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In Five Years

The Last Clinic

In five years...

The last longitudinal family medicine clinic in BC without user fees and annual memberships closes.

The clinic's aging and haggard director bemoans the loss.

Journalists publish moving pieces marking the end of an era.

A mock funeral is held in front of the Legislature.

The government loudly blames the greed of physicians — independent contractors outside their control.

At the same time, it quietly reallocates the last dregs of emergency stabilization funding elsewhere.

Physician Exodus

In five years...

One third of all physicians, already older and with greater need for healthcare, have already left the province.

They've known for years what was coming and what it would mean.

Family doctors were the first to leave.

Years of burnout and depression took their toll.

Most reached a breaking point of some kind. For too many, a permanent one.

Many left for careers outside of medicine. If they're to be interchangeable cogs, they may as well be paid for it.

Some younger family doctors have moved to BC. They went into medicine with eyes wide open. They see the lucrative opportunity ahead.

Other Specialist Physicians

In five years...

Like other physicians with healthcare needs for themselves and their families, many left.

Most of the younger, healthier ones stayed. But their practices changed.

Without family doctors, their responsibilities expanded.

Malpractice premiums for medical and surgical specialists skyrocketed.

In a panic, these specialists hired family doctors to provide followup care exclusively to their patients.

These extra costs were covered by mandatory user fees charged to all patients.

Charity programs sprung up to help those who couldn't pay. They helped a bit. But less every day.

Healthcare Ownership

In five years...

The latest round of corporate acquisitions has left 65% of BC's family medicine specialists as employees of two private companies.

Most are contracted out to hospitals, private healthcare facilities, and in-house medical services operated by employers.

Others support the multi-tier, for-fee "premium" physician services these mega-corporations offer to the public.

Promotions to gain healthcare customers draw comparisons to marketing of gym memberships.

The companies still offer services to the public that are fully covered by universal healthcare insurance.

These services are increasingly provided by physicians located in lower-cost jurisdictions around the world.

Waits grow and services diminish at the few remaining government-owned clinics.

Private Companies

In five years...

With public healthcare degraded, health services are the hottest employment perk.

Competition is fierce to offer the best services to employees and their families.

Larger companies offer dedicated in-house physicians for exclusive use by employees and families.

The largest have started to hire more specialized physicians and are looking to build their own surgical facilities.

Smaller companies contract out health services to a range of private providers.

Provision of employee health services is the fastest rising corporate expense.


In five years...

Employees are fearful of changing jobs and losing access to basic health services.

Job mobility and entrepreneurship plummet.

High net worth individuals pay for most services privately.

Everyone else struggles to make do with the services they can afford.

A growing portion of household expenses are devoted to healthcare.

More people are forced to choose between healthcare, shelter, or food.

Anxiety around choosing the wrong healthcare services grows.

People search for any distraction. The made-in-BC reboot of Logan's Run is number one on streaming.


In five years...

With less public healthcare services available, health budgets have fallen dramatically.

The government of the day is crowing about their financial acumen.

A minuscule portion of the savings are devoted to "unprecedented investments" in healthcare.

The media events accompanying these announcements are legendary.

Without fanfare, a larger portion of the savings goes to providing healthcare services for government employees.

MLA's and senior government executives are provided with elite in-house physician services.

Contracts with external providers subsidize user fees for lower-level public service staff.

Legislation is introduced banning publication of health outcome statistics.

Government has successfully sued journalists who publish negative health stories which are "contrary to the public interest."

Corporate media, owned by the health mega-corporations, stopped publishing such stories long ago.


As the saying goes, "the future is already here; it's just not evenly distributed yet."

The future is here.

Last chance.

Again, this is fiction.