According to a recent Angus Reid poll, the majority of British Columbians are concerned about the state of health care and frustrated with how it’s managed. Who could blame them? B.C. patients are often unable to access timely care whether you need emergency treatment, care related to cancer or diabetes, a hip replacement, and so on.

In fact, according to a recent report, in 2023 (the latest year of available data), a typical patient in the province waited 14.1 weeks for an appointment with a specialist after referral from their family doctor—then an additional 13.7 weeks for treatment after that consultation. In total, this 27.7-week wait was two and a half times longer than the 10.4-week wait they experienced in 1993 when wait times were first published.

Clearly, the system needs reform. And contrary to rhetoric, money isn’t the problem. Health-care spending in B.C. has increased significantly over the past 15 years and accounts for nearly 40 per cent of all provincial program spending in 2023-24. And B.C. spends the most on health care per person of any province (outside Atlantic Canada) at $6,045 in 2023.

Put simply, B.C.’s health-care woes can’t simply be solved by more government spending. Rather, the fundamental design of the province’s health-care system needs reform.

To find real solutions, one can look to several universal health-care countries that spend less (or comparably) on health care as a share of the economy while outperforming Canada on key metrics. For instance, Australia, Germany and Switzerland have more physicians, hospital beds, key diagnostic technology (e.g. MRIs) and larger proportions of their populations accessing specialists and non-emergency surgeries in a timely manner.

What do they do differently? To start, these countries embrace the private sector to help deliver publicly-funded services to patients. In Australia, for example, private hospitals have been contracted to provide publicly funded care since the early 1990s. In 2021/22, 41 per cent of all hospital care in Australia took place in private facilities.

All these countries also incentivize hospitals to deliver more care to patients by paying them based on the level of services they provide. This fundamentally contrasts with how government finances hospitals in most of Canada including B.C. where hospitals tend to operate on a pre-set budget each year and patients are viewed as costs to be minimized.

Clearly, B.C. patients continue to endure unacceptably long waits despite a heavy price tag to run their provincial health-care system. Unfortunately, without fundamental reform, B.C. patients and their families will continue to endure these long waits.