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A man wears a protective face mask as he walks past the emergency department of the Royal Columbian Hospital in New Westminster, B.C., in 2020. One in five people in B.C. don’t have a family doctor.JONATHAN HAYWARD/The Canadian Press

For several months now, B.C. Premier John Horgan has used his position as chair of the Council of the Federation to bring attention to the urgent need for a new federal-provincial revenue-sharing model for health care.

At times, Mr. Horgan has almost sounded desperate, as if more health care dollars is a life-and-death issue in his province. The fact is that it is, and the distress one detects in his voice is real.

The health care system in B.C. is crumbling. It’s in terrible shape in other parts of the country as well, just as more and more boomers are heading into a retirement in which they are likely to need the services of health care professionals – which there are not enough of at the moment.

Mr. Horgan’s frustration was on full display this week during Question Period. Fed up with heckling by the Liberal Opposition over the lousy health care conditions in the province, he waved them off with an expletive for which he would later apologize.

Mr. Horgan knows he has a problem on his hand. And it’s not just him. Several of his provincial counterparts are struggling with the same issue. In this case, the statistics don’t lie.

Nearly 900,000 British Columbians don’t have a family doctor, leaving walk-in clinics and ERs swamped

One of the biggest problems such provinces are facing is a critical shortage of family doctors. One in five people in B.C. don’t have one, with more people pouring into the province every day. Last year, 100,000 people arrived – a record number that only exacerbates a desperate situation.

B.C. Liberal MLA Shirley Bond pointed out that, on one day this week, almost every urgent- and primary-care centre in the city of Victoria was at capacity and not taking patients. The only one that was had a 4.5 hour wait.

B.C. currently has the longest average wait time for walk-in clinics in the country at 58 minutes. The typical wait time in Canada is 25 minutes. In Victoria, it’s 161 minutes.

The environment is not much better next door in Alberta, which has lost 188 registered doctors in the past three months. Some retired, while others left for greener pastures. The city of Lethbridge lost 13 doctors over the same three-month stretch – and a net 62 in the past two years. Almost half the city of 100,000 (43,000) is without a physician.

According to the Canadian Resident Matching Service, the portal used by graduating medical students to find jobs, there were 1,569 family-medicine positions available in the country in 2022. According to Statistics Canada, 4.6 million people over the age of 12 did not have a family doctor in 2019.

Part of the problem is graduating medical students not wanting to go into family medicine. The biggest issue is the payment model most provinces use in which doctors get a flat fee per visit – a fee, they say, that doesn’t recognize the length of the appointment or complexity of the problems a patient might have.

The shortage of physicians is a problem that has been growing over the years. Canada now ranks 51st in doctors per population, according to Index Mundi. In the 1970s, we ranked anywhere between fourth and eighth. The nursing shortage in Canada is just as severe.

The Organization for Economic Co-operation and Development has placed Canada 31st in hospital beds per population among the 38 countries that the OECD rank. In the meantime, according to the Canadian Institute for Health Information, total health care spending in the country was estimated to be $308-billion in 2021 – or $8,019 per Canadian. This number represents 12.7 per cent of our GDP, which puts our health care spending among the highest in the world.

It sure doesn’t feel like we’re getting our money’s worth.

Something is amiss, as others have noted over the years. We have a universal health care system that is administered by 10 provinces and three territories, and is anything but universal when it comes to quality of care. The degree to which health care dollars are wasted or misspent is staggering.

While I have some sympathy for Mr. Horgan’s position, I also hear the concerns of a federal government that is dishing out billions in funding with little to no control over how it is spent.

Canada, as a country, has a terrible reputation for the efficiency of its health care system – even though it’s the fault of individual provinces that don’t know what they’re doing. Now it’s all coming home to roost.

That system is crumbling at the precise moment an aging demographic and heightened immigration levels are putting more pressure on it than ever. We will soon have an emergency on our hands, if we don’t already.

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