Alberta’s dual practice health plan called out for fewer public protections than other jurisdictions

By ZOE MASON on February 12, 2026.

A report from the Canadian Centre for Policy Alternatives is objecting to the Alberta government’s claim that its proposed dual practice health system is emulating the public-private schemes of other parts of the world, including Australia and Western Europe.

At a press conference regarding Bill 11 in November, Minister of Hospital and Surgical Health Services Matt Jones said the bill modernized physician participation rules for surgeons and support professionals to expand on their flexibility to work in both public and private settings.

“This type of dual practice is already in effect in leading health jurisdictions around the world: Denmark, the Netherlands, the U.K., France, Germany, Spain and Australia all offer dual practice models,” he said.

Other Canadian jurisdictions approach the implementation of a parallel private health-care system differently than what has been proposed in Alberta, with more guardrails and reduced flexibility for participating physicians.

The new CCPA report is responding to those claims, and its findings indicate that examples in other jurisdictions abroad cited by the UCP also contain notable differences.

One key difference highlighted in the report is the use of private health insurance as a complementary or alternative option to the public insurance scheme.

Using the key example of Germany and linking to a 2020 study out of the University of Ottawa, the report finds that the German two-tier system involves substantial safeguards which ask residents to determine whether they would like to participate in the public or private scheme, and make it difficult to transition back to the public system after opting out. The private services are intended primarily for high-income Germans who can afford to forfeit access to the public system.

Likewise, Australia issues penalties to high-income individuals who do not purchase private health insurance. While about 46 per cent of Australians have private insurance for hospital care, the Australian government also provides substantial tax subsidies for residents purchasing insurance. In 2025, these subsidies totalled $7.6 billion.

Alberta’s system would enable physicians to provide the same services in both the public and the private system, differentiating on a case-by-case basis.

The report’s authors contend that this will allow private insurance to provide a “queue-jumping” function that other jurisdictions protect against.

In several of these jurisdictions, limits are also in place to constrain the ability of physicians to work outside contractual hours in the public system, or require them to offer availability in the public system.

Minister Jones told reporters in November that similar safeguards would apply to Alberta’s proposed system.

“Bill 11 includes safeguards to protect our public system, for example, by mandating minimum public practice to be eligible for private practice, restricting specialties where shortages exist or may occur, maintaining separate records so public dollars are not subsidizing private activity and, where necessary, limiting private practice hours or locations to evenings, weekends or underutilized areas of Alberta,” he said.

But no such safeguards appear in the text of the legislation itself, with much left to be determined by regulation.

These jurisdictions also offer a more robust foundation in primary care.

Alberta offers 2.4 physicians per 1,000 people, while Germany had an estimated 4.6 and Australia an estimated 4.2 as of 2022, according to OECD data.

Both Australia and Germany also invest more in public health spending. Whereas 29 per cent of health spending is already private in Canada, 27 per cent is private in Australia and only 13 per cent is private in Germany.

Last week, press secretary for the Ministry of Primary and Preventative Health Services Maddison McKee responded to a joint CCPA-Parkland Institute report criticizing Bill 11, which was co-authored by Andrew Longhurst, the researcher who wrote today’s CCPA report.

McKee told the News that Longhurst’s research represented an “ongoing campaign of false claims and distortions that have been corrected multiple times in the past.

“We remain committed to building a stronger publicly funded health system with better access to surgeries and other care, and upholding Alberta’s Public Health Care Guarantee, ensuring that no Albertan will ever have to pay out-of-pocket to see their family doctor or receive the medical treatment they need.”

No specific examples of alleged false claims were provided at the time.

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