(November 27, 2025)

By: Iris Gorfinkel, Toronto Star

Ontarians need to be on high alert. Alberta has taken a major step toward privatizing health care. Bill 55 will allow surgeons to work in both public hospitals and private‑pay clinics. Under this dual-practice model, cataract surgeries and joint replacements done during business hours would be covered by the province, while the same procedures in evenings or on weekends could be sold to patients for out-of-pocket fees.

Alberta would also let investor‑run corporations operate public hospitals — turning them into profit centres and throwing the doors open to a two‑tier system. It’s framed as “choice, efficiency and innovation,” but it effectively turns patient wait-lists into a customer list, targeting those who can pay with shorter waits.

This sets a concerning precedent. Ontario doesn’t have a Bill 55 by name, but a version of this is already taking shape through expanding for‑profit clinics and extra fees. We’re promised “you’ll show your OHIP card, not your credit card” — there’s nothing to fear. But Ontario’s reality shows how quickly a publicly funded procedure can turn into a profit-generating business once regulation allows it.

Privately run centres in Ontario perform cataract operations, orthopedic surgeries and imaging, such as MRIs and CT scans. These are funded through the provincial plan, but independent investigations have documented patients being charged thousands of dollars in extra fees for services that should have been covered.

The Ontario Health Coalition’s report, “Under the Skin” details clinics billing seniors for premium lenses, administrative fees and mandatory “consultation packages.” Many vulnerable patients didn’t realize those fees were illegal or that the basic surgery was already covered by OHIP under both the Canada Health Act and Ontario law.

Proponents argue that for‑profit centres are harmless because core services on offer remain publicly funded. But the dividing line between “public” and “private” quickly blurs when providers make more income from those who pay. In practice, this means promoting upgrades, upselling services and steering patients toward paid options, whether or not they’re medically needed.

Ontarians who can afford it buy their way to faster care, while patients living paycheque to paycheque are left with even longer wait times as the public system is drained of staff by higher-paid private work. This is gradually shifting Ontario away from universal, equitable care toward a system where health justice hinges on income.

International experience with privatization sends a stark warning. A recent comparison of 25 wealthy countries by the Canadian Centre for Policy Alternatives found that countries that rely more heavily on private health care tend to suffer more preventable illnesses and die sooner. Maternal and infant mortality rates also rise when countries are more reliant on for-profit health systems.

In contrast, countries with strong public systems — like Sweden, Norway and Denmark — live longer, have fewer preventable diseases, and suffer less maternal and infant deaths. The global record is blunt: When countries choose more privatization, they choose shorter, sicker lives.

Canada’s Health Act stands at a fork in the road. One path diverts resources to for‑profit clinics, normalizes extra fees and enables investor‑run facilities to put revenue over the public’s health.

The other path invests in health care workers, expands public operating rooms, funds team-based care and rewards family doctors offering comprehensive primary care.

The second path is worth defending, and it demands enforcing existing laws against extra-billing and consequences for clinics that break them.

Alberta Premier Danielle Smith said, “Health care shouldn’t be about blind and outdated ideologies or politics.”

Let’s hope she wasn’t referring to universal public health care. What happens in Alberta doesn’t stay in Alberta. Every dollar “invested” into for‑profit clinics drains the public system. When profits are prioritized over health, it results in more preventable illnesses and shorter lives.

Alberta sets a dangerous precedent for Ontario, tying timely care to a person’s bank balance and ignoring a fundamental truth: Privatization leaves the sickest and poorest behind, while those who can pay leapfrog to the front of the line.

Link to original article: https://www.thestar.com/opinion/contributors/alberta-is-turning-public-hospitals-into-private-businesses-will-ontario-follow/article_ab5e58c3-af4a-4879-a92f-d63c4a2bbded.html