Fraser Forum

B.C. budget does nothing to reform health care despite long wait times

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Much of the media buzz following British Columbia’s recent budget focused on the government’s proposed cut in Medical Services Plan (MSP) premiums. What went relatively unnoticed, however, was the fact that health-care spending is projected to increase annually by 3.2 per cent (on average) over the next three years.

No major reforms are planned, so the government will continue to spend more on health care without changing how the system is funded and how services are delivered. This is a problem.

Before explaining why, it’s first important to understand how MSP premiums can be cut while health-care spending continues to increase. Simply put, there’s no direct connection between the MSP (which is a tax) and health-care spending. Revenue collected from MSP premiums constitute a small fraction of the total spending on health care, which is actually funded by the government’s pool of general revenue collected from a variety of tax sources.

Of course, the planned increases in health-care spending announced in this week’s budget are a far cry from the sort of unsustainable growth observed over much of the 2000s. But again, continuing to spend more on health care without significant policy reforms is misguided. Importantly, while the government seems to be slowly realizing the limits of indefinite spending increases, B.C’s health-care system still fails to deliver health-care services in a timely manner.

In fact, in 2016, physicians in B.C. reported that their patients were waiting 25.2 weeks for medically necessary treatment after referral from a general practitioner (GP)—longer than the national average (20.0 weeks), longer than what they considered clinically reasonable, and the longest ever for the province in the survey’s 26-year history.

Moreover, British Columbians could expect to wait 24 weeks for an MRI scan last year—longer than any other province in Canada.

While some of the new health-care spending is earmarked for increasing the number of new surgeries and scans, this is a Band-Aid solution. Something fundamental needs to change. Years of spending increases (across Canada) have clearly had no impact on the long waits for treatment, and the government seems to be nearing its limit in terms of health-care spending increases, which are still projected to grow, albeit at a slower pace

It’s time for Victoria to focus on policy reforms. Instead of fighting the private sector, it should work with it to deliver more services. Instead of tweaking MSP premiums at the margin, it should examine income-based user-fees and copayments. Instead of relying on Ottawa for more money through CHT payments, it should ask for more freedom to experiment with policies found in other successful universal health-care systems around the world.

The cuts in MSP premiums will surely be welcomed by the majority of British Columbians. However, the health-care system is broken and it’s time for the government to consider more meaningful policy reform for the sake of patients and their families.


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