Alberta's Stealth Plan to Bring in Two-Tier Health Care What does it all mean? A two-tier system requires private-pay diagnostic testing Creating a new private health insurance market Undermining care and adding unnecessary testing

The province now allows private-pay testing that lets the wealthy jump the line. … Article written by Andrew Longhurst.
As premiers and the prime minister gathered in Charlottetown last month to discuss public health care at the Council of the Federation, the Alberta government was quietly working to further its two-tier system.
On July 22, the Alberta government approved three orders-in-council that shed light on how the provincial government is building a private health insurance market and undermining equal access to health-care services.
The three cabinet orders relate to the implementation of Bill 29, which the legislative assembly introduced in April as the legal framework for two-tier diagnostic testing without requiring a practitioner's referral.
This legislation formalizes queue-jumping. Those who can pay out of pocket or with private insurance can self-refer for testing in order to jump to the front of the line for treatment. It is also a move designed to feed the for-profit health-care industry and create a market for private health insurance products.
The first order-in-council brought key provisions of Bill 29 — the two-tier diagnostic testing legislation — into force effective July 31.
The second amends the Alberta Health Care Insurance Regulation by creating a new category of "preventative health testing services" which are "not insured services" under the Alberta Health Care Insurance Act. This makes it appear that the Alberta government is maintaining compliance with the Canada Health Act, even though it is not. The amendment also establishes that "all preventative health testing services… are extended health services" under a forthcoming Preventative Health Testing Services Benefit Regulation.
The third regulation maintains that certain procedures involved in providing these "preventative health testing services" remain restricted activities that must only be performed by authorized regulated health professionals. These include administering anesthetic gases for the purposes of anesthesia or sedation, radiopharmaceuticals and diagnostic imaging contrast agents, and ionizing radiation (such as X-rays).
In a press conference on July 27, the Alberta government announced that CT, MRI, ultrasound, X-ray and CT services will initially be under the banner of these "preventative health testing services." If cancer is found through these "preventative" scans, the government will reimburse for the private cost.
At the press conference, a radiologist spokesperson also revealed that the Alberta government has been already allowing private-pay medical imaging tests (that number in the "low tens of thousands" annually), which suggests that the Alberta government has already been in violation of the Canada Health Act.
These legislative amendments are part and parcel of establishing Alberta's two-tier health care system with a private health insurance market for medically necessary health-care services that are already covered under the public plan.
In order to build this market, the Alberta government must give legal certainty to investors, for-profit facilities, insurance corporations and physicians and health professionals intending to work in the private-pay tier.
The implementation of private-pay diagnostic testing is part of the government's overall plan for a two-tier system that will allow physicians and surgeons to work simultaneously in the private-pay market as well as the public system (referred to as "dual practice" under Bill 11).
The legislation and regulations are written in an open-ended manner to include any form of diagnostic testing, ranging from lab testing, medical imaging and any other diagnostic procedures performed in any health-care settings. To start, the Alberta government is beginning with the most common medical imaging procedures.
A two-tier system demands that private-pay diagnostic testing be in place to enable queue-jumping. Individuals must generally have some form of diagnostic testing ...