The recent announcement by Prime Minister François Legault that Quebec plans to charge unvaccinated adults “significant” fees – nicknamed “unvaxxed tax” in English or “vaccimpôt” in French – has sparked controversy among journalists, health professionals. health, politicians and people with Twitter accounts.
Although the idea garnered some support – for example, the president of the Chamber of Commerce of Metropolitan Montreal, Michel Leblanc, called the measure “fair” and said that “anything that helps to reduce the pressure on the health system brings us closer to resuming a return to a more normal life. “- it was also strewn with criticism.
Blaming the unvaccinated is a ‘dubious shortcut’
Quebec Doctors for the Public Plan, a group of 500 physicians, residents and medical students, released a statement emphasizing the importance of vaccination while calling for a financial penalty for unvaccinated “unacceptable”.
According to the MQRP, the unvaccinated are not to blame – or at least not the only ones to blame – for the pressure COVID-19 is currently putting on the province’s health care system. On the contrary, he says, the government’s mismanagement, including “austerity and centralization reforms”, brought the health system “at the end of the rope” even before the pandemic began.
“The last 30 years of erratic management and chronic public underfunding of health care, which has led to difficult working conditions for health care providers, staff shortages and service interruptions, do not can be used as an argument to impose such a measure “, indicates the press release of the MQRP. .
“Blaming the current health system problems on the unvaccinated population is a dubious shortcut. A better supported system would be able to more easily support a population with an immunization coverage of 88%.
Marginalized communities
The MQRP press release also dealt with the “slippery slope” effect that this measure could have in terms of opening the door to a health contribution system based on risk factors. Right now, health care taxes are levied on the basis of income, which means they ignore lifestyles, even when those lifestyles could increase the likelihood of people getting sick. or get injured.
For example, people who do not exercise regularly and people with drug addiction problems are not taxed more for health care.
“These are often seen as poor individual choices, while underlying complex social structures lie,” MQRP said. He cited lack of education, lack of access to resources, like the internet and language barriers as reasons why people might not get vaccinated.
MQRP is not the only group to make this argument.
“The Prime Minister has a bad habit of making decisions without considering vulnerable people. Among the 10% of unvaccinated are homeless, undocumented, people with mental health problems. Will he send them an invoice? tweeted the leader of Quebec solidaire Gabriel Nadeau Dubois.
Canadian Civil Liberties Association Director of Fundamental Freedoms and Acting General Counsel Cara Zwibel said in a statement that Quebec’s proposal “raises significant fairness concerns.”
“We have universal public health care in Canada. We do not impose fines on people who make poor diet and exercise choices, those who choose high-risk occupations or recreational activities. Some essential services – such as basic health care for sick people – transcend such individual choices.
The Charter and the Health Act
The CCLA described the unvaxed tax as a direct penalty “forcing individuals to undergo medical treatment.”
“[The Canadian Charter of Rights and Freedoms] recognizes individual autonomy over our bodies and medical decisions. Allowing the government to impose fines on those who disagree with the government’s recommended medical treatment is a deeply troubling proposition, ”Zwibel said.
According to Dr. Andrew Baback Boozary, executive director of social medicine at the University Health Network of Toronto, the unvaxed tax also goes against the principles of the Canada Health Act, which states that the primary objective Canadian health care policy is “to protect, promote and restore the physical and mental well-being of residents of Canada and facilitate reasonable access to health services without financial or other barriers.”
He tweeted: “As a doctor who has never received a dollar from the pharmacy, I believe I have been as pro-vaccine as any in the country – because they save lives and our health system, but Quebec taxing people who are not vaccinated is regressive and will undermine Canada’s health law.
“Let’s not rush things”
Some critics have expressed more concern about the Coalition Avenir Québec, better known as the CAQ’s approach to implementing the measure than the measure itself.
The leader of the Quebec Liberal Party, Dominique Anglade, tweeted: “With arrogance, @francoislegault delivers us a beautiful ‘smoke and mirror show’ without public health advice, without any details, without having answered questions and without having consulted the Assembly. Again, he is basing himself on the polls and his political instinct. “
Meanwhile, the Montreal Economic Institute, a nonprofit think tank “promoting economic liberalism”, called the tax an “interesting idea” with “misguided application.” The title of his press release? “Let’s not rush things.”
“The idea of the CAQ government to model the contributions to the health system according to certain characteristics of individuals is not far-fetched in itself. After all, it is the very foundation of the principle of insurance. However, in its current form, this contribution format strikes us as superficial and ill-advised, ”declared Miguel Ouellette, Director of Economics and Operations at the MEI.
Advocating the very idea that MQRP characterizes the bottom of a slippery slope, Ouellette said the amount taxed should not be random. It should be calculated based on a person’s risk to the health care system, such as a private insurance premium.
And – for consistency – Ouellette suggested the same model should be applied in other cases, such as “risk-adjusted billing” for smokers and extreme athletes.
“It has been shown in several European countries, such as Switzerland, that it is perfectly possible to maintain universal coverage for medically necessary care while using secure funding. It is enough that the less fortunate see their premiums subsidized by taxpayers according to their level of income ”, declared Ouellette.
Despite these criticisms, a Léger poll, conducted in the days preceding the announcement of the non-vaxxed tax, revealed that most Quebecers are in favor of adding measures related to vaccination status. However, the poll did not specifically ask about a tax.
The cover image for this article is used for illustration purposes only.
