EDMONTON — Premier Ralph Klein says he may be "branded a devil," but he believes a new joint replacement centre in the province should have pay-for-service options.

Klein said a world-class bone and joint centre he will formally announce Friday for Calgary should be allowed to offer upgraded services for patients willing to pay, as well as joint replacements to foreign patients.

"That's my own thoughts and I will be branded a devil, but I am a firm believer that there can be a mix of public and private," he told reporters before a $400-a-plate fundraising dinner that attracted more than 1,500 people Thursday.

"This idea that everything has to be totally and absolutely public and everything has to be done in a hospital is one of those straitjackets that we're faced with."

He welcomed a report out of Ottawa that Paul Martin's government may consider revising the Canada Health Act to give provinces more flexibility to try new things.

"We need flexibility within the Canada Health Act to try new and different things that will allow us to raise revenue and deal with certain situations in a more flexible manner."

Klein and Health Minister Gary Mar are planning to launch the Alberta Bone and Joint Institute - a facility touted to reduce wait times and improve patient care for people with arthritis, bone or spine diseases.

The institute is not being built as a private-public partnership, but Klein said the doctors who work there should be allowed to contract out their services.

"We have to look at other countries that do have a mix and look at why these countries are ranked higher than Canada," he said. "Why is Sweden ranked higher than Canada?

"We haven't looked at the nine other countries ranked ahead of Canada, all of which have some form of public and private mix."

He deviated from the written text of his speech to tell an applauding crowd that Alberta will reform its health system.
"We're no longer talking about it," he said. "We're going to do it."

He said he told the head of Capital Health, which runs Edmonton hospitals, that if she wanted to build a hospital that provides extras such as room service and private suites, she should do it.

The Alberta budget, tabled Wednesday, warned the province will go it alone if Ottawa and the other provinces aren't willing to make the changes he believes are necessary to make health care sustainable.

Klein has already said the province will implement reforms before the end of the year, which may include user fees, more private delivery and delisting some services covered by medicare.

Alberta's health care budget has hit $8 billion, which is more than some entire countries pay for health care, Klein told his audience. He contends the system is not sustainable and will collapse in 10 years or less.

Finance Minister Pat Nelson took a similar message to the Edmonton Chamber of Commerce earlier in the day.

"I really want to encourage all of you to be prepared to think differently when you hear about new ideas," she said.

"Don't let them try to convince you that we have a secret agenda to open up more private health care and don't listen when they say there's really no problem," she warned.

But she spent most of the day defending the government's decision to continue to collect health insurance premiums.

She said Alberta's system is more open than other provinces which pay for health care out of general tax revenue.

"I can do what other provinces do and hide it, and stick it into your taxes somewhere, and make you think you're not paying for it, but you clearly are."

Nelson said she would rather be honest with Albertans and send them a bill so they realize the system is not free.

Mar said the premiums contribute $1 billion to the health-care budget.

Several groups - including the New Democrats, Liberals, the province's largest union and the Canadian Taxpayers Federation - have been calling for the province to eliminate its health-care premiums. They complain the $1,056 annual charge to families is a regressive tax since everyone pays the same amount regardless of income.