David Eby's decision to call a snap election returns BC’s deficit to the centre of political debate. The province's public accounts put last year's deficit at $7.7 billion, and a larger shortfall is projected this year.

The NDP points to Trump's economic turmoil and sovereignty threats to explain the deficit. While both contribute fiscal pressure, they obscure a deeper fiscal challenge: governments have failed for decades to prepare for the predictable rise in medical costs that accompanies population aging.

In this election, every party should explain how it will address that failure. Otherwise, balancing the books will remain out of reach, while younger generations, already squeezed by BC's exceptionally high housing costs, inherit a growing share of the bill for medical care in our aging province.

For decades, governments have known that the baby boom generation would move into retirement, increasing demand for medical care and driving up public costs. Data from the Canadian Institute for Health Information (CIHI) consistently show that Canadians over age 65 use roughly four times as much medical care as those under 50. As the population ages, costs rise predictably.

In the late 1990s, Ottawa anticipated the fiscal impact of population aging on the Canada Pension Plan. It acted by increasing premiums 68 per cent. Those higher contributions, paid in part by baby boomers during their working years, helped build a reserve so the CPP would remain sustainable as they now draw down their largely pre-funded CPP benefits.

Provinces made no comparable adjustment for medical care. 

Instead of pre-funding the predictable rise in medical costs as boomers aged, governments allowed spending pressures to grow without matching revenue. The result is evident in provincial budgets across the country, regardless of which party governs.

Take BC. If the age of our population still looked like it did when baby boomers were young — with just 10 per cent of residents over age 65 in 1976, compared to 20 per cent today — the province would be spending roughly 22 per cent less on medical care.  That’s enough to transform BC’s $7.7-billion deficit in 2025/26 into a modest $800 million surplus.

The real issue is not that this fiscal pressure exists. It’s that governments failed to adapt their revenue systems years ago. The outcome is a growing bill passed to younger generations, alongside underinvestment in the priorities that matter most for Millennials, Gen Z and their children. 

That context is essential for understanding the spending choices in BC’s 2026 budget, and whether any party proposes a different approach.

By 2028, annual medical spending will rise by $3.2 billion, more than double the combined increase for K-12 education, child care, trades training and social services. That works out to about $2,100 per retiree, compared with roughly $440 for residents under 45. Meanwhile, the province projects another $37 billion in deficits over the next three years.

No one should be surprised that people need more medical care as they age. That’s a success story, one that reflects longer lives and medical progress.

But this reality points to a harder question we must ask of all parties in this campaign: how will the government pay for the medical care we always knew boomers would need, while ensuring the costs are shared fairly across generations in proportion to their use of the system?

 Answering this question is essential to sustain high-quality care for older residents. It’s also necessary to invest adequately in the building blocks of a healthy society for younger generations: affordable child care, quality education, safe homes, adequate incomes, and a healthy environment.

 In this election, one or more parties should propose a Better Late Than Never Task Force to examine how revenue systems should adapt to population aging, bringing together fiscal experts, health leaders and the public to answer a question deferred for decades: how do we pay, better late than never, for the care we always knew was coming?

 When we blame today's deficits on Trump's economic turbulence, we overlook the challenge of paying for the rising medical costs of an aging population. The longer we postpone that conversation, the higher the bill. Voters should expect every party to offer a credible answer.

Tell the next BC government to be honest about our deficit - and invest where health begins