This report, by leading health policy expert (and practising physician) Dr. Michael Rachlis, offers a sharp critique of the Alberta government's planned legislation to allow regional health authorities to contract with for-profit companies for inpatient medical and surgical procedures. Rachlis argues that the proposal 'would be bad for Alberta's health care system, almost certainly raising costs and potentially diminishing quality.' While not immediately contrary to the letter of the Canada Health Act, the Alberta legislation offends the spirit of medicare by building into hospital care the concept that patients can be charged privately for non-insured clinical services while they are receiving an insured service. Not only would this development inevitably eventually interfere with the medicare canon of reasonable access, but it also might activate worrisome provisions under the North American Free Trade Agreement (NAFTA) - first, binding succeeding Alberta governments to deal with for-profit hospitals; and second, allowing foreign companies to claim to an international arbitration tribunal that they should be allowed into all provinces because the Alberta law has the effect of changing federal legislation.