The Alberta government’s proposal to allow surgeons to conduct operations outside the province’s health-care plan partially funded by the federal government is not only an excellent and humane decision in itself but further pries the lid off our terribly inadequate health-care system.
Many readers will remember the era approximately 40 years ago and extending for at least 20 years when Canadians actually purported in large numbers to believe that one of the defining characteristics of Canada as an independent country distinct from the United States was our superior health-care system. This was based on the theory that scores of millions of Americans received no health care at all, and in the event that they did receive health care, they would almost automatically be plunged into bankruptcy.
This was always a wildly exaggerated caricature of the state of medical care in the United States. At that time, 70 percent of Americans were covered by public or private plans. They had total health-care coverage, which they paid nothing or little directly for, in a health system that provided a very high standard of care and where there were no significant waiting lines for even elective procedures. The accompanying theory that if a sick or injured person did not have an acceptable credit card during a medical emergency, then that person would not be accepted by an ambulance or hospital, was another complete fiction.
In the United States, all people in need of medical attention receive it promptly. Those who do not have the means to pay for it are automatically maintained in full care until their condition is stable and they are fit to be released. Those of very restrained means do benefit from a public health payment supplement system, but it does not protect everyone from the full cost of expensive procedures. This is a gap that the Americans are working on, and President Trump has recently proposed a system of supplementary health insurance for those in need of it. In fact, 80 percent of Americans receive superior health care to Canadians, and their employers or the taxpayers pick up the cost. Our pompous health-care idyll is a fraud.
The one point that all American legislators agree on is that they do not want to emulate the Canadian system. We have a thoroughly inadequate number of doctors for our population of 41 million, with the result that an inordinate number of health issues have to go to the emergency rooms of general hospitals, which are notoriously overcrowded with people who often have no serious medical reason to be there and should be in clinics to deal with simpler medical issues. Waiting periods for even life-and-death procedures in Canada are notorious and are a subject of widespread and not unjustified denigration in the United States.
This fact is piquant given that on the revelation of the news in Alberta last week that private surgery would be permitted if Bill 11 passes, the more militant socialized medicine advocates, including spokespeople for the nurses’ unions, objected that Alberta was sliding down the slippery slope towards “the American for-profit system.” It was one of the greatest and most discreditable blunders of the long Pierre Trudeau government that he and Health Minister Monique Bégin, for unexplained and apparently capricious reasons, determined that Canada must be the only country in the world that completely banned private medicine—although there were a few interludes when Cuba and North Korea flirted with that status, and both those poor communist countries have more doctors per capita than Canada does.
Following that decision by Trudeau and Bégin, approximately 10,000 doctors departed Canada immediately and ever since we have had the lowest number of doctors per capita of any advanced or even semi-developed country in the world. Approximately 23,000 people died in Canada between April 2024 and March 2025 while on waiting lists for vital operations, and that number does not include Alberta and part of Saskatchewan. Not all of the operations would have been successful, but all were worth a try, and our hideously expensive system, still defended by those on the left looking down their noses at the Americans, was clearly responsible for the death through negligence of at least 10,000 people.
This fits in well with the great emphasis now being placed on the MAID (medical assistance in dying) program; in the perversity of its inadequacy, our health-care system, which is designed to extend and maximize the useful lives of the whole population, is preaching the virtues of suicide. Of course, people in a desperate and hopeless condition should be able to make arrangements like this without anyone being prosecuted for it, but for this to become a major preoccupation of our health system is a mockery of health care worthy of Evelyn Waugh or Aldous Huxley.
Most of the provinces were already, under heavy pressure from justly angry citizens, tinkering with health care to mitigate its failings without giving the federal government the excuse to reduce what is called the Canada Health Transfer, a large federal subsidization of provincial health care. The quantum of this transfer is expected to reach $65 billion annually in the next four years. Alberta’s Bill 11 requires surgeons to perform these operations out of their normal hours and emphasizes elective procedures, in order not to violate the terms of federal government assistance to the provinces. It is expected that a good deal of surgeons’ time in normal hours will be freed up and a sharp reduction attained in waiting periods for essential surgery.
New Brunswick has already instituted a system somewhat similar to this, and Saskatchewan is encouraging private health-care partnerships. Ontario has been sponsoring private clinics to tackle health-care waiting lists, and has announced an expansion of that program to more procedures, including $125 million to cover up to 20,000 orthopedic operations in private clinics.
The most advanced province in this respect is Quebec, following what is known as the Chaoulli case of 2005, in which the Supreme Court of Canada determined that banning private medicine was a violation of the Quebec Charter of Rights and Freedoms, though the court could not decide if it was also a violation of Canada’s Charter, as one justice abstained. A steadily increasing number of Quebec doctors are returning to private practice in the province.
The problem of an inadequate number of doctors is aggravated by an unconscionable waiting time for foreign doctors to be admitted to practice, as the medical associations fiercely defend their monopolies at the expense of the people the Hippocratic Oath requires them to serve. Canadian health care is a disaster area, and while the provinces are to be admired for getting around it as best they can, it is time for leadership in Ottawa in this field, as in so many others.
