The Alberta government has just introduced Bill 11, called the Health Statutes Amendment Act. This new piece of legislation gives physicians the freedom to work in both public and private healthcare systems. Premier Danielle Smith launched this move along with a wider plan to improve the delivery of health care across the province. The bill has set off a firestorm of worries about its possible repercussions, particularly the establishment of a two-tiered healthcare system.
The current bill provisions leave family doctors out of the private system. As it stands today, they are excluded from joining. This is an important decision to ensure that everybody can continue to access primary care. Simultaneously, it allows experts to perform elective procedures on nights and weekends. Surgeons should be allowed to fill this void by using their skills even when public operating rooms go underutilized. This recommends shifting the burden on public health assets.
Concerns from Medical Professionals
Dr. Brian Wirzba, then president of the Alberta Medical Association (AMA), wrote an op-ed suggesting deep concern over what the passage of Bill 11 would mean. He noted that the AMA was not consulted prior to the bill’s introduction, raising questions about stakeholder engagement in shaping healthcare policy.
“None of this was something that Albertans were asked about in an election,” – Chris Gallaway
Gallaway, executive director of Friends of Medicare, sounded a similar note, condemning government’s failure to consult with Albertans and stakeholders. He’s concerned that this bill would lead to a two-tier healthcare system, similar to America’s. In this model, access to care is determined by how much someone can afford to spend on private treatment.
Dr. Wirzba also drove home the fact that Alberta is in competition with other jurisdictions in Canada and North America for recruitment of healthcare professionals. He emphasized that this bifurcated system has the potential to bolster recruitment and retention initiatives. It’s important to get the right safeguards in place.
“So I would more look at it as we have an ability to allow physicians to do some private activity while making them responsible to do the majority or some portion of the public system,” – Dr. Brian Wirzba
Recruitment and Operational Challenges
The Alberta government continues to claim that all measures under Bill 11 are compliant with the Canada Health Act. Matt Jones, Alberta’s minister of hospital and surgical specialized services, has highlighted the benefits of a two-tier system. He thinks it would be a great recruitment tool for physicians and other health professionals. This would go a long way to help solve the perpetual problem of attracting talent to our province’s healthcare system.
Yet, Dr. Wirzba warned against rushing headfirst into those changes without a complete understanding of operational new challenges. He asked whether there are sufficient anaesthetists and surgical nurses to service the increasing number of private procedures. Most importantly, he raised the alarm that America’s public resources may be too maxed out.
“The literature would suggest that’s a big challenge,” – Dr. Brian Wirzba
He requested a detailed description of how the proposed system would work in reality. He pointed out that rigorous planning and strict monitoring safeguards are both necessary to ensure that public healthcare access isn’t compromised.
Potential Solutions and Guardrails
The bill dramatically expands the market opportunity for private healthcare practices. Additionally, it recommends strong guardrails to ensure the emerging technology is accessible and equitable. Such as restricting private surgeries to evenings, weekends or spare capacity at rural hospitals. Moreover, there should be conditions mandating physicians to develop their expertise within the public sector prior to moving into private practice.
Dr. Wirzba welcomed these measures as a useful way to align the interests of public and private actors. He proposed that we make the most out of our available public operating rooms. He suggested establishing centralized referral lists for surgeries to eliminate wait times altogether.
“From our perspective at the AMA, we think that it’s going to be really important to have the details really well laid out, a good plan in place about monitoring safeguards.” – Dr. Brian Wirzba
