Quebec will impose a tax on those who have not been vaccinated against COVID-19 to offset their disproportionate health care costs and encourage more people to get their injections.
Prime Minister François Legault pointed to the composition of hospital admissions in Quebec’s intensive care unit as the driving force behind the levy. Unvaccinated Quebeckers make up just 10 percent of the province’s adult population, but comprise about half of those admitted to ICU with the disease, he said.
“It’s a matter of justice,” he said. “Right now, these people are placing a very heavy burden on our healthcare network. I think it’s normal for the majority of the population to demand a consequence.”
The painful fifth wave of the pandemic has overwhelmed Quebec’s hospitals and the government has imposed strict restrictions. On Monday evening, Horacio Arruda, the director of the province’s Health, resigned after citing an erosion of public support in his explanations for the lockdown measures.
The tax will be for a “significant” amount, Mr Legault said, offering some additional details about a policy that would be a Canadian first. The levy will not be applied to hospitals in exchange for health services, but will be more like the premium Quebec residents pay for public prescription drug insurance, which is collected through income tax returns, he said.
The government is still studying legal issues surrounding the tax, but those with valid medical reasons will be exempted, Mr. Legault at a press conference on Tuesday.
On social media, his chief of staff, Martin Koskinen, tweeted a defense against indicting unvaccinated people. “To avoid having to pay health insurance benefits or a COVID fine, there is a simple solution: a free and accessible vaccine,” he wrote. “We have rights, but we also have obligations. The democratic debate on this issue will be exciting.”
The new tax overshadowed Dr. Arruda, Quebec’s longtime director of public health, who resigned Monday after a tumultuous 22 months helping lead the province’s pandemic response. In the early days of the crisis, Dr. Arruda a popular and colorful personality, whose gestures, lively clothes and talk about Portuguese custard tarts reassured Quebeckers in a terrifying time.
But as the death toll rose and the months passed, the public soured his style and began to question some of his advice. The punitive fifth wave of the virus, with Quebec imposing a second curfew, has fueled calls for his departure. In a letter of resignation, Dr. Arruda that doubts about its scientific credibility had eroded support for restrictions.
Introducing his interim public health chief – Dr. Luc Boileau, a veteran of the province’s public health bureaucracy – explained to Mr Legault his case for the imposition of the tax measure in Quebec’s fight against COVID-19. He said the province still plans to expand the use of vaccine passports to places like shopping malls and hairdressers, but the vaccinated majority deserve even tougher measures.
“I think it’s a matter of fairness to the 90 percent of the population who made sacrifices,” he said. “I think we owe them these kinds of measures.”
When asked about his position on the tax, Dr. Boileau that the policy was in place before he took the new job and that it was too early for him to give an opinion.
Some researchers have been sharply critical of paying unvaccinated people, arguing that it could harm underprivileged people and be difficult to enforce. Pierre-Carl Michaud, a health economics specialist at the HEC business school in Montreal, wondered who can’t afford the fee.
“I’m just worried that if the penalty is set at a really high level then of course it will change people’s behaviour, but we’re going to have this problem with people who can’t pay. And in my opinion there are probably a lot of people in that situation,” he said. “Suppose they set the fine at $5,000 or even $1,000. And you get someone from welfare, not vaccinated, what do you do with those people? Do you go to their house and confiscate food from the fridge?”
Quebec is not the only jurisdiction to impose financial penalties on people who refuse to be vaccinated and do not have a valid medical exemption. In December, Austria said people who violate the country’s vaccine mandate could be charged up to about $5,171 every three months from this year. In Greece, the government this month mandated vaccines for everyone 60 and older, with people who refuse to pay a monthly fine of $144.
While Mr Legault released few details on Tuesday, it appears his policies do not violate the Canada Health Act, said Katherine Fierlbeck, the chair of Dalhousie University’s department of political science that researches policy and governance in the United States. healthcare.
“It would only conflict with the [Canada Health Act] if necessary at the point of service, and if non-payment resulted in denial of service,” said Prof. Fierlbeck in an email. She said the surcharge for people refusing COVID-19 vaccinations, proposed by Quebec, is similar to the health premium model that provinces such as Ontario apply in addition to provincial taxes. According to that model, Prof. Fierlbeck said that the penalty for not paying is the penalty for not paying taxes.
“Services are not refused, so no violation,” she said.
Prof. dr. Fierlbeck said Quebec’s policy is not as strict as a mandate, but it does increase pressure on people who have so far refused a vaccine. She said it will raise questions of fairness depending on whether it is applied on a sliding scale based on income and whether it is applied equally to people regardless of their risk of contracting COVID-19 and suffering serious consequences. to get.
In a brief statement late Tuesday, a spokesman for federal health minister Jean-Yves Duclos said the government is reviewing Quebec’s announcement and focusing on what it can do nationally to increase vaccination coverage.
“Provinces and territories will continue to make decisions about their own public health measures under their jurisdiction,” said spokesman Marie-France Proulx.
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