Commentary
By Mackenzie Moir
No matter where you look, you’re bound to find major problems with British Columbia’s health-care system. Whether it’s the hundreds of thousands without a family doctor or the temporary closures of emergency rooms in rural parts of the province, it’s little wonder why dissatisfaction is so widespread.
Health-care reform is clearly on the mind of most Canadians and was a core issue in the recent B.C. election. Unfortunately, with its latest budget, the Eby government has decided to follow a staple of “health-care reform” in Canada—namely, to spend more but make almost no fundamental changes.
Specifically, the Eby government’s latest budget increases health-care spending by $1.7 billion from 2024/25 to 2025/26, representing a 4.6 per cent increase from the previous year. In total, the provincial government expects to spend $39 billion this year on health care. Despite the ongoing spending increases, British Columbians continue to suffer from lengthy delays for medical care.
Last year, British Columbians faced a median wait of 29.5 weeks, the longest wait for non-emergency surgery since 1993 (when these waits were first measured across the country). When broken down, 15 of these weeks were spent waiting to see a specialist while the remaining time was spent waiting for the actual treatment.
The study also found that patients in the province waited more than five weeks longer than what was considered reasonable. Long waits for care are not benign—they result in continued physical suffering, psychological distress and even potentially worsened treatment outcomes.
So what’s to be done?
There are several reforms Victoria can implement without worrying about Ottawa’s approval.
For example, hospitals in B.C. generally receive a lump sum of money, based mostly on historical trends (and some other factors) from the provincial government each year and are expected to operate within that budget. But this funding method disconnects the money hospitals receive from the amount of care they provide to patients. Consequently, hospitals view patients as a cost that drain their budgets.
Instead, B.C. should follow other high-performing universal health-care countries such as the Netherlands and Germany and pay hospitals for the services they actually provide. By funding hospitals this way (known as “activity-based funding”), policymakers create an incentive for hospitals to treat more patients since each extra patient represents additional resources (i.e. money) instead of an additional cost. Incidentally, Quebec is now moving to embrace activity-based funding.
And when hospitals provide more care, they can work through wait lists faster and thus reduce wait times.
The Eby government plans to pour more money into a severely broken health-care system rather than enact genuine reform based on experience and evidence from other countries that spend comparable amounts on health care but achieve better results. Without fundamental reform, simply spending more will not solve the core problems at the heart of B.C.’s health-care crisis.
(Mackenzie Moir is a Senior Policy Analyst at the Fraser Institute.)
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