Alberta’s Bill 11, which will take effect in September, allows doctors to provide some public and private services simultaneously. But a new survey finds that 56 per cent of Albertans are against the legislation, and only 34 per cent in support.
Canadians broadly oppose Alberta’s new dual-practice health care law, according to the results of a new survey, which also found strong support for Canada’s public health care system.
The survey, commissioned by the Canadian Health Coalition on the subject of Alberta’s controversial Bill 11—which will allow doctors in the province to provide public care and some private care, focusing on elective surgeries, simultaneously once it takes effect next month—found that 29 per cent of Canadians strongly oppose the bill, and only 7 per cent strongly support it.
“Canadians outside of Alberta don’t have much awareness of Bill 11,” explained David Coletto, the founder and CEO of Abacus Data, the polling firm that conducted the survey. The survey polled 1,500 Albertans and 1,500 Canadians outside of Alberta between July 9 to July 20, with a margin of error of about 1.79 per cent overall.
But “once we tell them what that law was designed to do, most think that it’s really the wrong direction, and they worry that it’s going to create the kind of inequalities that they don’t want to see in their system,” he said in an interview with The Hill Times.
The survey found that only 33 per cent of Canadians had heard about the legislation, as opposed to 70 per cent of Albertans.
In Alberta, support for the legislation was low. Fifty-six per cent of Albertans said they opposed the legislation, with only 34 per cent responding in support of the legislation. Eighty-seven per cent of Albertans who responded to the survey also agreed that universal health care based on a person’s need, not how much money they have, is a core Canadian value.
Nationally, firm support for the legislation was only at six per cent, whereas firm opposition sat at 27 per cent.
“This is something that’s going to severely impact every Canadian, we believe,” said Jason MacLean, chair of the Canadian Health Coalition, adding he was “pleasantly surprised” to see broad opposition to the legislation.
“Albertans and Canadians, as a whole, are against Bill 11 and what it’s going to do to their own pocketbooks, and the affordability that they’re going to have moving forward,” he said, noting that most voters are aligned, regardless of political affiliation.
Seventy-four per cent of Canadians responded that they were concerned about Bill 11 expanding, or similar policies being adopted elsewhere in Canada, with that number two points higher in Alberta at 76 per cent.
Broken down by Liberals and Conservatives, 59 per cent of Liberals opposed the bill, compared to 41 per cent of Conservatives. Eighty-two per cent of Liberals responded that they were concerned about the bill’s influence across Canada, and 66 per cent of Conservatives said the same.
Conservative respondents were more open to private models of health care and the approach Alberta is taking, but it’s not “black or white,” Coletto said.
‘We expect the federal government to respect Alberta’s jurisdiction,’ says Alberta Premier Smith
The federal government, for months, has been quiet on Bill 11, even though federal funds are dispersed to provinces for their health-care systems through the Canada Health Act, which requires provincial health insurance to be non-profit and publicly run. Recently, however, Health Minister Marjorie Michel (Papineau, Que.) broke her silence on the topic, sending a letter on July 24 to the province detailing her concerns.
“Why did I send the letter? Because, for sure, dual-practice, I don’t know how it can work within [the Canada Health Act],” Michel told the Toronto Star.
That legislation also includes criteria on health-care comprehensiveness and accessibility—which some worry could be violated by Alberta’s law. In total, the legislation outlines five criteria: public administration, comprehensiveness, universality, portability, and accessibility.
But, Alberta Hospital and Surgical Health Services Minister Adriana LaGrange recently told CBC that the province’s health-care system is outside federal jurisdiction, and that dual practice “does not prohibit private practice outside the publicly insured system.”
Alberta Premier Danielle Smith has touted the law as a method to reduce wait times for surgery, increase flexibility for doctors, and allow Albertans to pay for non-emergent procedures within Alberta, instead of leaving the province for services.
“Let me be clear: the administration and delivery of health care is an area of provincial jurisdiction, not federal. We expect the federal government to respect Alberta’s jurisdiction and its authority to determine how health care is delivered in this province,” Smith also wrote in an Aug. 18 social media post, adding that the dual-practice model “does not” violate the Canada Health Act.
“The federal government gave Alberta $7-billion last year, and for $7-billion, you’re telling [me] ‘give me my money, and you stay out of my health care’?” said MacLean of the province’s response.
“What they should be doing is partnering up on what are the best ways forward.”
He added that he believes, “wholeheartedly,” that the feds must have a say in the legislation, not just because they’re funding the province’s health care system, but because the Canada Health Act gives them teeth to police it.
“It’s not even a question of, ‘does [Prime Minister Mark] Carney even care, or does Carney even want to claw back’ … It’s the law: they’re going to have to claw back, because what it’s going to show is that it is a violation of the Canada [Health Act].”
MacLean also stressed that the federal government reducing funds isn’t “retaliation,” but required under the act.
“If these violations occur, they have to do it,” he said.
In a statement to The Hill Times, Michel’s spokesperson Guillaume Bertrand said the ministry is “listening” to Albertans’ concerns about protecting the integrity of their health care system, and that Michel is regularly meeting with LaGrange.
“We have taken a collaborative approach with all provinces and territories, including Alberta, that respects their jurisdiction to explore innovative ways to improve access and care while strengthening the public, universal health-care system,” reads the statement.
Pollster Coletto says he would be ‘surprised’ if feds got involved soon
Coletto called it a “very tricky space” for the feds, which is why he believes Carney (Nepean, Ont.) hasn’t fully engaged with the province’s bill yet.
“Because of the pending referendum in Alberta, because of a Quebec election—where [the] federal government stepping into provincial jurisdiction is is such an obviously sensitive topic— … at least for the moment I would be surprised if the government got engaged,” Coletto said.
Alberta’s referendum will put a variety of questions to its citizens on Oct. 17, and Quebec’s provincial election, where the separatist Parti Québécois remain in the lead, is set for Oct. 5.
Once those events are over, however, and the impacts of the law are evident, Coletto suggested the feds might then engage.
“There will be pressure, I think, increasingly, put on the federal government to respond, and it’s a perfect issue for the New Democrats and Avi Lewis,” said Coletto.
The NDP’s new leader has yet to indicate when and where he will run for a seat, but he has been spending much of the summer drumming up support for his party, which was brought to a new low in the April 2025 election, and is now down to only five seats in the House of Commons.
Coletto said that without a “stong voice on the left,” there isn’t a staunch defender of public health care, if the Liberals aren’t willing to take on the charge.
In April, the Liberals passed two resolutions at the party’s convention focused on protecting Canada’s public health system, as defined in the act.
Still, Coletto said health care will become an increasingly important political discussion, and that there “is still room for debate” on methods, especially as most Canadians aren’t satisfied with the current system, though Alberta’s bill hasn’t yet become a large national conversation.
Ninety-one per cent of Canadians responded that they were concerned about the future of Canada’s public health care system, which has been under increased strain in recent years.
Coletto said provincial elections over the next decade will “fundamentally be about health care,” as shifting demographics are going to “demand debate” about how the system cares for an aging population amid slowing birth rates. Canada’s birth rate continues to decline, and in 2024, it reached a record low of 1.25 children per woman.
“We’re not replacing our population, so we’re headed to, I think, a political clash over the future of our health system.”