Alberta’s healthcare system is heading down the slippery slope from universal access for all to priority access for those who can pay. Recent changes to the provincial healthcare system accelerated this process. On September 1st, Alberta’s new dual practice model came into effect allowing approved physicians to split their working time between seeing patients in the publicly funded system while also caring for patients who pay privately. And Bill 29 came into force earlier in the summer allowing Albertans to self-refer for MRI, CT, ultrasound and X-ray examinations if they were willing to pay for the tests.
There is no question that Alberta’s healthcare system needs resuscitation. There is hardly a person in this province who has not experienced some symptom of our ailing system: waiting weeks to see a family doctor—or not having one at all—sitting for hours in an overcrowded emergency department, waiting months for diagnostic imaging or years for a joint replacement.
This is why the UCP government’s recent changes are so disappointing. Rather than substantially expanding access for everyone, they are focusing on creating faster access for those who can pay. Studies show that introducing a parallel private-pay system has not reliably reduced wait times in the public system and, in some cases, increased them. Despite years of private clinics providing cataract surgery in Alberta, wait times remain long, with fewer than half of Albertans receiving surgery within the national benchmark of 16 weeks.
“We need to build more capacity within our healthcare system instead of dividing what exists into two systems.”
Bill 29 allows self-referral for what the government calls “preventative health testing”. But testing is not necessarily prevention. Evidence-based cancer screening does not consist of periodically scanning healthy people’s bodies looking for something that might be wrong. Screening programs target particular diseases in particular people, at particular ages and levels of risk, using tests whose benefits outweigh potential harms like radiation or false positive findings.
Bill 29 does not improve access to many of the evidence-based preventive interventions Albertans actually need. It does not make colon cancer tests or PAP tests for cervical cancer more accessible and Alberta already has a breast-cancer screening program through which eligible women can self-refer for mammography for free. Nor do these changes provide better access to assessment for cardiovascular risk, hypertension or diabetes – common conditions that need early diagnosis and treatment to prevent complications.
Rather than making primary care reliably available to all Albertans, our government is creating a system in which consumers are invited to shop for medical tests and then navigate the healthcare landscape without professional guidance. Self-referral cannot replace conversations with family physicians who can help patients choose the right test, understand the benefits and harms of diagnostic tests, and arrange follow-up treatment.
We need to build more capacity within our healthcare system instead of dividing what exists into two systems. Our government needs to address the underlying shortage of infrastructure, equipment and healthcare professionals. This means large investments in primary care access, acute care beds, supportive living, long-term care and public health. Today, we have far fewer hospital beds than fifty years ago, despite our population having roughly tripled. Alberta’s supply of long-term-care beds has also failed to keep pace with its rapidly aging population, and hundreds of patients are waiting in hospital for continuing-care placements.
But the most limiting resource is not infrastructure; it is people. Alberta struggles to fill thousands of nursing positions and several hundred thousand Albertans do not have a family doctor. Creating a parallel private system does not create another pool of healthcare professionals—it just spreads them thinner.
In the context of a worldwide shortage of healthcare professionals, we have to become self-sufficient in creating our own healthcare workforce. Alberta needs to ramp up training programs in the most needed skilled healthcare jobs. The large volume of applicants turned away every year from Alberta medical and nursing schools speaks to the lack of training spaces despite high interest among our youth.
Albertans do not have to accept the steady erosion of universal healthcare as inevitable. We should be asking our provincial representatives for improved outcomes: more Albertans with family doctors, shorter surgical and diagnostic waits, adequate hospital and continuing-care beds, and enough trained health professionals to provide us with care.
We should also ask our federal Members of Parliament to ensure that the Canada Health Act continues to protect access based on medical need rather than ability to pay. We can write to or meet with our elected representative and ask them what measurable improvements they will deliver, how they will increase the healthcare workforce, and how they will protect universal access.
Our healthcare system belongs to all of us, and we need to insist that governments strengthen rather than divide it.
By Vamini Selvanandan© 2026. This work is licensed under a Creative Commons CC BY 4.0 license. Photo credit: Josh Sorenson on Pexels.com
