GLOBERMAN / MOIR: Here’s how the Eby government can help fix BC’s broken healthcare system

Mackenzie Moir and Steven Globerman are analysts at the Fraser Institute.British Columbia’s healthcare system is broken. In 2025, the latest year of available data, BC patients faced a median wait of 32.2 weeks from GP referral to specialist treatment, the longest in the province since 1993 (when estimates were first published). And this measure doesn’t include the wait to see a GP in the first place, assuming you have one.But there’s good news — solutions are available, they just require political will.For starters, the Eby government should expand the use of private clinics to deliver publicly funded surgeries. When Saskatchewan used private clinics (alongside other reforms), the median wait time in that province dropped from one of the longest in Canada (outside the Atlantic provinces) at 26.5 weeks in 2010 to one of the shortest at 14.2 weeks by 2014, the second-shortest that year (only Ontario had a shorter median wait).Of course, opponents of this approach claim that private clinics, due to higher salaries or better working conditions, siphon off surgeons from government hospitals and thereby reduce their capacity to perform surgeries. But in BC, the provincial government could simply pay private clinics the same effective rate it pays government hospitals for comparable surgeries. Then, the only way private clinics could afford to lure away surgeons from hospitals is if private clinics were more efficient in providing services and thus able to provide better pay and working conditions for surgeons.As a result, if private clinics improve the overall productivity of the healthcare sector, they will help reduce patient wait times without necessarily increasing government healthcare spending..The Eby government should also adopt a funding method for hospitals (known as “activity-based funding”) often used in other better-performing universal healthcare countries. Under this model, hospitals are paid for services they actually deliver to each patient. Currently, the provincial government provides hospitals in BC with a predetermined budget, which effectively disconnects funding from the actual volume of services provided. In reality, this method encourages hospital administrators to view each patient as a cost, whereas “activity-based funding” actually incentivizes hospitals to deliver patient care because each patient now represents a source of revenue.Some critics claim that activity-based funding encourages hospitals — and private clinics, for that matter — to do more procedures than is medically appropriate to make more money. But even assuming that medical professionals in Canada are willing to violate their ethical obligations to patients, provincial government health authorities can address this risk through periodic audits of facilities that bill for an unusually large number of procedures.And while some critics may claim that these reforms violate the Canada Health Act (CHA), and thus would trigger financial penalties in the form of reduced transfer payments from Ottawa, in reality, several provinces, including BC, have contracted private clinics to perform surgeries and have experimented with activity-based funding, without penalty from the federal government.British Columbians should demand that the Eby government implement reforms based on better-performing healthcare systems abroad, despite the slings and arrows from critics. Mackenzie Moir and Steven Globerman are analysts at the Fraser Institute.

GLOBERMAN / MOIR: Here’s how the Eby government can help fix BC’s broken healthcare system

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