Re: Everyone deserves better health care

Issue: BCMJ, vol. 68, No. 6, July August 2026, Pages 192-193 Letters
By: Derryck H. Smith, MD, FRCPC

The authors of “Everyone deserves better health care” clearly outline the problems with health care in Canada,[1] including a decline in hospital beds from 7 to 2.6 per 1000 people from 1970 to 2021.[1] Although not referenced in the article by Wang and colleagues, in 2025, there were 700 000 people in British Columbia without a family doctor.[2]

To put this in perspective, in February 2013, the Government of BC, along with the then–BC Medical Association, announced a $132 million pilot program that would ensure that every resident had a family doctor.[3] By April 2015, the Ministry of Health announced that it would not meet that goal and, having spent a lot of money, wrapped up the program but left the funding in place.[4] By 2017, it was estimated that 700 000 people in BC did not have a family doctor.[5] The situation hasn’t improved, and those who cannot remember the past are condemned to repeat it.

Wang and colleagues embraced the standard Canadian solution to every problem: more money from the federal government. However, the federal government is not primarily responsible for funding health care. That is a provincial mandate.

There are no votes in addressing health care. Furthermore, there is simply no money. An editorial in The Globe and Mail posits that “Canada is a country drowning in a flood of red ink.”[6] The national debt is $2.3 trillion.[7] BC is running a $13.3 billion deficit for 2026–2027, and the total provincial debt is $183.4 billion.[8] More recently, in April 2026, the Government of BC cancelled—or, to use its term, “re-paced”—the commitment to expand Burnaby Hospital.[9]

The federal government will not take a leadership role in health care. The federal government is not going to invest in infrastructure for Fraser Health. There are more pressing needs for federal funding for defence, trade, and infrastructure.

We need bold leadership and outside-of-the-box thinking that totally rejigs the way we deliver health care in Canada today. Medicare in Canada, as we know, is a dysfunctional system. We need to embrace some of the innovation seen in European countries and provide affordable, quality health care with a mixture of private and public funding. Without new innovations, health care is going to get worse rather than better. I am pessimistic that this will not happen until the entire system collapses.
—Derryck Smith, MD
Vancouver

This letter was submitted in response to “Everyone deserves better health care.”

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References

1.    Wang EJ, Bal J, Ross K, et al. Everyone deserves better health care. BCMJ 2026;68:57-60.

2.    Aslam S. 700 000 British Columbians still don’t have access to a family doctor. CityNews Vancouver. 30 January 2025. Accessed 4 April 2026. https://vancouver.citynews.ca/2025/01/30/british-columbia-family-doctor-shortage-continues/.

3.    Government of British Columbia, BC Medical Association. Government and doctors partner to improve primary care [news release]. 22 February 2013. Accessed 4 April 2026. https://archive.news.gov.bc.ca/releases/news_releases_2009-2013/2013hlth0031-000309.pdf.

4.    McElroy J. Government admits family doctor promise unlikely to be met. Global News. 7 May 2015. Updated 6 August 2016. Accessed 4 April 2026. https://globalnews.ca/news/1986101/government-admits-family-doctor-promise-unlikely-to-be-met/.

5.    Brend Y. We’re graduating more doctors than ever, so why is it so hard to find a GP? CBC News. 4 May 2017. Accessed 4 April 2026. www.cbc.ca/news/canada/british-columbia/bc-doctor-shortage-medical-fees-1.4100251.

6.    Editorial Board. Canada is a country drowning in a flood of red ink. The Globe and Mail. 4 April 2026. Accessed 4 April 2026. www.theglobeandmail.com/opinion/editorials/article-canada-is-a-country-drowning-in-a-flood-of-red-ink/.

7.    Fuss J, Hill T, Dunstan W. Canadians responsible for $2.3 trillion in government debt. Fraser Institute. 27 September 2025. Accessed 4 April 2026. www.fraserinstitute.org/commentary/canadians-responsible-23-trillion-government-debt.

8.    Hill T. B.C. government continues disastrous record in 2026 budget. Fraser Institute. 17 February 2026. Accessed 4 April 2026. www.fraserinstitute.org/commentary/bc-government-continues-disastrous-record-2026-budget.

9.    Lazenby A. Shock, horror as province cancels contracts to build health-care facilities. Vancouver Sun. 30 April 2026. Accessed 30 April 2026. https://vancouversun.com/news/shock-horror-as-province-cancels-contracts-to-build-health-care-facilities.

Derryck H. Smith, MD, FRCPC. Re: Everyone deserves better health care. BCMJ, Vol. 68, No. 6, July, August, 2026, Page(s) 192-193 - Letters.


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