Alberta’s Health-Care Privatization Courts Disaster

Dec. 22, 2025

The UCP government has chosen a discredited ideology over real solutions.

Alarmists have compared the decline in Canada’s health-care systems to the Titanic disaster — an “unsinkable” system that has run into the iceberg of an aging population.

You’ll remember that ship’s sinking off the west coast of Italy in 2012. A captain distracted on the bridge by a Moldovan dancer with whom he had a romantic relationship miscalculated and ran the cruise ship into a reef near the Isola del Giglio. After drifting out of control, the cruise ship grounded a few kilometres away and rolled onto its side. Thirty-two people died.

The Alberta government’s minister of primary and preventive health services, Adriana LaGrange, is a bit like Concordia’s disgraced Capt. Francesco Schettino.

Distracted by its enduring romance with the ideology of privatization, Alberta’s United Conservative Party government is allowing a once-great provincial health-care system to drift toward the reef that will tear a deep hole in the hull of public health care, allowing in a flood of opportunities to “job” the system.

LaGrange argued in a recent “friendly” interview with the Hub’s Sean Speer — that is to say, an interview in which none of her assertions was questioned — that other jurisdictions around the world, including Germany, the Netherlands, Switzerland, Sweden, Australia and New Zealand, all have dual (public/private) practices, “and they’re provided better service, quicker access to surgeries.”

Well, actually, the minister is not presenting an accurate picture of those other jurisdictions.

Take Germany, for example. In that country, 88 per cent of the population is covered by public health care. Private health care is available to the wealthy but also to non-citizens who are living in the country. And if the goal was to save money while improving service, Germany’s system gets an F. The country spends 12.8 per cent of its GDP on health care, one of the highest among Organization for Economic Co-operation and Development nations (and just a tick above Canada’s 12.7 per cent of GDP).

In New Zealand, the health authority recently awarded 10-year contracts to private hospitals for elective surgeries such as cataracts and joint replacements, but it won’t say how much it is paying these facilities. Hmm. One can only imagine why.

There are several studies from both New Zealand and other high-income nations that suggest private providers often prioritize profitability over patient care. A recent University of Oxford review of 13 longitudinal studies in Canada, Croatia, England, Germany, Italy, South Korea, Sweden and the United States found increases in privatization generally corresponded with worse quality of care, lowered staffing levels to increase profits and fewer cleaning staff per patient that led to higher rates of patient infections and, in some cases, death.

Private clinics increase profits by choosing to treat only people with less complex problems, by reducing surgery times, by over-prescribing services and even by shifting the financial burden of complications onto the public system. Some doctors, for example, discharge patients on Friday afternoons to avoid weekend staffing costs.

Kaaren Mathias, associate professor in public health and social justice at the University of Canterbury, argues that doctors work in both public and private systems and reduce their hours in public hospitals for higher pay in private hospitals. Overall, this leads to poorer outcomes and reduced provision of health care.

What about reducing waiting times? As privatization critics like to say, privatization doesn’t reduce the waiting list; it merely reorders it. Unless there is a net increase in the number of doctors and nurses available to work (something that would add even more costs), the net waiting times don’t change. In other words, the people with money get to move to the front of the line, leaving lower-income citizens waiting even longer than they are now.

It could be even worse than that. A report from the Canadian Centre for Policy Alternatives indicates that privatization in Ontario may actually increase wait times because for-profit centres will poach workers from the public system.

None of which — believe it or not — is to argue that privatization should be entirely off the table. Rather, that unquestioning faith in privatization will almost certainly make matters worse for our beleaguered health-care system than they already are.

There might be ways some privatization could help ease the strain. Look to Australia’s intriguing experiment. That country allows private health care but it has abandoned the concept of “free” (not really) health care to everyone, regardless of income level. Australians earning more than AU$97,000 — about C$89,000 — and families earning more than AU$194,000 must either arrange their own private health insurance or, if they wish to remain covered by the public system, pony up for a Medicare levy surcharge that ranges from one per cent to 1.5 per cent of income. Many are opting to do so, since major private insurers have increased premiums by up to 9.4 per cent in the past year.

The lesson for Alberta is simple. If it could set aside its blind faith in privatization, it might be able to look more creatively at potential solutions that may or may not involve a private component.

It seems the province has learned nothing from the catastrophic failure of contracting out lab services to private provider DynaLife, which cost taxpayers $109 million.

To help increase hospital efficiency, Alberta could also look to Switzerland and the Netherlands. Those countries finance their hospitals based on their activity. Hospitals are paid for the services they provide for each patient and are incentivized to provide higher volumes of care. In Canada, hospitals receive fixed annual budgets.

Of course, there are two big elephants in the room. The first is that Canadians live more than two decades longer than when the country’s first medicare system was introduced in Saskatchewan in 1947 (61.9 years then versus 82.9 years today). And for every Canadian senior, there are only three working adults to pay the bills. In 1966, as most provinces adopted universal health care, there were 7.7 working Canadians for every senior.

Problem 2 is that the costs of health care continue to rise. In 1964, when most provinces began the shift to universal health care, the annual cost was $84 per person (roughly $907 in today’s dollars). In 2025, that per capita cost has ballooned to $9,626 per Canadian.

As aging Canadians develop ever more complex health problems, and drugs and treatments become ever more costly, there are far fewer high-income taxpayers to cover health-care bills. This puts enormous pressure on governments to find efficiencies in systems that are generally held to be plagued by waste.

And it’s not just cost. In a recent ranking of health care in wealthy countries by the U.S.-based Commonwealth Fund (in conjunction with the Canadian Institute for Health Information), Canada came in near or dead last on key measures of timely access, including wait times for specialists and non-emergency surgery.

But we have to be very thoughtful about tackling these vexing problems. Blowing up the system, as the UCP government did by breaking Alberta Health Services into five separate divisions, is a costly and chaotic distraction. And privatization is just one of several ideas that should be explored.

Unlike for the Costa Concordia, there is still time to patch the breach and right the listing Alberta health-care system. Doing so will require smarter thinking than we’ve seen so far from this government. By turning to the largely discredited notion of privatization as a silver bullet, LaGrange and gang have shown they still have their blinders on. Unless we change course, it’s hard to see how we can avoid running aground.

[Top photo: Alberta’s push toward for-profit health care will lead the province onto the rocks, writes Doug Firby. Photo via the Canadian Press.]