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LETTER: All provinces should cover out-of-country health costs


Nova Scotians believe health care has declined in the province over the past three years, according to a recent study by a market research firm.
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Should Newfoundland and Labrador follow the lead of Ontario? Premier Doug Ford plans to cancel government health coverage outside of Canada. Or perhaps should it, like other provinces, instead increase their coverage for health claims outside of Canada and follow the examples of P.E.I. and the territories?

For emergency care outside the country, most provinces pay up to the rate that their own physicians would have received. P.E.I. follows the requirement of the Canada Health Act and pays $1,169 for a standard room and $2,712 per day in the ICU.

The Northwest Territories reimburses up to $2,741 for a standard room and $9,092 for an ICU bed. Yukon pays up to $2,010 and Nunavut $2,730 daily for all inpatients.

All other provinces pay much less.

The Newfoundland Hospital Insurance Plan pays a maximum of $350 per day for a stay in a community hospital, and $465 in a tertiary one. New Brunswick, Quebec, Saskatchewan, and Alberta pay up to $100 per day, Ontario $400, Nova Scotia $525, Manitoba $570, but British Columbia only $75.

All urge persons to obtain private insurance.

However, some persons cannot qualify for or afford it. They may have severe pre-existing illnesses or have changed the dose of medications recently.

Most claims involve care in the United States. To be true, 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.

Many residents of larger Canadian cities come from Third World countries. Thus many of them may travel to visit relatives and friends in countries in which daily hospital charges are surprisingly low.

Bill Frezza recounts (FEE, July 10, 2017) how his wife spent four days in a Beirut hospital with two days in the ICU, an MRI and a CT scan, etc. and the total hospital bill was one tenth what it would have been in Boston.

An increase in out-of-country payments would permit many to travel with government coverage not dependent on previous good health.

Their physicians could then fine tune their diabetic, antihypertensive, and heart failure medications shortly before they leave Canada.

If this loss of coverage dissuades new Canadians from visiting relatives back home, some may instead ask their parents and grandparents to come for a prolonged stay in Canada. Many of these elderly patients have pre-existing conditions, and may not be adequately insured.

This would put an added burden on our own health-care system.

Cancellation of out-of-country coverage would violate the Canada Health Act, but all provinces except for P.E.I. have been violation the Act for many decades.

This puts the federal Health minister and the Prime Minister in a most difficult situation. After all, on Feb. 7, Justin Trudeau stated, “We have acted in the past when provinces have not aligned themselves with the Canada Health Act.”

However, in addition, he should also address Quebec’s longstanding violation of a different part of Section 11 of the Canada Health Act (CHA). That province pays only its own rate when its residents receive medical care in another province, although the CHA clearly indicates that the host-province rate is to apply.

Trudeau should not criticize Doug Ford if he is unwilling to penalize Quebec for its own violation of the CHA. However, the above examples demonstrate that most provinces have also been flagrantly violating part of Section 11 of the Canada Health Act and getting away with it. Meanwhile, Ottawa has selectively been enforcing only parts of the CHA on certain provinces. 

Surely, after 35 years, it is time for the federal government to update and amend this legislation. Canada’s health delivery system ranks near the bottom in terms of efficiency as well as patient and physician satisfaction.

In addition to pipelines and the world marketing of Canadian oil, this should be an issue for discussion when the premiers meet in Saskatoon on July 9-11 for the Council of the Federation.

Charles S. Shaver,
Ottawa, Ont.


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