The Vancouver Island Health Authority's plan to deal with provincial underfunding is a destructive mishmash of measures that hurt patients, increase long-term costs and ignore real health issues.
And it's a pattern occurring across the province as all the regional health authorities struggle to find $360 million in spending cuts.
Fewer surgeries and diagnostic tests, cuts to care for seniors and the addicted, reduced community programs - VIHA revealed a list of measures that reduce the level of care in the region.
The problem is simple. The health authority's funding from the provincial government, despite a 5.9-per-cent increase, is $45 million short of what's needed to provide care to residents.
VIHA proposes service cuts, higher fees and property sales to deal with the lack of money from the province.
The other health authorities face the same crunch and have announced, or soon will reveal, similar cuts.
The timing is ridiculous. VIHA's fiscal year started last March 31, like the other health authorities. It is only now, more than halfway through the year, revealing plans to address a $45-million shortfall it knew about nine months ago.
That's not competent. Practically, it means cuts need to be deeper. Instead of 12 months of savings, the authority needs to find the same money in five months.
Politically, it means people voted in May without knowing the effects of Liberal policies. The cuts reflect a choice by the Campbell government to limit health-care funding; the consequences were never made clear in the election campaign.
Quite the contrary. Premier Gordon Campbell promised that despite financial pressures, core services like health would be protected. The authority knew in February cuts were needed; so did the Liberals.
Only in October did they reveal the reality.
VIHA will cut the number of surgeries by 1.3 per cent. Fewer operations means longer waits for suffering people, some unable to work or care for their children. It has reduced the number of MRIs and closed mental health beds.
Those are cuts to services. That's a Liberal promise - an important one - broken.
The other major problem is that the cuts are desperate and short term. They don't really save money.
Cutting the number of operations just means that more will be needed next year. Making people wait means more emergency room visits, more pain drugs and worse outcomes.
It's a straightforward equation. About 30 people a month in the capital region are told they need non-urgent hip replacement. It's called elective surgery, but it's not. No one is going to let doctors cut away their hip bones unless it's desperately needed to stop pain and restore mobility.
If system provided 30 operations, the wait would remain the same.
But if it provided 25 operations, then five people would be bumped to the next month. By the end of the year, 60 people would be parked on the waiting list. And each year, the wait would grow longer.
The health authority is also cutting grants to community organizations that deliver front-line services. That too is a short-term saving with long-term costs.
Victoria Citizens' Counselling, for example, provides help for more than 1,000 people annually, mainly working poor and those on income assistance. Demand has increased by 25 per cent in the past 12 months. VIHA has eliminated its funding, which was 30 per cent of the budget.
The health authority is also selling real estate and privatizing care homes. Publicly operated seniors' homes will be closed and the property sold to corporate providers. The authority will pay for spaces for seniors needing residential care.
Leave aside the public-private debate. The health authority is selling assets - a one-time gain - and using the money to cover operating deficits.
Next year, based on the three-year budget, the funding shortfall will be just as great. The money from selling real estate will be gone. And the cuts to health care will need to be much deeper. The year after that, more of the same.
It's cruel to make people wait for care or treatment without at least discussing whether it makes more sense to look after them promptly.
It's dishonest for the government have promised to protect services during the election campaign.
And it's foolish to think that pushing costs into the future is any real solution.