Why Grand Forks Has Put Money into Health Care

Paying for health care is not the job of a municipality. Grand Forks and a handful of other local governments are doing it anyway.

Last year, a local physician warned Grand Forks’ council that two of the town’s five doctors were planning to leave the community. In response, the municipality, alongside a local non-profit and the region’s electoral area directors, committed hundreds of thousands of dollars to cover the costs of operating the local medical clinic.

Local officials were told that paying for the medical clinic’s costs would help attract and retain physicians. And the advice panned out: since they took over rent, utilities and licensing, Grand Forks has welcomed three new physicians to town.

Similar efforts have taken place, and shown promise, in Colwood and Sicamous .

But municipally funded health-care efforts raise thorny questions for both local and provincial politicians — and one expert warns that “haphazard” local health-care initiatives could set off counterproductive bidding wars for physicians.

Grand Forks is a small town of about 4,000 people located just north of the U.S. border in the West Kootenay’s Boundary region.

Last year, Dr. Mark Szynkaruk visited Mayor Everett Baker and his council to warn about the departure of physicians from his clinic — and the potential for upcoming retirements.

The medical clinic’s physicians shared the cost to rent the aging, 60-year-old clinic where they saw patients. As doctors left, those who remained had to shoulder a greater cost of the rent. Grand Forks faced its own version of a common story, in which the loss of one or two physicians reduces the happiness of remaining doctors and makes it harder to recruit replacements.

Local governments, however, are limited in how they can respond to health-care challenges. Municipalities cannot, for instance, directly finance private businesses, including doctors’ offices. And the province and its health authorities are traditionally the ones who pay physicians and set rates for incentives like those designed to fill vacancies in rural communities.

Municipalities also have limited finances that are dwarfed by the scale of health-care spending; the provincial health-care budget of $35 billion is more than double the combined spending of every municipality in B.C.

But that hasn’t stopped some municipalities from innovating. The Victoria suburb of Colwood, for instance, directly hired doctors, as it would other specialist employees. Sicamous, meanwhile, helped build a brand new medical clinic for its health-care professionals.

Earlier this year, the municipality began funding the clinic’s hard costs: its rent, utilities and licences.

The Grand Forks arrangement increased the financial incentive for physicians to choose to move to Grand Forks. It also amounts to a health-care subsidy.

In exchange, the municipality got doctors to sign an agreement in which they pledged to provide sufficient and ongoing care both in the local hospital and in the medical clinic. The doctors would also cover the cost of staffing the clinic.