Communities across Canada are set to rally against Alberta’s move toward a two-tier health-care system as Bill 11 takes effect on Tuesday, allowing some physicians to treat both publicly funded and privately paying patients. . 

At a press conference Monday, members of the Canadian Health Coalition called on the federal government to intervene, arguing the legislation violates the Canada Health Act and risks drawing doctors and other resources away from the public system. 

The coalition is organizing more than 30 demonstrations across the country as part of a national campaign against the legislation. 

“We don’t understand why the federal government is mute on this. This is an issue of national consequence,” Jason MacLean, Chair of the Canadian Health Coalition said, arguing that once “queue jumping” in health care starts in Alberta, it could set a precedent for other provinces. 

Bill 11, formally known as the Health Statues Amendment Act, 2025, received royal assent in December and amended Alberta’s health legislation to establish a “dual practice” model.

Under the changes, eligible physicians can provide publicly funded care through the provincial health system while also offering certain privately paid services—allowing patients to pay out of pocket rather than waiting for care.

“When doctors split their practice between public and private pay, staff resources mitigate or migrate towards the private pay system and it makes the rest of us wait longer,” MacLean said. 

The provincial government argued that the model could ease pressure on the public system by moving some patients into privately funded care, while requiring participating physicians to maintain a minimum commitment to the public system. Emergency and life-threatening procedures, including cancer surgeries, are excluded from the private pay model. 

Braden Manns, a nephrologist and professor at the University of Calgary, pushed back on that argument, saying that a parallel private system could instead lengthen public wait times by drawing health-care workers away from it. 

“Evidence from Manitoba, Quebec, and other countries tells us that parallel private pay systems divert scarce health workers away from the public system, and they increase public wait lists,” Manns said. 

He pointed to Manitoba’s experience with cataract surgeries in the 1990s, when the province temporarily allowed dual practice. Private patients waited an average of four weeks, compared with 10 weeks for patients of public-only surgeons and 23 weeks for public patients treated by dual-practice eye surgeons, he said. 

“The difference disappeared after Manitoba banned dual practice,” Manns said. “The private pay system doesn’t work if you don’t allow public wait times to rise.” 

The health minister’s office stopped short of saying whether it believes Bill 11 violates the Canada Health Act or whether Ottawa would consider financial penalties against Alberta, instead emphasizing ongoing discussions with the province. 

“Albertans care deeply about protecting the integrity of the public healthcare system, and we are listening to those concerns,” Alexandre Bergeron, the health minister’s press secretary, said in a statement to iPolitics.

Bergeron said the minister is holding “targeted discussions” with Alberta Health Minister Adriana LaGrange to ensure access to necessary medical care and the principles of the public health care system are protected. 

“We have taken a collaborative approach with all provinces and territories, including Alberta, that respects their jurisdiction to explore innovative ways to improve access and care while strengthening the public, universal health care system,” Bergeron said. 

Michel also sent a letter to the Alberta government on July 24 after Ottawa reviewed regulations and a ministerial order published by the province in June, according to her office. 

Bergeron said the two governments remain in close contact to mitigate any potential adverse effects on the public system and ensure the principles of the Canada Health Act are respected. 

The coalition is calling on Ottawa to go further, saying the federal government should use its enforcement powers under the Canada Health Act if Alberta proceeds with the dual-practice model.

MacLean added that federal action should not be a matter of political discretion if the system results in extra billing or user charges. 

Manns also said legal opinions reviewed by the federal health minister suggest Ottawa would not have to wait for evidence that public wait times have increased before taking action. 

He acknowledged that withholding federal health funding through discretionary penalties would amount to a “nuclear option,” but argued that Ottawa should be prepared to use it. 

“Again, it is the right move,” Manns said.