B.C. Faces Health Care Crisis Despite Government Review

The government of British Columbia has announced findings from its recent health care “administrative review,” yet significant changes for patients remain unlikely. The review, conducted by the Eby government, revealed some potential savings of $60 million that could be redirected toward frontline care. However, the persistent issues surrounding access to health care in the province continue to pose a serious challenge for residents.

Patients in British Columbia faced a median wait of 32.2 weeks for care last year, marking the longest wait time on record. In addition, those needing imaging services encountered median waits exceeding three months for CT scans and nearly six months for MRIs. Such delays have prompted many British Columbians to seek treatment outside the country, underscoring the urgency of reform in the health care system.

The Eby government’s administrative review has primarily focused on trimming bureaucratic inefficiencies rather than implementing meaningful changes to improve patient access. While the estimated $60 million in savings represents a mere 0.15 percent of the province’s $40.7 billion health care expenditure for 2025, the government has announced plans to create a new shared service bureaucracy. This initiative aims to streamline administration across health regions, but critics argue it will not fundamentally alter the patient experience or address the ongoing access issues.

Learning from Global Health Care Models

To effectively address the challenges facing its health care system, British Columbia could benefit from studying better-performing universal health care models in countries such as Australia, Germany, the Netherlands, and Switzerland. These nations deliver timelier care while often spending equal to or less than Canada on health services. One significant difference lies in how hospitals are funded.

Currently, British Columbia’s government allocates a lump-sum budget to hospitals at the beginning of each fiscal year. This model inadvertently creates disincentives for hospitals to treat more patients, as each additional patient is seen as a financial burden on their budget. In contrast, successful universal health care systems typically reimburse hospitals based on the number and complexity of patients treated. This funding approach encourages hospitals to expand their capacity and improve patient care, as every patient treated represents a potential source of revenue.

Studies indicate that adopting activity-based funding can lead to increased care volume, reduced costs per admission, and, most importantly for British Columbians, shorter wait times. By reforming hospital funding to align with successful international practices, the Eby government could take significant steps toward alleviating the current access crisis.

Opportunities for Reform

The Eby government does not need to reinvent the wheel when it comes to reforming hospital payment structures. Countries that adopted similar funding models began their reforms in the 1990s, allowing them to develop generations of innovations in their health care systems. Additionally, British Columbia previously conducted a pilot project utilizing an activity-based funding approach from 2010 to 2013. Lessons learned from that initiative could inform future reforms.

As it stands, patients in British Columbia should prepare for continued lengthy wait times. The Eby government’s focus on administrative adjustments rather than fundamental reform suggests that meaningful change is not on the immediate horizon. Without a shift towards evidence-based strategies proven to enhance patient care and reduce wait times, many residents may find themselves navigating an increasingly challenging health care landscape.

Mackenzie Moir serves as a Senior Policy Analyst at the Fraser Institute, providing insights into the pressing need for comprehensive health care reform in British Columbia.