Abbotsford councillor John Smith accepts the fact the Vancouver Coastal Health Authority provides more costly and specialized services than the Fraser Health Authority.

He also understands that economies of scale in Fraser Health's jurisdiction - with a population of 1.77 million compared with one million served by Coastal Health - can keep certain health care costs lower in the Fraser Valley.

But he refuses to accept the major disparity in per-capita funding for the health authorities, with 2011/2012 figures showing Fraser Health received $1,585 per capita compared with $3,008 per capita for Coastal Health.

"I just don't buy the difference because it's so huge," Smith said in an interview Wednesday. "Somebody needs to take a harder look at this because the funding formula does not adequately address the changing population. We're the fastest-growing area of the province."

A recent report from Auditor General John Doyle showed that Coastal Health topped the per-capita funding list with $3.008 billion in 2011/2012, or $3,008 per capita.

Vancouver Island Health Authority was second, with $1.94 billion, or $2,554 per capita, followed by the Northern Health Authority ($690.3 million or $2,465 per capita), the Interior Health Authority ($1.755 billion or $2,372 per capita) and Fraser Health ($2.8 billion or $1,585 per capita).

Smith said the provincial budget tabled this week shows the government is scrambling to balance the books, with health care spending projected to rise by just 2.6 per cent annually over the next three years - down from a recent annual average of 4.4 per cent.

He said the province would probably have to reduce future funding increases to other health authorities to ensure Fraser Health gets a fairer share.

"Will any future governments have the guts to do that?" Smith said. "That's their problem and that's why we elect them - to make tough decisions. Why should Fraser Health continue to struggle on? We're not secondary people."

Health ministry spokesman Ryan Jabs said it can be misleading to judge health authority funding on a per-capita basis.

He noted the ministry reviews demographics, growth rates, population size, client needs, remoteness of communities and services each health authority provides to patients from other health authorities.

Jabs said Coastal Health spends more money for many reasons, including:

. Providing specialized services such as organ transplants, bone marrow transplants, cochlear implants and adult metabolic services for rare diseases.

. Providing significant services to people who live in the Fraser Valley region but regularly commute to Vancouver.

. Serving people in the Downtown Eastside, who tend to be more vulnerable and have higher health care costs.

He said the Fraser Valley's higher population growth rate has been reflected in Fraser Health's funding the past six years, with the authority's funding increase averaging seven per cent a year, compared with less than five per cent a year for Coastal Health.

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