MORGAN: Alberta's private surgeries aren't the threat — Canada's failing healthcare status quo is

Dual-practice surgery is now the law in Alberta. Not a white paper. Not a campaign promise. Bill 11 took effect this week. Eligible specialists can keep doing publicly funded work and, if they meet a minimum public hours requirement, perform privately paid elective procedures in accredited facilities. Family doctors are out, except for a few surgical sidelines. Cancer and life-threatening cases stay in the public system.First surgeries are slated for the fall. The province says nearly four hundred physicians already put their names in over the summer. That is not a rounding error. That is a labour market signal.This is a common model in many European nations offering universal coverage. It's not a profound or dangerous new experiment.As usual, Alberta is villainized for trying to do what other provinces already do.Danielle Smith's ask of Ottawa was almost polite. Give us latitude. We will show you this does not gut the Canada Health Act. She pointed to Quebec, where opting out of the public plan to treat private patients is not a criminal novelty. Adriana LaGrange's line is the federalism argument in one sentence: delivery is provincial. The Act does not ban private practice outside the insured plan. Albertans who can pay for a cataract or a knee have been flying to other provinces and other countries for years. The innovation, if you want to call it that, is letting some of that work happen at home..Watch what happens next, because it is the Canadian ritual. Wait lists are the crisis everyone recites. Care is 'free' as long as you survive long enough to get it. Cancer surgery benchmarks have slipped, and emergency rooms have documented preventable harm from crowding. But heaven help a premier trying to do something about it aside from tossing more funds at the issue. Friends of Medicare, the Canadian Health Coalition, and a stack of union letterheads want Health Canada to treat Alberta as a compliance problem. A union-commissioned legal opinion decries extra billing and queue jumping. Ottawa has already sent a warning letter and is holding 'targeted discussions.' The Canada Health Act's real teeth are transfer deductions. They will punish Alberta by withholding Alberta's own funds. So, the fight will be about money and precedent, dressed up as morality.Here is the part the slogans skip. Universal coverage and a monopoly on how a surgeon spends Tuesday afternoon are not the same thing. Plenty of countries offering universal healthcare let doctors work in both public and private systems, but with rules. Alberta's rule is simple: keep your public volume or lose the private ticket. You can argue the hour floors are too soft. You can argue private rooms will skim easy cases. Those are empirical questions. They are not answered by chanting 'American-style' at a Liberal MP's constituency office.Which brings me to Tuesday's National Day of Action. The press release had the full costume. Twenty-six communities across the country! Information pickets! Town halls all fall! 'Tens of thousands' in the activist copy. Stop two-tier care! Force Ottawa to crush Bill 11! In other words, the same old crap from the usual suspects.What actually happened was the usual circuit: a few dozen outside Corey Hogan's Calgary office, a cluster in Edmonton, about fifty in Red Deer, and the Lethbridge Friends of Medicare chapter doing what it always does. Local TV found enough people to fill a wide shot and a quote about wealth care. That is not a national uprising. That is the professional protest class showing up on a weekday noon hour and discovering, again, that most people with a job and a wait-listed relative did not rearrange their lives for the coalition.If the model were the death of universal healthcare, you would have seen it. You would have seen rallies in hospital parking lots, not on MPs' lawns. You would have seen working families, not the same banners from the last three healthcare fights. A flop is not zero people. A flop is a National Day of Action that cannot outdraw a busy Tim Hortons..The province says it will watch volume. Fine. Watch it. Publish it. Kill the licences of anyone who games the public minimum. That is adult government. What is not adult is the pretence that the status quo is a sacred delivery model. People already buy their way around the queue. They go to BC, they go to the States, or they go to a cousin who knows a clinic. Pretending the only egalitarian option is that everyone waits equally long is a recipe for continued decline and failure.Canada's healthcare system is failing, and it's undeniable. The story is the same in every province, whether it's a conservative government or the NDP. Waiting lists are literally killing Canadians as a struggling system rations care. Smith is daring to challenge the model, and she should be applauded rather than disparaged. Were she Quebec's premier, she would already be cast as a hero.But alas, this is Canada.For now.