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Mark Roseman @markroseman.com · 26/09/2026

For background on the importance of these issues, especially public accountability and transparency on health system performance (including regional disparities), please see my website: healthdatabc.ca Data available on: primary care, emergency rooms, imaging, UPCCs, …

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Mark Roseman @markroseman.com · 07/08/2026

All hospital emergency rooms in Fraser Health have stopped reporting estimated waiting times (via the edwaittimes.ca site). Comment from MOH or Fraser Health about this? The public's right to be informed on the state of our health system must be protected.

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Mark Roseman @markroseman.com · 07/08/2026

BC's UPCC's spend $52M a year (31.4% of total budget) on overhead. That's 55% over budget—at a time when they're spending less than expected on doctors and nurses. 11 UPCCs spend over double their budget on overhead.

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Mark Roseman @markroseman.com · 27/06/2026

Health system getting you down? Problem solved!

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Mark Roseman @markroseman.com · 26/06/2026

BC CT and MRI waiting times for 2025, via FOI. The FOI unfortunately only includes median wait times (i.e. half the people waited longer than this), though best practice is to also report 90th percentile wait times and % meeting targets. More: healthdatabc.ca/wait/imaging...

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Mark Roseman @markroseman.com · 25/06/2026

In particular, look at this stat, the biggest reason people are looking for a new family doctor—they've lost access to the one they have. This is the stat BC wants people to believe doesn't exist. Because people are always attached, never unattached. Right?

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Mark Roseman @markroseman.com · 25/06/2026

Look what Nova Scotia manages to PUBLICLY report about it's primary care waiting list. In BC? We get nothing. To get any data, we can wait for cherry-picked scraps from MOH or wait months for FOI requests. Widespread lack of transparency is enabling health system failure in BC.

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Mark Roseman @markroseman.com · 21/06/2026

BC Greens used to be THE strongest party on health. They understood what was going on and how to fix it. Did the hard work, no cheap slogans. Now? If we hear anything, it's about CHCs (attached). Which I like, but I wonder how much of it is that they use the word "community."

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Mark Roseman @markroseman.com · 18/06/2026

When the government makes an announcement, it helps to have a guide to interpret it. Think all those health services promised are going to turn into reality? In your dreams. What's it actually costing, and what are you getting in return? Find out → healthdatabc.ca/upcc/

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Mark Roseman @markroseman.com · 16/06/2026

Most discussion on mental health and psychiatry focuses on the vitally important issues related to involuntary care. But that's not what most people who need help deal with. The "system" is failing them too. You deserve an honest discussion of how, why, and what you can do.

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Mark Roseman @markroseman.com · 11/06/2026

In what kind of organization would this happen? You go 18% over budget on overhead. Nobody notices or says anything. The next year you go 36% over budget on overhead. Problem right? Nope. The next year you go 55% over budget on overhead. What's next?

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Mark Roseman @markroseman.com · 09/06/2026

Even reporting on a completed analysis by an independent needs a ton of work. They're a nobody so to meet journalistic standards you need to verify it. Go through a detailed analysis, find experts to comment, etc. Again, still a ton of work.

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Mark Roseman @markroseman.com · 09/06/2026

That doesn't say anything about quality of the claim. But govt saying it is news. Consider instead what would be required to do a detailed investigative analysis like on UPCCs. Conservatively, several hundred $, months, 80h to review and do analysis. Lot of work.

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Mark Roseman @markroseman.com · 09/06/2026

For a journalist receiving a govt press release or a quote at a media event, it's an easy decision to regurgitate it. Just the fact that "govt says..." is newsworthy. Publishing it meets journalistic standards—quickly, easily.

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Mark Roseman @markroseman.com · 09/06/2026

There are some perverse incentives built into the structure of today's media business. Those make it far more likely you'll see unquestioned government sound bites vs. any kind of detailed analysis. And no, it's not some big conspiracy.

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Mark Roseman @markroseman.com · 08/06/2026

Anyone want to take a shot at explaining/justifying this? 🤯

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Mark Roseman @markroseman.com · 08/06/2026

On the surface, UPCCs aren't seeing many patients given the number of staff. Maybe those visits are so much more in-depth that it justifies the numbers? If so, govt owes us some actual data to support that. If not, we need an explanation why those resources aren't better used.

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Mark Roseman @markroseman.com · 08/06/2026

For me, the real question is not whether we should pull the resources we're putting into UPCCs and deny care, but whether they could be used more effectively for more/better care. Looking at things like the following, I have to conclude they could. Thanks again.

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Mark Roseman @markroseman.com · 08/06/2026

11/11 This work is only one part of a larger conversation. It's not about blame but fixing what's broken. Delivering the health care we all need via an effective public system can happen. But only if we're honest and commit to real transparency and accountability. healthdatabc.ca

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Mark Roseman @markroseman.com · 08/06/2026

10/11 UPCCs are just the start of health authority incursion into primary care. Spending on "community" is up 2.5x since NDP took power, second only to "corporate" increases. We know little about the performance of other primary care initiatives they're involved with.

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Mark Roseman @markroseman.com · 08/06/2026

9/11 But don't take my word for it. You can download the government's own data on each UPCC, my detailed analysis, and a convenient Excel spreadsheet with all the data, calculations, and charts so you can explore further. All at healthdatabc.ca/upcc/

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Mark Roseman @markroseman.com · 08/06/2026

8/11 UPCCs are a political solution but not a sound healthcare solution. They haven't delivered on the services that people in BC desperately need. We can do far better with the resources we have. But not while politicians and health authorities are in charge.

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Mark Roseman @markroseman.com · 08/06/2026

7/11 Are things really so bad at UPCCs? Yes. And it's because of a government so focused on public relations, that it ignored experts or the needs of citizens. And won't dare tell the truth about the tremendous resources we're wasting.

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Mark Roseman @markroseman.com · 08/06/2026

6/11 Not only are the overall statistics quite dramatic, but when you start comparing across different UPCCs, you see huge differences in performance, whether it's availability of doctors, excess nursing staff, overhead spending, etc. Why do some perform so poorly?

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Mark Roseman @markroseman.com · 08/06/2026

5/11 One of the striking findings is the very high cost per average visit at UPCCs: $186.06. Compared with the $39-$58 for a typical visit at an independent family practice clinic, it seems outrageous. Overhead alone per UPCC visit is more than that!

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Mark Roseman @markroseman.com · 08/06/2026

4/11 In fact, once you start digging into the details, you find some pretty staggering results about costs, staffing, use of resources, access to care, and overall productivity. When we entrust govt to provide us with essential health services, we should expect better.

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Mark Roseman @markroseman.com · 08/06/2026

3/11 There have been many promises about UPCCs: • they'll keep patients out of ERs • attach them to primary care providers • and provide access to primary care on an urgent basis. On those fronts, UPCCs have clearly failed. And done so at an incredibly steep cost.

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Mark Roseman @markroseman.com · 08/06/2026

2/11 We can't afford to keep throwing endless piles of money at health care projects under the assumption that the more we spend, the more care we get. That's how government often operates, but it's not true. Results matter. But those results are often hidden.

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Mark Roseman @markroseman.com · 08/06/2026

📢 BC NDP opened the first Urgent and Primary Care Centre (UPCC) 8yrs ago. We now have 48. Govt has given us only cherry-picked good news. No detailed accounting of performance. I reviewed their own data obtained via FOI. It's bad. Strap in. 🧵1/11 healthdatabc.ca/upcc/

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Mark Roseman @markroseman.com · 05/06/2026

Putting the finishing touches on my analysis of several years of FOI'd data on BC's Urgent and Primary Care Centres. Expect to release it on Monday. It's a stark lesson on why healthcare orgs—especially ones dependent on public opinion for survival—need independent oversight.

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Mark Roseman @markroseman.com · 02/06/2026

Three words that are necessary (although not sufficient) to save health care in BC.

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Mark Roseman @markroseman.com · 28/05/2026

I would love for someone to explain to me why there are so many nurses in Urgent and Primary Care Centres, relative to family physicians and nurse practitioners. On average, it's a 2:1 ratio, in some much higher. What do they actually do that requires so many?

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Mark Roseman @markroseman.com · 28/05/2026

And if you thought the previous chart (showing UPCC visit costs vs. independent clinic family medicine and specialist visits) was scary, check this out. Per-visit OVERHEAD-ONLY costs at UPCC's and how they stack up against FULL VISIT fees for indie docs. 🤯

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Mark Roseman @markroseman.com · 28/05/2026

Still crunching through FOI data on BC's UPCC's, which tend to be filled with too many nurses and administrators but not enough doctors. Effective cost per visits are insanely high—$185.74—on par with MSP fees for specialist consultations. Nobody is looking out for public $$$.

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Mark Roseman @markroseman.com · 26/05/2026

Phew! First draft of my analysis of several years of FOI data on BC's Urgent and Primary Care Centres is finally complete. Looking forward to releasing this soon. Despite knowing how little impact it will actually have on our unaccountable government.

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Mark Roseman @markroseman.com · 09/05/2026

If you work it out on a cost per patient visit, average overhead cost is $58.46. Per patient! Just overhead! By comparison, a family physician working under LFP can bill $57.50 for a 15-min visit (98010,98031). And that amount covers all their costs incl/ overhead!

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Mark Roseman @markroseman.com · 09/05/2026

One thing that jumps out from UPCC numbers from FOI. Overhead costs are insane—average 55% over budget. Some sites way higher. This is government running health care with access to unlimited funds and without any oversight.

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Mark Roseman @markroseman.com · 09/05/2026

Starting to look at UPCC data over last few years… aggregate data, still preliminary. Patient visits up (good). Costs way up (not good). Primary care hiring still slow (uh oh). Overhead and nursing way over budget (yikes). Productivity vs. independent practitioners? Horrible.

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Mark Roseman @markroseman.com · 06/05/2026

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Mark Roseman @markroseman.com · 29/03/2026

BC first to end medicine as a self-regulating profession. BC is also the first province to have it's medical association (Doctors of BC) receive 2/3 of its operating funding not from its physician members, but direct from government. Coincidence? bsky.app/profile/mark...

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Mark Roseman @markroseman.com · 27/03/2026

I've written elsewhere about the govt's growing influence in DoBC and its negative impact on physician autonomy (and patient's interests). And how the NDP govt has been successful at using DoBC to further its own policy interests. You can find that here: markroseman.com/docs/

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Mark Roseman @markroseman.com · 27/03/2026

If you look at DoBC's financial statements, you'll see that—unlike other provincial medical associations and contrary to the terms of the BC Societies Act—an overwhelming portion of its operating funding comes directly from government (around 2/3).

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Mark Roseman @markroseman.com · 27/03/2026

A "member-funded society" has a specific legal definition (in the BC Societies Act). One of the stipulations is that no more than 10% of its revenue can come from public donations (non-members or government funding). That helps those societies act in their members' interests.

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Mark Roseman @markroseman.com · 27/03/2026

One thing missing in the (few) media stories about HPOA is why there was so little opposition from Doctors of BC and why it was so meek and ineffective. After all, doesn't DoBC represent doctors' interests? It's a "member-funded society" created to do exactly that. 🧵

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Mark Roseman @markroseman.com · 28/01/2026

So how well is our "urgent" care call-leave-a-message-and-we'll-call-you-back system working? Apparently, not so well. Enough with this bullshit. What does it take to get medical care in this province? This is not what we pay govt to provide.

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Mark Roseman @markroseman.com · 23/01/2026

Here are Island Health's own metrics on MRI's, showing a steady decrease in timeliness going on for years. At what point do you stop putting up with all the ribbon-cutting spin, and start demanding to see a concrete plan with metrics and accountability to restore services to acceptable levels?

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