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Quebec plan to tax the unvaccinated met with harsh reviews: ‘This really tears at the roots of the Canada Health Act’


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Quebec plan to tax the unvaccinated met with harsh reviews: ‘This really tears at the roots of the Canada Health Act’

In what would be a Canadian first, the premier of Quebec says the province is making plans to tax the unvaccinated in the face of soaring COVID-19 case counts and hospitalizations.

But the measure, expected to be well received by parts of a pandemic-weary public, is being panned by critics as a step too far that would be impractical to implement, inevitably challenged in court, and could further sow seeds of societal division.

Premier François Legault dropped the bombshell news of his no-vax tax Tuesday.

“I’m announcing that we are currently working on a health-care contribution that will be charged to all adults in Quebec who refuse to get vaccinated,” Legault told reporters.

“All people who are not vaccinated for non-medical reasons will have to pay a contribution.”

Legault likened the contribution to drug-insurance coverage in Quebec, where if a person’s employer doesn’t cover drug insurance, the person pays a contribution as part of their taxes.

Legault said he would be working with his finance minister to work out the logistics of such a contribution but said it would be a “significant amount.”

“Fifty dollars or $100, for me, is not significant,” said Legault. “But we haven’t yet set the amount.”

Legault castigated those in his province who remain unvaccinated 22 months into the pandemic, saying they have put a significant burden on medical staff and a financial burden on the majority of Quebecers.

“It’s also a question of fairness for the 90 per cent of the population who have made some sacrifices. I think we owe them this kind of measure,” he said.

Making the announcement now is a savvy political move on Legault’s part, some say.

In the 24 hours preceding Legault’s press conference, Quebec reported:

• 2,742 hospitalizations total — an increase of 188 over the day before;

• 62 new deaths; and

• 255 people in intensive care, an increase of seven over the day before.

Quebecers are currently under a curfew and a strict regime of restrictive health measures.

As Omicron cases and hospitalizations continue to soar and lockdown measures raise public frustrations, much conversation in the province has begun to turn to the “why” of this fifth wave, said Daniel Béland, director of the McGill Institute for the Study of Canada at McGill University.

Many people are looking for a target for their anger — with the two obvious ones being the government and the unvaccinated.

About 10 per cent of adult Quebecers aren’t vaccinated, but they represent about half of all patients in intensive care, the premier said during his remarks.

“The government has been criticized a lot for some of the measures they have announced,” Béland said.

“The idea that you hear a lot in Quebec right now is that the vaccinated are paying for the unvaccinated, in the sense that they are paying a price and that the nonvaccinated are responsible for proportionally way more hospitalization.

“There is a lot of discussion about personal responsibility, and who should pay the price for what’s happening now with Omicron.”

Around such talk, a larger, Canadian conversation continues about mandatory vaccines.

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On Friday, federal Health Minister Jean-Yves Duclos signalled that provinces might need to consider mandatory vaccine laws to battle the current COVID wave.

The debate over compulsory vaccination is ongoing in Germany, said Béland; and in Austria, the government is about to start issuing fines to unvaccinated citizens.

In Quebec, as elsewhere in the country, frustrations are increasingly directed at those who flout public health measures at the expense of those who, to their minds, make sacrifices to get past the pandemic as quickly as possible.

Against that backdrop came the recent story of the Sunwing party flight from Montreal to Cancun, where partying travellers were filmed ignoring public health regulations, dancing in the aisles, openly vaping and passing bottles of booze around on their Dec. 30 flight.

Lining up against the unvaccinated may by a smart move for Legault.

“The fact that he’s talking about this is a sign that the government is under pressure to do something about it,” said Béland.

“He’s saying, ‘Yes, I understand your frustration, and this is what I will do about it.’”

Of course, given the number of caveats presented at his news conference, it’s entirely possible that Legault might quietly shelve the idea a month or two down the line, at which point the Omicron wave may have run its course.

“I don’t want to be cynical, but they could also start to talk about it to increase the pressure on the nonvaccinated to get vaccinated, but not implement it in the end.”

Kerry Bowman, who teaches bioethics and global health at the University of Toronto, sees problems for anyone trying to adopt a no-vax tax.

“My concern would be that it is divisive — enormously. How far do you want to push people? And will it be effective?”

Fundamentally, he says, Legault’s tax undermines what Canadians like to think of as the basis of their health-care system.

“The health-care system does not make judgments about the kind of behaviour that we like and don’t like in our patients,” he said.

“We don’t lecture people that drank too much wine with dinner the night before, people that smoke. You can point out the health risks to people, but you don’t turn them away. You don’t lecture them, and you don’t fine them.

“This really tears at the roots of the Canada Health Act and the ethics that underpin the Canada Health Act.”

Still, Raisa Berlin Deber, a health policy professor at the University of Toronto, says she thinks a tax on the unvaccinated would be allowed under the Canada Health Act, which governs the country’s provincially run universal health-care systems.

If the government planned to charge people without a COVID-19 vaccine for health care, that would be a different story, she said. “But if I just say there’s a tax on you if you’re not vaccinated, that’s not related to your access to specific health-care services.”

The other thing that bothers Bowman, meanwhile, was the timeline.

Based on the current research on the ideal time between vaccines, the timeline for a person starting from scratch to get all three vaccinations would be upwards of six months.

Given that the current theory is that one vaccination dose does not provide much protection from the Omicron variant, he questioned how effective Legault’s tax might be in actually curbing COVID cases in the short term. The fruits of that policy might only ripen six months down the line, and the cost in terms of polarization may be too great to justify the means, he said.

Legault offered his news during a media availability that had been ostensibly arranged to address the resignation of his top public health official, Dr. Horacio Arruda, a day earlier.

The premier briefly thanked Arruda and named his replacement, Dr. Luc Boileau, before turning to the issue of the unvaccinated.

Files from The Canadian Press

Steve McKinley is a Halifax-based reporter for the Star. Follow him on Twitter: @smckinley1

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