Healthcare advocate warns Alberta heading toward two-tier system

By Lethbridge Herald on March 7, 2026.

A health-care advocate says Alberta is at a crossroads, warning that recent policy changes could push the province toward a two-tier system resembling that of the United States.

Speaking Thursday to the Southern Alberta Council on Public Affairs (SACPA), Friends of Medicare executive director Chris Gallaway argued that a series of reforms under Premier Danielle Smith could fundamentally alter how health delivery in the province.

“I’m not usually alarmist,” Gallaway told the lunchtime audience. “But right now we’re facing what I would describe as an existential threat to Canadian Medicare.”

Gallaway said Albertans across the province are already worried about healthcare access; concerns he said his organization hears repeatedly during community visits.

“Everywhere we go in Alberta, people tell us they’re worried about health care.They’re worried about not having a family doctor, about emergency rooms closing, about long waits for surgeries and diagnostic tests, and about services disappearing from their communities,” he said.

He argued those problems are being compounded by structural changes within the health system.

The provincial government has been restructuring the health-care system, including dismantling the centralized authority of Alberta Health Services (AHS) and replacing it with separate agencies responsible for primary care, acute care, continuing care and mental health and addictions.

Gallaway said the result has been confusion and fragmentation across the system.

“Front-line health-care workers describe it as chaos. People don’t know who’s responsible for what anymore,” he said.

Gallaway said that uncertainty combined with growing private-sector involvement could pave the way for a more privatized model.

“We’re facing the possibility of full-on two-tier, American-style health care coming to Alberta,” he said.

A key concern for advocates is legislation passed late last year allowing the sale of private insurance for services already covered by the public system. Critics argue that could allow wealthier patients to pay for faster access to care.

“That means people could buy insurance to move ahead in the queue. Once you allow that, you start to erode the principle that access to care should be based on need — not the size of your wallet,” he said.

Gallaway also criticized the growing role of private surgical providers and other for-profit services within Alberta’s health system.

Public funding directed to those companies can build a private market that becomes difficult to reverse, he said.

“When you create that private infrastructure, those companies aren’t going anywhere. Once they’re embedded in the system, it becomes much harder to put the genie back in the bottle.”

The presentation sparked an animated question-and-answer session, with audience members pressing Gallaway on everything from hospital closures and private-sector involvement to the political strategy needed to defend public health care.

Several questions focused on whether Alberta’s system is already drifting toward privatization and what ordinary citizens can realistically do to push back. Gallaway encouraged people to contact their MLAs, organize in their communities and keep the issue visible beyond political circles.

“Don’t underestimate the impact of people speaking up. When hundreds of people in a constituency start emailing or calling about health care, it gets noticed very quickly.”

Others shared personal experiences with the U.S. health-care system, reinforcing Gallaway’s warnings about what a more privatized model could look like. 

One audience member who had lived and worked south of the border described the experience bluntly.

“I spent more than 40 years in the United States and was uninsured twice,” he said. “It’s not a fun place to be. If anyone wants to see what a gong show U.S. healthcare is, start with Googling UnitedHealthcare.”

Despite his concerns Gallaway said public support for universal health care remains strong.

Polling consistently shows health care remains a top issue for Albertans, and dissatisfaction with the current system is growing. That public concern may ultimately shape the future of the system.

“The good news is that people care deeply about public health care. Canadian Medicare exists because people fought for it.”

He added that governments ultimately respond to enough public pressure.

“We can decide what kind of health-care system we want in this province,” Gallaway said. “And if people speak up loudly enough, they can make sure public health care is protected for the next generation.”