Since the presentation of the BC Conservative Party’s health plan, David Eby’s New Democratic Party (NDP) has been suggesting that John Rustad’s party plans to cut $4.1 billion from the province’s health care. What’s the story?
In addition to repeating this amount in one of the NDP’s ads, Premier David Eby repeated it in a press conference: There is one number, one number in the entire health care document. It is a $4 billion reduction in health care spending in British Columbia.
This statement is misleading.
In its health care reform plan, the Conservative Party clearly states its desire to reduce the health care budget and cites a percentage target, but does not give the amount. The party believes it can achieve this by focusing on what it considers to be efficiency gains.
An initially higher budget
For 2024-25, the health budget in British Columbia is $32.9 billion.
Conservative Leader John Rustad believes that if he becomes prime minister, his government’s health care budget could initially increase: The initial challenge for the health care budget is that it will have to increase to be able to implement the change because there is so much backlog. […] especially with long lists and wait times.
But our goal for the system is to bring stability and lower our cost per capita, since we will be much more efficient in delivering services. [en Colombie-Britannique] than we are now in Canada, added John Rustad during the question period following the presentation of his health plan in July.
How does the NDP get to $4.1 billion?
The NDP cites indicators found in the Conservative Party’s health plan to justify the $4.1 billion figure: Buried on page 12 of Mr. Rustad’s background document is a plan to reduce health care spending from 12.5 per cent of GDP to 11 per cent. That’s a 12 per cent cut, or $4.1 billion.
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The BC Conservative Party’s health plan cites a Deloitte study on the future of health care.
Photo: Conservative Party of British Columbia
The Conservative Party’s health plan actually refers to a study by the consulting firm Deloitte (New window) (in English) on Canadian health spending as a share of GDP. According to the firm, the sum of these public and private spending as a share of GDP will increase from 12.4% to 13.9% by 2040, unless a change in direction is made, in particular due to the aging of the population which is accompanied by an increased demand for services.
However, by using emerging technologies and scientific advances, among other things, Deloitte estimates that Canada could reduce health spending to less than 11% of GDP by 2040.
Deloitte cites actuarial models developed by the consultancy firm and only gives the proportions, without however specifying the estimate of costs or GDP for the reference years.
What is GDP?
Gross domestic product (GDP) is the value of all goods and services produced within the geographical boundaries of a country or territory during a given period, usually a year.
An indicator set to grow
The health spending-to-GDP ratio is a way of counting health spending relative to the size of the economy, explains Olivier Jacques, assistant professor at the University of Montreal’s School of Public Health.
He specifies that several factors can influence this ratio: For example, if there is an economic crisis and the GDP decreases, we increase our spending in proportion to the GDP, but we have not done anything better, it is just that we have a less good economy.
According to the professor, the ratio is expected to grow over time. It will increase in all Canadian provinces. And British Columbia is not a province that has particularly favourable demographics, he says.
According to the 2021 census, British Columbia, Quebec, New Brunswick and Saskatchewan have the highest proportions of people aged 85 and over in Canada.
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“When we have an aging population, there is generally a little more spending per capita. So, spending on GDP will also increase,” says Olivier Jacques, assistant professor at the School of Public Health at the University of Montreal. (Archive photo)
Photo : Radio-Canada / Ben Nelms
Cuts, according to a researcher
According to Andrew Longhurst, a health policy researcher and PhD candidate at Simon Fraser University, reducing the ratio of spending to GDP would require, as the NDP claims, cuts to the health care budget.
We need to hear from Mr Rustad where he sees these cuts going, the researcher said.
For now, the Conservative Party is responding that it will use private health care providers from outside the province.
However, according to Olivier Jacques, there is absolutely no empirical demonstration that increasing funding or private provision of care will improve efficiency. On the contrary, we observe that when there is more private, it costs more without generating more gains, more services.
