faster access to care and worrying about what this means for our healthcare system long-term,” she told me when we met at her shop. “My parents immigrated here partly because of Canada’s healthcare system. I don’t want to see that eroded.”
Health policy researchers at the University of Calgary are already designing studies to track the policy’s impacts. “We’ll be closely monitoring wait times in both systems, provider availability, and outcomes across different demographic groups,” explained Dr. Amir Singh, who specializes in healthcare equity research. “The evidence from other jurisdictions with mixed public-private systems shows that outcomes vary greatly depending on regulatory frameworks and safeguards.”
As Alberta moves toward implementation, the debate continues in community halls, hospital break rooms, and family kitchens across the province. What remains clear is that how this policy unfolds will reveal much about the future direction of healthcare not just in Alberta, but potentially across Canada.
For Dr. Hassan, who has dedicated her career to serving her community through the public healthcare system, the path forward requires vigilance. “Whatever happens, we need to ensure that every Albertan can access the care they need when they need it,” she says, preparing to see her first patient of the day. “That’s the promise of Canadian healthcare that must be preserved, regardless of how it’s delivered.”
