Should B.C. follow the lead of Ontario and threaten to cancel government health coverage outside of Canada? Or should B.C. increase its coverage for health claims outside of Canada? The answer is far from simple.
Most provinces pay up to the rate that their physicians receive when people require foreign medical care. For hospital care, Alberta, Saskatchewan and Quebec pay up to $100 per day. Ontario pays $400, Nova Scotia $525, Manitoba $570 but B.C. only pays $75. All those provincial governments urge persons to obtain private insurance when travelling abroad.
However, some persons cannot qualify for or afford private travel insurance. They may have severe pre-existing illnesses or have changed the dose of their medications recently.
Most claims involve care in the United States. Provincial governments now cover only a small percentage of these potentially catastrophic hospital bills. Yet not all of the Canadians who leave on business or vacation travel to the U.S. or Europe have coverage.
Many residents of the Lower Mainland, Toronto and Montreal come from developing countries or China. Thus many of these new Canadians may travel to visit relatives and friends in south and east Asia, Mexico, Lebanon or other countries in which daily hospital charges are surprisingly low. As an example, the existing Ontario provincial health coverage would have been sufficient to cover most or all of these bills. This would permit many to travel with government coverage not dependent on previous good health.
If this loss of coverage dissuades new Canadians from visiting relatives back home, some may ask their parents and grandparents to come for prolonged stays in Canada. Many of these elderly patients have pre-existing conditions and may not have adequate medical insurance coverage. If they needed health care, it would put an added burden on our healthcare system.
As a result, some provinces — especially B.C. — should significantly increase their out-of-country health coverage. What would be fair? You decide. Consider that the B.C. government pays Ontario hospitals according to an interprovincial schedule set by each province. The rate for a standard room is $1,010 a day at a community hospital and $1,958 at the main teaching hospital.
Cancellation of out-of-country coverage, as proposed by Ontario Premier Doug Ford, would violate the Canada Health Act. This could put the federal health minister and the prime minister in a difficult situation.
Justin Trudeau might intervene. After all, on Feb. 7, he said, “We have acted in the past when provinces have not aligned themselves with the Canada Health Act.”
However, to be consistent, he should also address Quebec’s longstanding violation of a different part of Section 11 of the act. That province pays only its own rate when its residents receive medical care in another province, although the act clearly indicates that the host-province rate must apply.
This affects persons in West Quebec who seek specialized services in Ottawa and Quebecers who are treated for unexpected accidents or illnesses while on vacation or on business trips elsewhere in Canada. It also impacts Quebecers during the first three months after a permanent move to another province or territory. All usually pay directly and are later partly reimbursed.
Trudeau should not criticize Ford if he is unwilling to penalize Quebec Premier Francois Legault for his own violation of the Canada Health Act. Persons deserve to be treated equally under federal law in every province and territory.
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