Shawn Whatley, writing in the National Post via the Macdonald-Laurier Institute, defends Alberta’s decision to let patients pay out of pocket and book their own MRI, CT, ultrasound and X-ray scans without a physician referral. The change is modest on paper. It is explosive in Canadian politics because it touches two of Medicare’s sacred rules: no self-referral and no self-pay for medically necessary diagnostics.
Critics at Canadian Doctors for Medicare, Friends of Medicare and the Alberta Medical Association warn that the policy will raise costs, lengthen public waits, expose people to unnecessary tests and pull staff out of the public system. Whatley argues those claims rest on a zero-sum story that the evidence does not support. A patient who pays for a scan and gets a normal result often needs less follow-up in the public queue, not more. Saskatchewan’s Surgical Initiative between 2010 and 2014 used private clinics and cut waits from 26.5 weeks to 14.2 weeks at a cost 26 percent lower than public delivery. Polls have found a majority of Canadians open to more private access outside the existing monopoly.
The public system that is supposedly being protected is already leaking people. A 2025 study found nearly 40 percent of Canadian nurses under 35 leaving within five years. A 2019 Globe and Mail report found almost one in five new specialists unable to find full-time work in Canada. In British Columbia, operating-room time for surgeons has collapsed from more than 22 hours a week in the 1990s to less than five. Ontario community physicians’ average retirement age has fallen from about 70 before the pandemic toward 55 after it. Canadian doctors report higher burnout than many of their international peers. Those are not hypothetical risks from Alberta’s experiment. They are the status quo.
Medicare’s defenders often treat any breach of the old rules as the beginning of the end. Whatley flips the question. If the current model cannot give people timely scans, cannot keep young nurses, and cannot give surgeons enough theatre time, then protecting the model ahead of the patient is the real act of ideology. Alberta is not abolishing public coverage. It is allowing people who can pay to get a test now instead of waiting months. Ottawa should leave that experiment alone long enough to see whether patients actually get hurt, or whether they simply get answers sooner.
