VANCOUVER—Health-care organizations are throwing their support behind proportional representation in B.C.’s electoral referendum.

The Health Sciences Association of British Columbia (HSA), a union representing approximately 18,000 health professionals, has endorsed proportional representation (PR) and will host a “Get Out the Vote” night prior to the end of the referendum on Nov. 30.

Voters in B.C. have been asked to choose between our current first-past-the-post system, in which the candidate who receives the most votes wins; and a PR system, in which seats are won in proportion to the votes cast.

Val Avery, president of HSA, said the organization decided that PR was the best choice after researching the health-care systems in countries that already use a PR model, such as New Zealand, Germany, Denmark, Norway and Scotland.

“Our members have supported PR, and they see that governments that have some sort of pro-rep system generally devote more resources to health care, social programs and education,” said Avery.

She added that health and community workers in the union “see a need” for better funded programs.

“The poverty and inequality that we are currently experiencing are addressed to a greater degree under pro rep.”

In a document outlining its decision, the HSA cited political scientist Arend Lijphart, who studied PR systems worldwide and found that nations with a PR system spent approximately 4.75 per cent more on social programs compared to countries using a majoritarian system (such as first-past-the-post).

Lijphart did not find any relationship between a country’s economic growth and the electoral system that they used.

The BC Health Coalition is also putting its support behind PR, arguing it will deliver a more collaborative government and more equitable health policies for everyone in the province.

Edith MacHattie, co-chair of the BC Health Coalition, said PR would improve representation in government so that policies are “more relevant” to all people across B.C.

“Access to health services is very different in urban versus rural environments, for example. Getting access to enough specialists in urban and rural settings looks quite different,” MacHattie said. “We need to have a very representative team around the table.”

MacHattie said B.C.’s current first-past-the-post system has resulted in poor health policy. She referring to the “chronic underfunding of the public system” under the 16-year period of Liberal rule. From 2005-2013, the BC Liberal party won a majority leadership while still garnering less than half of votes.

“Because those governments were elected with a smaller percentage of the popular vote, then that smaller percentage got to decide things for everyone,” said MacHattie. “So if you have a government who is less for public services and more for business, that has a real impact on the day-to-day lives of people that receive those services.”

Max Cameron, director of the Centre for the Study of Democratic Institutions at the University of B.C., agreed there’s a connection between electoral systems and the quality of public health-care systems.

“There’s no question if you look at some of the best-funded welfare states in the world, they tend to be northern European countries that have proportional representation, so there’s clearly some kind of correlation,” Cameron said.

He said scholars have found that first-past-the-post can lead to “policy lurch,” in which policies are harder to implement in the long term because they do not garner the same support by ideologically opposed governments elected over time.

“It’s harder to build a sustained consensus around long-term policy development,” he said.

Cameron explained that, under PR, more centre-left representatives tend to be elected and that consensus-lead polices within the centre-left result in better-funded social programs and health care.

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“In a PR system, it pulls policy towards the centre-left ... Over time you have more robust welfare states,” he said.

Cameron cites a recent trip to Sweden, which has a PR system, as one example.

“What I noticed was that not only do they have the same kind of social protection we do, but they’re all seamlessly integrated. That’s a reflection of the fact there is a tendency in the systems to develop policy over many years.”

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