From medical professionals to politicians to a civil liberties group.
Premier François Legault's recent announcement that Quebec plans to charge unvaccinated adults a "significant" fee — dubbed the "unvaxxed tax" in English or "vaccimpôt" in French — has sparked controversy among journalists, medical professionals, politicians, and people with Twitter accounts.
While the idea has garnered some support — for instance, Chamber of Commerce of Metropolitan Montreal president Michel Leblanc called the measure "fair" and said "anything that helps reduce the strain on the healthcare system brings us closer to resuming a return to more normal life" — it has also been fraught with criticism.
Blaming the unvaccinated is a "dubious shortcut"
Médecins québécois pour le régime public, a group of 500 physicians, residents and medical students, released a statement that stresses the importance of vaccination while also calling a financial penalty for the unvaccinated "unacceptable."
According to MQRP, the unvaccinated are not the ones to blame — or at least not the only ones to blame — for the strain COVID-19 is currently placing on the province's health care network. Rather, it says, government mismanagement, including "austerity and centralization reforms" brought the health care system to "the end of its rope" before the pandemic even started.
"The last 30 years of erratic management and chronic public underfunding of health care, which have led to difficult working conditions for health care providers, staff shortages and service disruptions, cannot be used as an argument to impose such a measure," MQRP's statement said.
"Blaming the current problems in the health care system on the unvaccinated population is a dubious shortcut. A better-supported system would be able to more easily care for a population with 88% immunization coverage."
Le PM a la mauvaise habitude de prendre des d\u00e9cisions sans consid\u00e9rer les personnes vuln\u00e9rables. Parmi le 10% de non-vaccin\u00e9s, il y a des sans-abris, des sans-papiers, des gens atteints de probl\u00e8mes de sant\u00e9 mentale. \n\nVa-t-il leur envoyer une facture?— Gabriel Nadeau-Dubois (@Gabriel Nadeau-Dubois) 1641935335
MQRP's statement also discussed the "slippery slope" effect this measure could have in terms of opening the door to a health contribution system based on risk factors. Currently, health care taxes are collected based on income, which means they don't take lifestyles or pre-existing health conditions into account — even when those factors could increase the likelihood of people getting sick or injured.
For example, folks who do not regularly exercise and people with substance abuse issues aren't taxed more for health care.
"These are often seen as bad individual choices, while underneath lie complex social structures," MQRP said. It cited lack of education, lack of access to resources, like the internet and language barriers as reasons why people might not get vaccinated.
MQRP isn't the only group to bring up this argument.
"The PM has a bad habit of making decisions without considering vulnerable people. Among the 10% of the unvaccinated are the homeless, the undocumented, people with mental health problems. Will he be sending them a bill?" tweeted Québec solidaire leader Gabriel Nadeau-Dubois.
The Canadian Civil Liberties Association's director of fundamental freedoms and acting general counsel, Cara Zwibel, said in a statement that Quebec’s proposal "raises significant equity concerns."
"We have universal, public health care in Canada. We do not fine individuals who make poor diet and exercise choices, those who choose higher-risk occupations or recreational activities. Some essential services – like basic health care for those who are ill – transcend such individual choices."
The Charter & Health Act
The CCLA described the unvaxxed tax as a direct penalty "compelling 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 levy fines on those who do not agree 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 Toronto's University Health Network, the unvaxxed tax also goes against the principles of the Canada Health Act, which states that the Canadian health care policy's main goal is "to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers."
He tweeted, "as a physician who has never received a dollar from pharma i believe i have been as pro-vaccine as any in the country — because they save lives and our health care system. but quebec taxing individuals who are not vaccinated is regressive and will undermine the canada health act."
"Let's not rush things"
Some critics expressed more concern with the Coalition Avenir Québec, better known as the CAQ's approach to implementing the measure than the measure itself.
Parti libéral du Québec leader Dominique Anglade tweeted, "With arrogance, @francoislegault gives 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."
1/3 Aujourd\u2019hui, @francoislegault a choisi de diviser et de faire diversion. \n\nNous n\u2019avons rien entendu sur:\n Une rentr\u00e9e s\u00e9curitaire pour nos enfants; \n Plus de tests rapides;\n Une reprise des chirurgies.\n\nBref, rien pour rassurer les Qu\u00e9b\u00e9cois-es.\n#polqc #assnat— Dominique Anglade (@Dominique Anglade) 1641936421
Meanwhile, the Montreal Economic Institute, a non-profit think tank "promoting economic liberalism," called the tax "an interesting idea" with a "misguided application." The title of its press release? "Let's not rush things."
"The CAQ government's idea of modelling contributions to the health system according to certain characteristics of individuals is not far-fetched in itself. After all, it is the very basis of the insurance principle. However, in its current form, this contribution format strikes us as shallow and misguided," said Miguel Ouellette, economic and director of operations at the MEI.
Advocating for the very idea that MQRP characterized as the bottom of a slippery slope, Ouellette said the amount taxed shouldn't be random. It should be calculated based on a person's risk to the health care system, like 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 demonstrated in several European countries, such as Switzerland, that it is perfectly possible to maintain universal coverage for medically necessary care while using insurance-based financing. All that is needed is for the less fortunate to have their premium payments subsidized by taxpayers according to their income level," said Ouellette.
Despite these critiques, a Léger survey, conducted on the days leading up to the unvaxxed tax announcement, revealed that most Quebecers are in favour of adding measures related to vaccination status. However, the poll did not specifically ask about a tax.
This article's cover image was used for illustrative purposes only.
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