Read the Story Battle lines are being drawn up as health ministers in Ottawa and Alberta begin to square off on health-care reform. The cause? Alberta’s decision to allow doctors to provide care in both public and private settings. While Adriana LaGrange, Alberta’s minister of hospitals and surgical services, has claimed provincial jurisdiction over the delivery of health-care services, Marjorie Michel, Canada’s federal health minister, has expressed concern about the compatibility of Alberta’s proposal with the reality of the Canada Health Act (CHA). Lawyers can quibble over who is right, but what Ottawa should be doing is welcoming Alberta’s move and committing to amend the CHA if need be so that the Alberta government can continue to make its health system more like better-performing universal systems in Europe. Let’s be clear: physicians in Alberta (and indeed most of Canada) are already able to opt out of the public system. However, to do so, they must give up their public role entirely. To continue supporting the public system, few have chosen this path. However, increasing frustration with the government’s approach to health care threatens a potential exodus from public to private settings. Just ask Quebec, where the increasingly rigid rules to keep physicians stuck in the public system backfired spectacularly and led to physicians applying for jobs in Ontario. Media have previously reported on some Calgary-based physicians travelling to the Caribbean to deliver private care—not to local residents—but to Albertans who fly there with them. Alberta’s government understands this approach doesn’t make sense, and in fact provincial barriers actually threaten the very system they’re intended to protect by forcing physicians into a binary choice. Enter dual-practice legislation that offers physicians a more flexible option – allowing them to participate in the private sector without abandoning patients in the public queue. But there’s a catch. Alberta receives billions of dollars in health care funding from Ottawa every year, and therefore needs to play by its rules. The federal Canada Health Act does not explicitly prohibit dual practice, so long as services in public settings continue to adhere to the principles of the…​Read More