Keywords: academic physicians, Canada, Health Resource Centre / Group, market principles, medical administrative elite / knowledge elite / rank and file, Medical Care Act / The Canada Health Act, medical sociology, Medicare Plan, private for-profit / public not-for-profit healthcare, public health policy / management,
Abstract: The extent to which health systems rely on for-profit mechanisms to deliver public health services varies and can be a source of tension for managers as well as politicians. Canada is generally understood to have a not-for-profit public health system that is frequently contrasted with that of the US, heavily reliant on market principles and price mechanisms. This article examines Canada’s public health system from the perspective of a single province—Alberta. In particular, this article examines Alberta’s various attempts to introduce private for-profit services into a seemingly public not-for-profit health system. It focuses on a case study of the demise of a private for-profit surgical facility and examines factors associated with its failure. Physicians are key actors in health systems. This article challenges assumptions held about physicians as policy actors and suggests that policy analysts and policy makers need to do a better job understanding the centrality of physicians for health policy outcomes.