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Despite David Eby framing this election around the U.S. trade war on Canada, B.C. voters will likely decide this election based on how they feel about parties’ respective proposals to improve their everyday lives. One of the key issues, on that front, is health care.

A recent Angus Reid survey found that health care comes second only to cost of living concerns for B.C. voters. Even the top priority for B.C. residents is also about health care: health care costs are a key driver affecting household finances. Many in B.C. pay out of pocket for prescription drugs, dental care, and other services.

The snap provincial election overlapping with the municipal election campaign hasn’t made it any easier to get a strong sense of where the parties stand on health care. This analysis evaluates commitments from the parties — and how their proposals align (or don’t) with the evidence.

The parties largely misdiagnose what ails primary care

When it comes to primary health care, CCPA research—based on Statistics Canada data—shows that the share of the B.C. population with access to a regular family doctor declined from 82 per cent in 2015 to 75 per cent in 2024, the most recent year available. On a positive note, access to a nurse practitioner increased over this 10-year period. However, nurse practitioners remain few and far between (only 3.7 per cent of B.C. adults had a regular NP).

With more than one in five B.C. residents lacking a regular primary care provider, this is an important election issue. With less than two weeks until election day, neither the Conservative Party of B.C. (CPBC) nor the BCNDP have yet released full platforms. The B.C. Green Party and CentreBC have released the most extensive commitments.

The CPBC commits to creating a $50 million fund to prevent the closure of rural doctor’s offices. The party also commits to hiring and retaining more doctors and nurses through increased training and recruitment. These vague commitments don’t reflect a coherent policy plan for primary health care are the foundation of the broader health care system.

The BCNDP commitments on primary health care leave a great deal to be desired, too. The incumbent party would further expand health authority-run urgent and primary care centres, of which there are already 48 across the province. While this model may fill the gap left by walk-in clinics, the focus on episodic (versus longitudinal) provider-patient relationships does not align with a large body of research evidence. High quality primary health care depends on patients having a long-term relationship with their provider or team with knowledge of their health history and who can help prevent illness and manage chronic disease.

The focus on training and recruiting more physicians, nurses, and allied health professionals is certainly important, but fails to address the significant health workforce retention challenges. On that note, the popular slogan by the CPBC and BCNDP of “hiring more doctors” underscores the one of the most persistent barriers to improving primary care access and quality—community-based family doctors generally aren’t “hired” as they work as independent contractors running small businesses. 

Mounting evidence shows that the younger generation of primary care providers are not attracted to running businesses due to the administrative burden. Instead, they prefer to work in multiprofessional teams, and receive a salary and other employment entitlements just like most other health care workers.

The Greens propose community health centres in every region—a primary health care model with a proven track record of improving care access, especially to underserved communities, and comprehensiveness through a team-based approach. Recent CCPA research identifies how the community health centre model is ideally suited to close the primary care access gap across Canada.

It also has the potential to bring together primary medical services with mental health and substance use care—services that have long existed in silos in British Columbia. CCPA researcher Rachel Pettigrew puts forward evidence-based solutions that would put B.C. on a better path to saving lives and improving mental health and substance use services, which could be very effectively integrated with community health centres, as we see in Ontario and other jurisdictions.

Hospital capacity is shrinking despite a growing and aging population

All parties want to keep emergency rooms open and reduce wait times, but none of the parties seem to grasp how exactly that would be achieved. The CPBC and BCNDP propose addressing this issue through increasing training and recruitment of health care professionals. In particular, the BCNDP has focused on recruiting U.S. health care workers. But B.C. should focus on becoming self-sufficient from its own health workforce training capacity while also improving retention. 

The BCNDP and CentreBC have committed to purchasing additional MRI machines. However, none of the parties specifically mention shortages of allied health professionals, including medical radiation technologists who are essential if B.C. hopes to fix the medical imaging bottleneck. While the B.C. Greens correctly state that better primary health care can help reduce demand for emergency care and inpatient care through prevention and after-hours access, their proposals don’t directly address B.C.’s shrinking hospital system.

Despite some well-intentioned commitments, none of the parties seem willing to grapple with B.C.’s declining acute care capacity, which must be addressed if B.C. hopes to improve timely access to care. In 2013-14, B.C. had the fewest staffed hospital beds of any Canadian province, at 188 beds per 100,000 people—which declined to 177 beds per 100,000 in 2022-23, behind Ontario at 198 beds per 100,000. There are multiple reasons for long emergency and surgical wait times, but hospital overcrowding and “access block” are among the most significant.

Access block occurs when patients cannot be admitted from the emergency department into the hospital because there are no inpatient beds available. In many communities, acute care expansion has not kept pace with population growth. Long hospital wait times, including surgeries, are also due to a lack of appropriate home and community care, including long-term care.

Long-term care capacity is also declining — when we need it most

In January 2026, the B.C. Seniors Advocate found that there has been a 19 per cent increase in the population of seniors 65+ since 2019-20, but only a five per cent increase in the number of publicly funded long-term care beds. The provincial government’s own data show that 16,000 additional long-term care beds will be needed over the next decade, but that the BCNDP only commits to 5,600 new beds under its “long-term care at home” model, which will only be suitable for seniors with minimal care needs and who have stable housing. These models also tend to download care onto unpaid family members, especially women.

The CPBC commits to restarting the construction of seven long-term care projects that were paused in Budget 2026 by the BCNDP government due to high relative construction costs to previous long-term care facilities. The Conservatives also propose to introduce a market-based voucher system for long-term care in which the provincial government would provide seniors with public funds to purchase long-term care on the private market. This privatization raises concerns about the erosion of equitable access with the loss of the current centralized health authority waitlist. Currently, seniors pay 80 per cent of their after-tax income for publicly funded long-term care (up to a maximum), and it remains unclear if the CPBC’s proposal would deregulate B.C.’s current co-pay model.

The BCNDP proposes to “move ahead with long-term care projects using standardized designs that lower per-bed costs,” but it remains unclear why the government couldn’t have done so in the first place. The BCNDP states that it would build 22 additional care homes if the party forms government. The Greens do not make any commitments on long-term care. CentreBC commits to 1,000 new beds by 2031, with 2,500 additional beds under construction.

The risk of greater privatization and out-of-pocket costs

Increasing private, out-of-pocket spending on seniors’ care is one of the main indicators that publicly funded seniors’ care is not meeting the needs of British Columbians. Private spending on long-term care has outpaced public long-term care investment. From 2014 to 2023, per capita private spending increased by 112 per cent while public spending increased by only 50 per cent. Too many B.C. seniors and their families end up paying out of pocket for the home and facility-based care that they need as waitlists. In other cases, families end up taking on unpaid caregiving—another form of privatization.

More broadly, there are serious concerns about whether parties will maintain B.C.’s publicly funded health care system while also phasing out publicly funded for-profit profit providers.

The BCNDP has raised concerns about CPBC candidates praising U.S.-style private-pay health care. In response, the CPBC committed to “protecting health care funding and keeping B.C.’s system universal and publicly funded [where] British Columbians will never need anything more than their health card.”

While the CPBC is distancing itself from past statements from its candidates, the CPBC’s response sidesteps the issue of publicly funded for-profit health care delivery—or outsourcing. The CPBC makes no commitments to use public and non-profit health care providers in the delivery of publicly funded care—and their proposed tax cut leaves a massive hole in the provincial treasury that will make properly funding health care more challenging.

The BCNDP similarly does not commit to phasing out publicly funded for-profit surgical and medical imaging facilities, which have benefited from increased funding over the years. The party does, however, propose ending the use of costly for-profit nursing agencies in health authorities. 

The Greens, too, want to end health authority contracts with these agencies and redirect these funds to the public system “support safe nurse-to-patient ratios.” (B.C. was the first province under the BCNDP to begin implementing nurse-to-patient ratios through collective bargaining.) The BC Greens are the most explicit in their commitment to “keep every public health dollar in public care,” suggesting that public funding should not be flowing to for-profit providers. 

In their platform, CentreBC commits to a publicly funded system and says it will “not allow private-pay options.” But once again, the question of publicly funded for-profit providers is not addressed. 

The far-right OneBC party seems preoccupied with fringe issues including support for anti-vaccine disinformation, and the party also expresses support for U.S.-style, two-tier health care system with “private health care alongside fully-funded public health care.”

The silence from the CPBC, BCNDP, and CentreBC on the issue of publicly funded for-profit health care delivery is a concern, especially as new CCPA demonstrates that the growth of this for-profit industry is associated with unlawful patient charges contrary to the Canada Health Act. In fact, B.C. has a long and problematic history of for-profit facilities engaging in unlawful billing practices, despite holding contracts with health authorities. 

Considering the difficult fiscal decisions ahead, the next provincial government would be wise to phase out the use of costly for-profit facilities where the same procedures have been found to be more expensive than delivering them in public hospitals—and at the same time that this form of privatization also paves the way to two-tier health care.

About the author

Andrew Longhurst

Andrew Longhurst is a senior researcher and political economist, with a focus on health policy, at the Canadian Centre for Policy Alternatives. He holds an MA from Simon Fraser University where he is a PhD candidate. He is the author of over 45 publications on public finance, health services, and the care economy.