Alberta’s Bill 11 would not only bring a U.S.-style health care system, but it would also end Canada’s health-care system, according to the Parkland Institute and the Canadian Centre for Policy Alternatives.
Bill 11, the Health Amendment Act, passed into law on Dec. 18, 2025. It amended several provincial acts, including the Alberta Health Care Insurance Act, Health Statutes Amendment Act, the Health Agencies Act, and the Public Health Act.
The government says it would modernize practice rules for physicians, drug coverage and health cards, along with offering flexibility for doctors and cutting wait times for surgeries in the public health system.
In the Tuesday report, researchers Andrew Longhurst and Rebecca Graff-McRae say Bill 11 may violate the Canada Health Act, marking the beginning of U.S.-style health care in Canada.
“This bill will wreak havoc on Alberta’s public health system at a time when doctors are pleading for stability and resources,” Graff-McRae said in a news release.
“This should send a red flag to the rest of Canada, as Bill 11 likely violates multiple sections of the Canada Health Act, including universality and accessibility principles, and ultimately threatens not just the premise of the Act but the foundation of Canadian values and identity.”
The report, which has 11 points of contention with the bill, says flexible “participating physicians” will be incentivized to spend less time in the public system, increasing wait times and public system health costs.
Hospitals will also be encouraged to compete for revenue from user fees and private health insurance, the report says, contrary to provincial hospital insurance legislation and the Canada Health Act, which are meant to prevent physicians and facilities from charging patients for health care.
A private insurance market for publicly insured care would be created as a result, according to the report, degrading the public system.
The Canada Health Care Act says public health insurance must be universal, comprehensive, accessible, portable, and publicly administered. It also focuses on “medically necessary” hospital and medical services.
Meanwhile, other institutes, such as the Fraser Institute, provided commentary to the contrary, saying it’s a “positive move away from the failed Canadian model.”
The province has also said it is following European countries like Denmark, along with citing long wait times in Canada as a motivating factor.
However, many of those arguments aren’t rooted in the factual evidence, says Longhurst, a senior researcher with the Canadian Centre for Policy Alternatives.
He says European jurisdictions used for comparative purposes have different health systems, with many having upwards of 50 per cent to double the number of physicians on a per capita basis, along with doctors working as salaried employees.
“Right now, the vast majority of doctors in Alberta, as well as across the country, work as independent contractors. So the public system has no control over their time spent within the public system, and in turn, their time spent working in the private system,” he said in an interview with 660 NewsRadio.
He adds that there are legislative guardrails in those countries, while Bill 11 offers no such thing.
“It’s going to be a private health insurance market, like we see in the United States,” Longhurst said.
“What we see from the international evidence and what we’ve seen from experience here in Canada is when you have that unconstrained, unfettered private tier, surgeons often move into that more lucrative tier. And that’s what’s being encouraged under this legislation without any guardrails to protect the public system from losing those resources and staffing.”
Issues include providing cancer treatment on time and having enough anesthesiologists, Longhurst said, as they may be “compelled to work in these private for-profit facilities.”
“There are a lot of concerns about what the government is setting up with this system that mirrors the United States and doesn’t have any resemblance to what we see in many European countries,” he said.
When asked to respond to the report, press secretary for the Minister of Primary and Preventative Health Services, Madison McKee, called the report a “collection of NDP talking points,” and the conclusions “politicized hyperbole.”
She also said the Parkland Institute was biased and lacks credibility, and “continues to work as the NDP’s unofficial research arm.” No answer was given when asked if this was the case for the Canadian Centre for Policy Alternatives, a co-author of the report.
“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,” her statement reads.
When asked about specific research used for Bill 11’s design, McKee pointed to a Fraser Institute commentary piece, a Montreal Economic Institute media release, and the video released when Premier Danielle Smith announced the legislation.
Private health care was the case in Canada until the 1960s. Some provinces have private diagnostic services, while others are publicly funded and privately delivered.
According to the RAND Health Insurance Experiment, an older U.S. study between 1971 and 1982 that the Canadian Medical Association (CMA) cites in a 2024 review of private and public health care, found fees — regardless of the plan — reduced the use of nearly all health services, affecting “the poorest and sickest subjects.”
The CMA also says more research is needed on dual physician practice, as current research is dated and largely based on countries that are not like Canada. However, what was found is that it leads to poorer access to care.
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