Dual Practice in Healthcare: The Hidden Tax Hike No One Is Talking About

The Trojan Horse of Healthcare Reform: Why Dual Practice is a Symptom, Not a Cure

Alberta's flirtation with allowing physicians to operate in both public and private spheres—often termed **dual practice**—is being sold as innovation. It’s packaged as choice, efficiency, and a necessary evil to retain talent. This is the narrative pushed by those who stand to profit. But look closer at the foundation of this debate. The real story isn't about doctor retention; it's about systemic collapse. The key concept here, **Canadian healthcare reform**, is being discussed through the wrong lens entirely. For decades, we have starved the public system. We’ve underfunded infrastructure, ignored wage stagnation for nurses, and treated primary care as an afterthought. Now, proponents argue that allowing doctors to siphon time and resources into lucrative private streams will somehow stabilize the public one. This is economic alchemy, and it never works. The real keyword driving this conversation is **healthcare funding** inadequacy. ### The Unspoken Truth: Who Really Wins? The winners are obvious: the few specialized physicians who can command premium rates for fast-track services, and the private equity firms circling the periphery, eager to monetize gaps in public service. The losers? Everyone else. When a highly skilled surgeon can earn significantly more by seeing fewer, wealthier patients privately, the incentive to remain fully dedicated to the public queue evaporates. This isn't a moral failing of the doctor; it’s a rational response to perverse incentives. The public waitlists—the very problem dual practice claims to solve—will inevitably lengthen. Why? Because the most motivated and capable providers will naturally gravitate toward the path of least resistance and highest reward. This fracturing of the medical workforce is the hidden cost of **medical privatization**. ### Deep Analysis: The Erosion of Universal Access Universal healthcare, at its philosophical core, is an insurance mechanism against catastrophic personal medical debt. It demands a commitment from practitioners to serve the collective need first. Dual practice violates this social contract. It creates a two-tiered system disguised as a choice. For the average Albertan facing a hip replacement wait time, the promise of paying more for faster service isn't choice; it's coercion born of desperation. This mirrors trends seen across the Atlantic, where similar experiments have led to significant disparities in access. We are being asked to accept that our public system is fundamentally broken and that the only solution is to carve out the most profitable segments for private enterprise. This isn't fixing the foundation; it’s pulling up the floorboards to build a luxury penthouse on top of a crumbling structure. Look at the data on physician compensation and public system strain; the correlation is undeniable. ### What Happens Next? The Predictive Collapse My prediction is stark: If dual practice is widely adopted without massive, simultaneous reinvestment into the public primary care network, wait times for complex procedures will double within five years. The public system will become a safety net primarily for the poor and the elderly, characterized by overworked staff and outdated equipment. Furthermore, we will see a 'brain drain' of mid-career general practitioners who feel ethically conflicted or financially unable to compete with their newly dual-licensed colleagues. The political fallout will force even more aggressive privatization attempts down the line, cementing a system where health outcomes are increasingly determined by net worth, not medical need. The only way to truly fix **Canadian healthcare reform** is to make the public option competitive again through systemic funding overhaul, not by creating parallel universes for care delivery.