Will parties promote the health and wellbeing of all ages?

Last updated October 13, 2024

British Columbians regularly report rising living costs and more timely access to medical care as top priorities for their wellbeing. The solution to both problems is the same: better balancing government spending on medicine with other priorities critical to our wellbeing, such as reducing poverty, housing and child care costs, and climate risks.

Science has long confirmed that our health depends more on the social conditions in which we live than on the medical care we receive. Provincial investment patterns have diverged from this evidence by allowing rising medical spending to crowd out spending on the building blocks of a healthy society, especially for younger and future generations. Finding the right balance of spending is a key consideration for any party seeking to form the next provincial government.

All political parties have a stake in building a British Columbia where we invest in wellbeing for young and old alike. Here are the questions we're asking as we evaluate parties for our Good Ancestor Report Card. Keep reading for our answers.

• Do parties acknowledge that BC already has more physicians per capita than other provinces, and by comparison with previous decades?
• Do parties recognize the importance of social investments for health?

TL;DR?

Check out the report card

Do parties acknowledge that BC already has more physicians per capita than other provinces, and by comparison with previous decades?

Good ancestors make sure their prescriptions are grounded in reliable data.

While we regularly hear it reported that BC faces a doctor shortage, one key fact is often missing from the conversation.

BC has more physicians per capita today than ever before. This includes more family physicians per capita than any other province, and more than in previous decades. The Canadian Institute for Health Information reports that in 2022, the province had a record 141 family doctors for every 100,000 British Columbians, compared to 123 in 2015, and 88 in 1976.

These data underscore that medical waits and a lack of primary care options are not driven solely by the number of physicians practicing in the province — and certainly not because we don’t have more doctors than in the past. We therefore need a more nuanced conversation about why barriers to access persist.

In this election, all parties affirm the importance of recruiting and retaining doctors, nurses and other health professionals as a strategy to expand access to medical care across the province.

Only one anchors its proposals in the recognition that BC already has a strong starting point, with an historically high (and growing) complement of physicians.

The Green Party Leader raised this fact explicitly during her comments in the televised leaders’ debate. This reflects her party's "Health backgrounder," which specifically invites British Columbians to wrestle with the evidence showing that "BC does not have a shortage of health care workers" by comparison with the past.

This recognition is essential to expand public and political dialogue on health beyond conversations about things like growing administrative burdens, public vs private delivery, and team-based care models. It’s time to look at the other end of the equation. We need to ask why the line of patients in need of physician care is so long — and what we can do to shorten it.

We assign the NDP and Conservatives a grade of ignoring on this criterion, and award a “proficient” grade to the BC Greens.

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Do parties recognize the importance of social investments for health?

Good ancestors prioritize preventing problems by addressing their root sources, not just their symptoms.

Questioning why there are so many patients invites greater attention to root causes of ill health — like financial insecurity and housing precarity. The evidence is clear that investing in these (and other) social supports is linked to improved health outcomes and decreased cost of living pressures.

To assess whether parties are turning this evidence into action, we examined platforms for evidence of two things. First, do the parties truly understand that health doesn’t start with medical care? Second, do parties commit to growing investments in the building blocks for a healthy society even more urgently than they plan to increase medical care spending? This ratio should be the north-star guiding all investment in health and wellbeing in BC (and beyond).

So far, the BC Green platform out-performs BC NDP and BC Conservative plans on these two issues.  

The Green platform stands out as the only plan organized around the concept of wellbeing. From the outset it highlights “Wellbeing frameworks” that have been used around the world to monitor wellbeing for “people, nature, infrastructure and society” (p. 4). It observes that the dominance of Gross Domestic Product (GDP) as an indicator of progress distorts public policies and investments because “GDP improves with an oil spill, the destruction of our last old-growth forests, or when we buy bottled water but not when we protect our watersheds” (p. 4). To chart a different course, the Greens propose to organize around the need for “better tools that measure the happiness of our people, the long-term impacts of our decisions and whether our communities are becoming safer and stronger” (p. 4).

The Green platform (p. 5) includes the following details:

• Develop a “new British Columbia Wellbeing Framework” in partnership with Indigenous and non-Indigenous leaders,
• Fund a Centre of Excellence dedicated to developing this Framework,
• Require all Ministers to provide evidence of how their work contributes to increasing wellbeing in BC as part of each budget presentation
• Transition all performance measures in Ministry and Crown Agency service plans to align with the Wellbeing Framework, ensuring accountability and transparency.
• Legislate a requirement for the Minister of Finance to report annually, as part of each budget, on improvements in wellbeing across 10, 30 and 100 year timescales
• Create a set of indicators to survey the public, and establish baseline measures to track progress over time, and
• Embed wellbeing considerations into land use planning and environmental assessments.

If British Columbians care about promoting health and preventing illness — not just delivering medical care after people fall sick — the BC Green approach would be a game changer. As the platform explains, “Preventing illness isn’t just the compassionate thing to do — it’s also the fiscally responsible choice” (p. 9).

The Greens party puts its money where its mouth is. The costed platform (p. 68) promises to add $191 million annually for medical care, and another $143 million for mental health. This will supplement the existing provincial budget plan, including $4.5 billion in new medical care spending in 2024 allocated by the NDP. At the same time, the Greens promise to invest in the building blocks for a healthy society much more aggressively than the BC NDP. The platform allocates $2 billion more per year to reducing poverty; $1.6 billion more to housing; and $1 billion more to education.

In short, the Green party would grow investments in these building blocks in ways that keep pace with funds allocated to medical care. This proposed distribution of provincial resources aligns well with the best available health science. For this criterion, we award the Green platform an “extending” grade.

For the BC NDP, it’s important to begin by acknowledging that the incumbent government’s 2024 Strategic Plan (p. 3) includes strong and important language about investing in health.

“Now, it’s more important than ever to invest in better care and growing our health-care workforce. Our commitment to high-quality, public medical care remains steadfast. And we know that health goes well beyond the clinic or hospital. It starts when we invest in affordable homes, livable incomes, affordable child care, healthy communities and a clean environment” (emphasis added).

However, the NDP platform doesn’t offer much detail about how this critical commitment will be further enshrined into government operations, should the party once again form government. This stands out as a shortcoming by comparison with the comprehensive approach the BC Greens promise to focus government planning and reporting around wellbeing.

The BC NDP also doesn’t put its money where its mouth is (namely, by aligning proposed platform investments with its own Strategic Plan). The biggest spending increase the NDP propose is $400 million/year for medical care and mental health (p. 63) — the line-item which already received a $4.5 billion boost in the pre-election budget. Despite the NDP already committing to the largest medical care increase in decades, the party is now doubling down on ensuring medical spending continues to outpace any other investments in wellbeing.

Case in point, the NDP platform adds relatively little for “getting people into homes they can afford” ($357 million), “helping people with costs” ($192 million), “training and skills for good jobs” ($67 million), and “support for students, teachers and staff” ($98 million) (p. 63). None of these investments add enough to the 2024 budget commitments to ensure that spending on the building blocks for a healthy society keeps pace with spending on medical care. As a result, the NDP’s costed platform does not align with the budget prescriptions from health science.

We award the NDP platform an emerging grade, valuing its observation in the Strategic Plan that health goes well beyond the clinic or hospital; but recognizing that its platform does not yet propose to budget accordingly.

The BC Conservative platform promises “universal healthcare for everyone under a single-payer system that increases spending each year and delivering care through both public and non-governmental facilities.”

Since the Conservative platform offers no costing, it’s impossible to assess with any confidence what the party will spend on medical care, or how that will compare to proposed spending on the building blocks for a healthy society — like housing, child care, education, poverty reduction, fighting climate change and more.

We therefore assess that the Conservatives are ignoring where health begins.

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