Quebec residents have some of the highest vaccination rates in the world, yet the province has endured some of the most restrictive preventative health measures in the country. Curfews, vaccination passports, school closures, restrictions on travel, sports, and social gatherings, and continued mask . . .
and physical distancing mandates. Even those who have been fully vaccinated remain subject to the full extent of these restrictions.
Just a few weeks ago, the government introduced measures aimed specifically at the unvaccinated. Without a vaccine passport, Quebec residents are now denied entry to certain stores. In a more recent announcement, Premier Legault added financial penalties that will be levied against unvaccinated people.
It is fairly easy to understand the philosophy behind Legault’s policy, that there should be consequences for your actions, or inactions, in this case. That you should pay extra if you are wilfully endangering other people, or that may cause you to require hospital services, or worse.
Humans are known for injuring themselves doing reckless things, and the health-care system has mechanisms for handling the consequences of these types of behaviours. But if people are doing reckless things en masse, it overwhelms the system. This is what is happening now, with unvaccinated COVID patients accounting for 50% of ICU hospitalizations.
But, this has happened before. When opiate drugs were being prescribed without sufficient oversight, addictive behaviour and the resulting health consequences strained the hospital system. In response, medical professionals and the government made changes. By tightening prescription policies they reduced the likelihood of obtaining a generous supply of narcotics, which deterred drug seekers, and social services were allowed to divert patients toward clinics and other community resources.
What didn’t happen: a tax on drug addicts to pay for the creation and maintenance of these services.
Similarly, large percentages of the people requiring medical attention do so for reasons traceable to the use of tobacco and alcohol. Apart from the taxes we pay for the purchase of these products, there is no levy for the harm our choices make on ourselves and others or the burden it places on the health-care system, in particular, or the economy, in general.
By proposing an ‘unvax tax’ Premier Legault is standing at the precipice of a slippery slope. A fee to remain unvaccinated only punishes those least able to pay it, while letting those with sufficient wealth ignore it. It is, in this sense, regressive, much like speeding tickets and taxes on gasoline.
And it risks setting a precedent for “imprudence taxes” in the future, that could require patients to comply with preventative healthcare initiatives in order to avoid a fine. If we start charging people who use a disproportionate amount of healthcare services, what might this imply for those 65 and older, who account for just 17% of the Canadian population yet use about 44% of all public-sector health care dollars spent by the provinces and territories?
This is the start of a bandwagon we shouldn’t jump on. It shifts the focus of our attention away from some of the other things that should be addressed. Like healthcare spending per capita, in Quebec, which is one of the lowest in the country, as it has been since before the pandemic. Yes, COVID broke the system, but it was already underfunded and cracks were showing.
After two years to address the problem, there should be a measurable, noticeable increase in resource allocation toward managing the increase in need. The first step is to acknowledge the necessity of expanding the scope of Quebec’s ICU capacity, and prioritizing infectious disease management in such a way that there is confidence in the government’s methodology.
We need investment in health care, and a solution that doesn’t rely on scapegoating unvaccinated patients — they are merely the straw that broke the camel’s back.
