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Health care remains B.C.'s biggest expense with some added 'wild cards'

B.C.'s aging population will only serve to add to health-care costs, says public health policy expert Jason Sutherland.
A "big ticket" item for the province's health ministry is addressing surgical wait times, says UBC policy expert.

Driving government operating expenditures are health care-related costs, accounting for $31.1 billion of the $82.5 billion in forecasted expenses last budget update.

Public health policy expert Jason Sutherland, a professor at the University of B.C. School of Population and Public Health, says the province’s aging population will only serve to reinforce this fact.

Sutherland told Glacier Media ahead of Thursday’s budget announcement that he’s keen to see if the B.C. government will reveal how it will specifically spend various new funds from federal bilateral agreements signed in 2023, including $1.2 billion for mental health supports. This is all in addition to a five per cent increase over each of the next five years to the Canada Health Transfer, currently sitting at $6.8 billion for B.C.

“There is a lot of money there and it’s sort of unclear how it’s going to be used. It’s new money that is not necessarily going to cost the government much,” said Sutherland.

Another “wild card,” said Sutherland, is a proposed federal pharmacare plan and seeing how that may free up money for the province once legislated in Ottawa this year, as planned.

But for now, addressing surgical wait times, cancer treatment delays and ensuring family physicians stay in their practice while more join the sector are immediate “big ticket” concerns for the Ministry of Health, he said.

Aside from operating expenses, health also consumes a major portion of capital projects. Last year’s budget has $18 billion earmarked for facilities over the next five years, the two largest being the $2.8-billion hospital and cancer centre in Surrey and the new $2.2-billion St. Paul’s Hospital in Vancouver.

While such facilities should facilitate growth in the health-care sector to address those big ticket concerns, the pressures rising from the province’s aging population have now arrived and money for long-term care for seniors both at home and via facilities has been “sorely lacking” in previous budgets, said Sutherland.

Recently, the provincial government signed another $733-million deal with the federal government for “aging with dignity.”

The money aims to support policies that allow people to stay living in their homes as opposed to going to a hospital or long-term care facility.

“I realize there have been announcements on this but I’m not clear on what that actually means on the ground. Is it home care nurses? Is it physical therapy? Is it up to the health authorities to decide what services are needed?” said Sutherland.

Meanwhile, even if seniors can be cared for at home in the future, the government will still need to build capacity to meet growing demand, such as in the form of home care policies and staffing (especially nurses).

“I feel they’ve been overwhelmed with issues management and haven’t done a great job in strategically planning not only capital expenditures but demand for aging seniors. We only have to look at the demographics to know that there are more people becoming seniors all the time. If you’re going to treat them with the same model of care as in the past then you’re going to need more services and more physical spaces to treat them,” he said.

For the most part, the BC NDP has upheld the public health-care system, said Sutherland, but there are leaks, especially in terms of seniors seeking home care and paying for it themselves.

This “clearly exacerbates socio-economic disparities,” and is something to keep an eye on in terms of how government addresses growing demand, he added.

“They’re probably willfully willing to look the other way as other people turn to private services,” said Sutherland.

And matters such as patients with “long COVID” add to new groups of people seeking help for a “complex constellation of symptoms,” said Sutherland.

What all this will cost next year and years down the road "depends on what the population is willing to bear in terms of taxation," said Sutherland.

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