Private-System Surgeries Are Just One Part of the Sweeping Changes Brought In by Alberta’s Bill 11

Alberta Premier Danielle Smith (R) stands with new Minister of Primary and Preventative Health Services Adriana LaGrange in Calgary no May 16, 2025. The Canadian Press/Jeff McIntosh

Explainer

The Alberta government this week introduced legislation containing a suite of health care amendments to overhaul the system, including changes to how physicians bill for their services and further steps to restructure the province’s health care.

Bill 11, known as the Health Statutes Amendment Act, 2025 (No. 2), proposes changes to five pieces of legislation. One proposed change that has drawn significant public attention is a dual-practice model that would allow surgeons and surgical staff to work in both the public and private sectors.

The province says the move will shorten wait times and improve access to care, while the Opposition NDP says it marks a step toward a two-tier health system.

Other proposed amendments include adding penalties for improper medical billing, setting up a new process for renewing health cards, strengthening food safety rules, and improving coordination between public and private drug plans.

Here is a look at what Bill 11 is about.

Dual Practice Model for Surgeries

After a leaked draft legislation broke the news last week about the province’s plans for a parallel private-public surgery model, the government is making the plans official by legislating changes to physician participation rules.

Bill 11 contains proposed amendments to the Alberta Health Care Insurance Act that would no longer restrict surgeons and surgical staff to working exclusively in either the public or private system, but would allow them to work in both.

The bill includes provisions the province says would limit participation in the dual model to protect the public health system, such as requiring physicians to perform a set ratio of public surgeries each year, restricting certain specialties to public practice, or potentially limiting private surgeries to evenings and weekends.

“For years, governments across Canada have tried to fix long wait times by spending more money, yet the problem keeps getting worse,” Premier Danielle Smith said in a Nov. 24 press release, announcing the model.

“Dual practice gives us a practical, proven tool that lets surgeons do more without asking taxpayers to pay more. It means shorter waits, better outcomes and a stronger health system for everyone.”

The Opposition NDP has criticized the bill, saying it would create a two-tier, for-profit health system and pointing out that the change was not part of Smith’s platform when she ran for premier.

Bill 11 “means Albertans having to pay out of pocket just to see a doctor or have health procedures done, and it won’t increase access to the care Albertans need,” Alberta NDP Leader Naheed Nenshi said in a Nov. 24 statement.

Legislation Amended

Through Bill 11, the Alberta government is proposing amendments to the Provincial Health Agencies Act, along with further changes to the Alberta Health Care Insurance Act, to implement operational changes it says are needed to continue refocusing the system into four specialized sectors: primary care, acute care, assisted living, and recovery.

Health reform has been a key part of Smith’s agenda, with a system overhaul underway since 2023. The changes aim to improve access to care and decentralize decision-making to the front lines through measures such as transitioning Alberta Health Services from a provincial health authority to a hospital service provider.

One of the amendments in Bill 11 involves repealing the Hospitals Act, which sets out how hospitals operate and are governed. Provisions related to these matters would be moved into the Provincial Health Agencies Act.

Addressing ‘Improper’ Billing, Streamlining Drug Coverage

Bill 11 contains additional amendments to the Alberta Health Care Insurance Act aimed at preventing health care providers and clinics from engaging in “improper billing practices” or making “inappropriate claims.” One of the proposed measures is introducing penalties for non-compliance.

In a related case, a Calgary physician last year was charged with fraud for allegedly submitting approximately $2.2 million in false billing claims to the Alberta Health Care Insurance Plan over a two-year period. Earlier this year, she was ordered to stand trial.

The province says the changes would improve billing accountability and transparency while helping prevent the misuse of public money.

Bill 11 also proposes changes to drug-coverage guidelines so that private insurance is used as the primary payer when available, with public programs serving as secondary support. The province says this will ensure taxpayer-funded programs are used efficiently.

In addition, the bill proposes amendments to prevent employers from reducing or terminating health benefits for employees who continue working beyond age 65. Under the current framework, many employers are not legally required to provide health benefits once employees reach that age.

Health Care Cards and Food Safety

If passed, Bill 11 would also establish a new process for renewing health cards and allow their seizure or suspension in cases of tampering.

Earlier this year, the province launched a digital wallet to give residents the option to store digital versions of government-issued documents, such as health cards, on their mobile devices. One of the aims of the measure was to address the “ongoing embarrassment of the flimsy paper Alberta health care cards,” the premier said.

She later said during a Sept. 2 town hall in Medicine Hat that another reason for her government introducing a digital health card was that the province has 600,000 more health cards than people.

“We need to make sure that we are protecting Alberta taxpayers so that we are not paying for expensive health care for people who don’t even live here or who are only here to take advantage of the social programs,” the premier said at the time.

Bill 11 would also enable information sharing with the ministries of technology and innovation, and service Alberta and red tape reduction, to support initiatives aimed at modernizing health cards, the province said.

Through amendments to the Public Health Act, the bill also seeks to enhance food safety standards by introducing stricter staff training requirements, increasing transparency of inspection results, and providing inspectors with new tools for oversight and investigation. The changes are aimed at increasing public confidence in the province’s food safety system, the government said.