Advocates are urging the federal government to increase health care funding and impose more conditions on what the provinces can do with that money.

Friends of Medicare director Chris Galloway says Ottawa shouldn’t give a blank cheque that could allow provinces like Alberta to dismantle the public system.

Galloway and more than 100 others gathered outside a meeting of provincial and territorial premiers in Charlottetown to protest Alberta Premier Danielle Smith’s plans to allow some physicians to offer privately paid surgical procedures beginning this fall.

The Alberta government is inviting surgeons to apply this summer to be able to charge patients for elective procedures like hip and knee replacements outside their publicly funded practice.

Surgical Services Minister Adriana LaGrange has said the status quo isn’t working as too many Albertans are sitting in the queue too long to get surgery.

She said the change will attract doctors, increase capacity and cut down waits by allowing some patients to choose a paid option close to home.

But Galloway on Wednesday said Alberta’s incoming changes creates a two-tier system for surgery access “that’s not allowed under the Canada Health Act.”

He said Alberta is proposing a unique health care sector that allows physicians to practice in both public and private sectors simultaneously — a practice not allowed in any other province.

“Alberta is trying to make it a system that’s lucrative for physicians to charge as much as they can to anyone they can, but still have the public system there to bill,” Galloway said.

A spokesperson for Alberta’s hospital and surgical health services ministry disputed Galloway’s claim.

“The act does not prohibit private practice operating outside the publicly insured system, and dual-practice and opt-out models already exist in other provinces without being found to be in breach,” Kyle Warner said in a statement.

Warner said the Alberta government is committed to ensuring Albertans “never have to pay out of pocket for medically necessary care.”

“Expanding access through dual practice does not take away from that — it adds to it. This is not an either/or debate. It is about giving Albertans more choice.”

While other provinces have private options, Galloway said Alberta is intentionally trying to put the private system on even footing with the public program.

For example, he said, Quebec requires physicians to choose between public and private practice exclusively, not simultaneously.

Ontario, meanwhile, has strict rules prohibiting physicians from practising in both systems, said Galloway, maintaining a strong public health care system.

“No other province allows what Alberta is calling dual practice where physicians can work in both systems simultaneously, and no other province is pursuing private health insurance for medically covered health care,” he said.

“So, it’s very different. It’s very structurally different than anywhere else.”

The Alberta government has also said “there will be clear safeguards in place, including limits on how physicians divide their time, minimum public surgery hour requirements, regular performance reviews and system reporting.”

“This is why we are proceeding through regulation rather than legislation, ensuring we remain nimble and able to implement additional safeguards, if necessary, to protect the public health care system,” the Alberta government said in a statement.

Galloway added it’s crucial for Carney to get involved and protect universal public health care as it’s one of the ways Canada can set itself apart from the U.S. and he’s worried about losing that distinction.

The protesters were rallying in front of a hotel in overcast Charlottetown where all 13 premiers were meeting to discuss health care and other issues of national interest.

Canadian Health Coalition chair Jason MacLean says Prime Minister Mark Carney should prioritize health care as a crucial part of nation building.

“The spending in health care hasn’t been keeping up with inflation year after year after year,” MacLean said.

“Therefore, provinces or premiers are coming to the decision, ‘well, maybe we can do better in the private sector.’ That’s not true.”

Other premiers said they would be asking for increased support from the Carney government for health care costs.

Carney was scheduled to attend a dinner with the premiers in Prince Edward Island Wednesday evening ahead of formal roundtable talks on Thursday.

This report by The Canadian Press was first published July 22, 2026.

— With files from Lisa Johnson in Edmonton.