Supporters argue that letting surgeons bill privately for extra work will add operating‑room capacity and cut elective‑surgery wait lists across the board.

Critics counter that the model may let money, not medical need, decide who receives care, creating a two‑tiered system and raising out‑of‑pocket costs for patients who cannot afford private options.

Quebec’s similar system now shows the worst wait‑time record among Canada’s four largest provinces: only 54 % of public patients meet the CIHI benchmark, compared with 84 % in Ontario.

Alberta’s own numbers are already below the national average. Only 63 % of public patients receive hip‑replacement surgery within the CIHI benchmark, while the Canadian average stands at 69 %.

Research from Canada, Australia, Ireland and the United Kingdom consistently finds that expanding private‑care does not meaningfully shorten public‑sector wait times and often widens inequality.

The provincial government says strict rules will keep doctors in the public system, including mandatory minimum hours in public operating rooms. Premier Danielle Smith noted that about 400 surgeons have expressed interest in dual practice.

Health‑policy professor Karen Palmer warned that no country has eliminated the harmful effects of dual practice, citing conflicts of interest that could encourage surgeons to lengthen public waits to push patients toward paid care.