Feb. 9, 2026 The Toronto Star
By Melanie Bechard Contributor
Dr. Melanie Bechard is a pediatric emergency physician in Ottawa and the chair of Canadian Doctors for Medicare.
It’s no secret that our health care system is on life support. As a pediatric emergency physician, I am constantly frustrated by how difficult it can be for patients to access care. Between torturous emergency department wait times and the almost 6 million Canadians without a family physician, it’s no wonder that health care administrators and political leaders are desperate for solutions.
Alberta’s recently passed Health Statutes Amendment Act is a big swing that is guaranteed to make matters worse — and all Canadians should take note lest their province follows suit.
The Health Statutes Amendment Act will allow physicians to practice in both the public and private system for medically necessary care — meaning that they can both bill the provincial health care plan for some patients and charge other patients out-of-pocket or through private insurance. This system, called dual practice, is currently not permitted anywhere in Canada.
Instead, in every province except Ontario, physicians must choose to either enrol in their province’s publicly funded plan or opt-out entirely and only charge patients privately. Physicians cannot work in dual practice as they are not permitted to toggle between charging some patients privately and billing the public payer for others.
The new dual practice legislation in Alberta will create a two-tiered multi-payer system. Dual practice does not address the real problems in health care because it does not involve adding more health care professionals to the system or enable more organized, efficient care.
Instead, physicians will be incentivized to spend more of their time treating lucrative private-pay patients. Alberta’s plan does not shorten any wait-lists — it rearranges them by placing those with deeper wallets at the top. This means patients who are not willing or not able to pay out-of-pocket will face wait-lists that are even longer.
Studies from around the world tell us that private-pay health care is not the answer to wait times. In Australia, creating a parallel private-pay system resulted in longer wait times for those who can’t pay privately. An analysis of several OECD nations concluded that parallel private-pay systems are not effective at reducing wait times. Parallel private systems essentially drain time and resources from the already struggling public system.
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