When we think about health care, one thing eventually surfaces in almost every patient’s mind: Time.

How long will I wait to see a doctor? How much time will I need off work? How long before I get my surgery? How much time do I have left?

We all have complicated relationships with time. We complain we don’t have enough of it and waste more than we’d like to admit. But when you are sick, time becomes the commodity that matters most. Time translates into days in pain. Weeks away from work. Months waiting for a diagnosis. Time stolen from your family.

That’s why time should be one of the simplest tests we apply to health policy — including Alberta’s Bill 11. Will it shorten the wait for surgery or to see a doctor? Will it give patients more healthy time with their families? And, perhaps most importantly, will it create more time in the health system?

Health care operates within finite resources. We don’t have endless numbers of doctors, nurses, operating rooms or dollars. Alberta also faces an aging population and workforce pressures. Even with unlimited funding, surgeons cannot operate 24 hours a day, seven days a week. Eventually, we must decide how limited clinical time is allocated.

Traditionally, that calculation has been driven primarily by clinical need and urgency: the sickest first. Life over limb. Cancer before cataracts. It is never perfect, but the principle is straightforward — need determines priority.

Bill 11 risks changing that prioritization equation.

Consider a simple example. Creating another place for a surgeon to operate does not create another surgeon. Opening another operating room does not magically produce an anesthesiologist and nursing team to staff it. Our health-care professionals may occasionally perform superhuman feats, but unfortunately, they remain human. They still get only 24 hours in a day.

If a surgeon has a finite number of hours available each week and substantially different compensation is available for spending some of those hours treating privately paying patients, those hours haven’t multiplied. They’ve been prioritized differently. Government can create guardrails requiring physicians to maintain commitments to the public system. But guardrails cannot manufacture time, and regulations cannot make financial incentives disappear.

This isn’t a criticism of physicians. It’s human behaviour. Give any of us two options for spending the same hour, with one offering substantially greater compensation, and most of us would at least consider option 2. Physicians have mortgages, families and retirement plans too.

So the important question isn’t whether private care is inherently good or bad. It’s whether Bill 11 creates new capacity or simply redistributes the capacity Alberta already has. If we are adding surgeons, anesthesiologists, nurses and clinical hours, show Albertans the numbers.

But if we aren’t increasing the supply of clinical time, we haven’t created more time. We’ve changed who gets priority for it. And that matters.

Once patients can purchase faster access, prioritization can begin shifting from clinical need and urgency toward price and ability to pay. Geography may also become a factor if services are concentrated in particular locations. That should concern us regardless of where we sit politically.

There’s an old lesson about limited time: the problem isn’t always that we don’t have enough of it. Sometimes the problem is what we choose to do with what we have. Alberta should apply that lesson to Bill 11.

Show us that it creates genuinely new clinical capacity. Show us that public operating time will not decline. And show us, through transparent wait-time data, that Albertans who cannot afford to pay will not wait longer because others can.

Because faster care for one patient isn’t a system-wide reduction in waiting if someone else simply waits longer. Choice is not the same as capacity. And activity is not the same as progress.

For patients, the question is far more personal: When my time matters most, will my place in line be determined by how urgently I need care — or by how much I can afford to pay for it? That is a question worth our time.

Stacey Litvinchuk, RN, MN, CHE, is a former senior program officer, with Provincial Surgery Operations, Alberta Health Services.

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