Mackenzie Moir is a senior policy analyst at the Fraser InstitutePatients, physicians and local MLAs recently held a town hall meeting in Kelowna to discuss the problems at the city’s general hospital. While the testimonies were troubling, this frustration expressed with the city’s hospital underscores the desperate need for reform in British Columbia’s health-care system.Health care in B.C. faces severe challenges. There’s the ongoing intermittent closures of emergency rooms in the Interior and the North, the crisis in primary care access that has left hundreds of thousands of British Columbians without a family doctor, and brutally long wait times for non-emergency care.After the wait to see your family doctor (assuming you have one,) there are two additional waits — the one between your referral and seeing a specialist (a median of 15 weeks in 2024) and the one between that specialist consultation and treatment (which was a median of 14.4 weeks.) With these two waits combined, last year the total median wait for treatment was 29.5 weeks — the longest in B.C. since wait-time measurements began in 1993 when the wait was 10.4 weeks..Of course, there are real consequences for long waits. They include physical pain, psychological distress, and the costs associated with a reduced ability to work or enjoy leisure time.But based on the experience of other countries, long waits are not an inevitable price to pay for universal coverage. According to data from 2023, Canada had the highest percentage (58.3 per cent) of patients waiting longer than two months for non-emergency care among nine developed universal health-care countries including Switzerland (21.1 per cent,) Germany (20.4 per cent) and the Netherlands (20.3 per cent). What does these countries do differently? For one thing, they pay their hospitals differently. .Currently, hospitals in B.C. receive a lump sum of money each year from the provincial government. Over the year, each hospital pays for patient care from this pot of money. Under this system, from a hospital administrator’s perspective, there’s little incentive to treat more patients since each additional patient represents a drain on their budget.In contrast, Switzerland, Germany and the Netherlands pay their hospitals for each patient treated based on that patient’s condition and other factors that may add additional costs to their care. This system, known as “activity-based funding,” flips the script and patients become sources of revenue rather than costs to be minimized.If the recent town hall in Kelowna is any indication, patients in B.C. are clearly frustrated with their health-care system. However, without fundamental reform including changing the way the provincial government compensates hospitals, they’re unlikely to see genuine improvement. Mackenzie Moir is a senior policy analyst at the Fraser Institute.
