Alberta had been one of the strongest opponents of the Canada Health Act but, by 1984, the economic problems associated with the recession were causing provincial bureaucrats to worry about deficits. Could the province afford to lose the $36 million in fines that would accrue by 1987? And did the government want to contend with more agitation from the Friends of Medicare, the Alberta branch of the Canadian Health Coalition? Using the Ontario doctors’ strike as an object lesson in poor negotiating strategy, the Alberta Medical Association and the Minister of Health, Marvin Moore, began to discuss how to meet the federal requirements. The end result was a deal to end extra-billing in return for increases in the fee schedule, a provision for an “extraordinary medical services fee,” which covered extra care and unlisted services, binding arbitration, and the option of both physician and patient opting out of the provincial plan without any expectation of reimbursement, as was done in Quebec.