A health care tax.
I am writing those ominous words sitting in a hospital emergency ward. Belleville General, emergency bed three.
A few days ago, I was biking in minus-twenty weather – I go out every day, year round – and wiped out.
Smashed my head, hard, on the ice that had – until that point – hidden it’s presence. Did you know that the human head bounces when it hits hard stuff? Mine did. Bang, bang.
I was wearing a helmet, which probably saved my life, but it didn’t mean no problems. Problems aplenty lay ahead.
Felt dazed. Didn’t black out. Bike mirror broken, bike scraped up. Because I’m a stubborn Irish bastard, I kept riding a bit, on asphalt. Then home.
The trouble started the next morning. Headaches, out of it (more than usual), and a lot of vision gone in my right eye.
I didn’t want to end up here in emerg, but my doc wanted to rule out a “brain bleed,” quote unquote. Despite being a stubborn Irish bastard, I relented.
So began my journey through an overburdened, overworked health care system. And you know why. We all know why. Underfunded by Ottawa, overwhelmed by a virus that has cancelled the future.
Sitting on assorted waiting-room chairs, I (naturally) did what I wasn’t supposed to do, and read the online response to Quebec Premier Francois Legault’s latest pandemic gambit: taxing the unvaccinated.
Punitive or proper? Unfair, unwise? Or right and reasonable?
Every other columnist in Canada has taken a whack at Legault’s plan, by now. But no one, to my knowledge, has done it from the perspective of a hospital bed. So here goes.
Legault is assisted by public opinion. Since Summer 2021, give or take, Canadians have overwhelmingly favored the vaccination side.
A considerable number, in fact, have favored actually punishing those who choose to be unvaccinated. Like, really punishing them: denying them employment, denying them mobility, denying them benefits – including health care benefits.
Legault is a politician, a popular one, and he’s seen the polling. His tax-the-unvaxxed policy will be popular. Count on it.
Before heading to the hospital I talked to a former Prime Minister about it. We agreed it won’t violate the Canada Health Act – various provinces have assessed health care premiums in the past. In my home province of Alberta, for example, I was denied health care because I – a penniless law student – hadn’t paid my premiums. Healthy or not.
Other jurisdictions in the world have been tougher than Legault. Austria plans to hit up the unvaccinated with penalties in excess of $20,000 a year. Greece has said it’ll do likewise, albeit for a smaller price tag.
So Legault has public opinion and precedent on his side. But what about constitutionality and fairness, which are intricately related?
Constitutions are documents which are all about equality – about ensuring all citizens are equal. Legault’s policy clearly (and proudly) discriminates against an identifiable group.
It doesn’t, or shouldn’t, matter that the group in question is stupid and reckless. Constitutions are arguably crafted to protect the reckless as well as the virtuous. Litigation is inevitable. A predictable result isn’t.
And what about fairness? Is Legault being unfair? Perhaps, but no more than the ten per cent of unvaccinated Quebeckers who are occupying 50 per cent of the province’s hospital beds. They’re being unfair, too. They’re putting their fellow citizens at risk.
From my perspective in emergency room three, I think Legault will get away with it. Mainly for one reason: because it’ll be popular.
People are tired of this. They’re mad, they’re sad, they’re fed up. They will vote for any politician who can promise them a speedy end to the pandemic.
And Francois Legault knows it.
Here’s a cautionary tweet. That mess on my @KaliCanada helmet is where my head would have hit the ice, at about 30kph, had I not been wearing it. Elbow, knee and hip hit, too, but helmet first, hard. Thanks, @KaliCanada: you saved me.— Warren Kinsella (@kinsellawarren) January 10, 2022
Always wear your helmet. pic.twitter.com/VlNcDDqhzz
As the pandemic grinds on, as more and more of us get infected, there’s lots of blame to go around.
Anti-vaccination spreadnecks, for making a bad situation much worse. Inept politicians, who falsely claimed that the pandemic was coming to an end, or that it was nothing to worry about. Canada’s federal government, for mishandling everything from vaccine procurement to border crossings.
The framers of Canada’s Constitution deserve some blame, too, even though it’s arriving more than a century late. Let us explain.
Responsibility for health care — and, critically, responsibility for the financing of health care — isn’t clearly addressed in our Constitution. Hard to believe, but it isn’t.
Federal responsibilities are listed in Section 91. Provincial responsibilities are detailed in Section 92.
But as no less than the Supreme Court of Canada ruled in 1982: “Health is not a matter which is subject to specific constitutional assignment but instead is an amorphous topic which can be addressed by valid federal or provincial legislation, depending (on) the circumstances.”
“Amorphous?” And: “Depending on the circumstances?”
You don’t need to be a constitutional scholar to recognize the problem created by this constitutional fuzziness. It is a sure-fire formula for federal-provincial squabbling over the funding of health care. And, in the intervening 155 years, there’s been plenty of squabbling — because, on average, health care costs more than any other program.
In Ontario alone, the biggest program areas are hospitals ($25.8 billion) and the Ontario Health Insurance Plan (which is made up of physicians and health practitioners, at $17 billion). Taken together, those two expenditures alone account for 58% of the health ministry spending planned for this year. Nearly 60%, and growing every year.
And in the decade leading up to the pandemic, provincial health-care spending grew by nearly 120%. That’s a formula for bankruptcy.
Throw in a pandemic, then, and you’ve got a fiscal crisis that defies description. COVID-19 has overwhelmed our doctors, nurses and hospitals — and has completely gutted provincial health budgets, and budgetary planning.
Because constitutional responsibility for providing health care, you see, has fallen mainly to the provinces. And responsibility for funding much of it is the role of the Justin Trudeau government.
The Trudeau regime repeatedly claims to “have Canadians’ backs” during the pandemic. But it simply doesn’t.
In September, the premiers and the prime minister met to discuss the health funding catastrophe. The premiers of the two biggest provinces, Doug Ford and Francois Legault, were quite specific: They told Trudeau the provinces need the federal government to do more.
Ford and Legault and others wanted Trudeau to increase health-care transfers to the provinces by $28 billion this year. That would boost the $42-billion transfer the provinces receive to $70 billion.
“We’re here to ask the federal government: Step up to the plate,” Ford said. Legault, meanwhile, issued a warning to the federal Liberal leader: “Don’t come and invent all sorts of new programs and new spending when the priority of Canadians is to properly finance health care. And right now it is not well financed.”
And it isn’t. Anyone on a waiting list, anyone seeking a vaccination or a booster, anyone who has tried to see a doctor or get a hospital bed knows that the Canadian health system isn’t at a cliched “breaking point” anymore. It’s broken.
The pandemic is the biggest personal, political, cultural, and economic event of our collective lifetimes. None of the other fetishes of the Trudeau government — like approving hefty pay hikes for its MPs — come close to being as important.
More than perhaps at any other time in our 155-year history, we need to properly fund health care. We need to dramatically step up our efforts to fight and beat COVID.
Our Constitution may not have addressed that.
But Canada needs to, now, if we are ever to be free of the prison that is the COVID-19 pandemic.
— Warren Kinsella is a lawyer and former Chief of Staff to a federal Liberal Minister of Health
A new year!
People make resolutions. People make promises. People promise to do things differently.
It’s likely that there have been fewer resolutions this time. Why? Because people have been hoping for a different kind of year. Because the resolutions they made a year ago didn’t work out so well.
2020 (most of it) and 2021 (all of it) were pretty awful. That’s stating the obvious in a way that is beyond obvious. You know that.
You also know: There has been so much death — more than five million people, globally. Five million lives, snuffed out. The statisticians and epidemiologists figure that it’s twice that number, if not more.
And the sickness, so much sickness that it is beyond measure. Millions and millions and millions of people, made terribly ill. All of us know people who are still struggling, more than a year after the fact. We love them and pray for them. That’s all you can do, some days.
Jobs lost. Businesses and careers lost. Worst of all — faith lost.
It’s terrible. It’s horrible. It’s so depressing and awful and sad. Will it ever end? As Ontario announces its millionth lockdown, as faith fades, it’s a fair question to ask.
So let me tell you something. My Dad — Dr. Doug Kinsella — was an immunologist. I remember him coming home, in Montreal, and telling us about this new virus.
They called it 3H, he said.
The “3H” were those who had been disproportionately targeted by the new virus: Haitians and heroin users and homosexuals. They didn’t have a name for HIV/AIDS, yet. But my father told my brothers that it would kill millions of people around the world before we would know how to deal with it. And it surely did.
Viruses are smarter than us, my Dad said. They change quickly. They mutate quickly. They have a little regard for borders or rules or pity.
But he also told us this: that, through our ingenuity and our science and our sheer determination, we always conquer these things. We push back the awful Black Tide. We prevail, in the end.
We will prevail with the Satanic COVID-19 virus, I think. My Dad isn’t here, now, but I believe that he’d tell us that.
I think it will take another year, at least. I don’t think we are out of it yet. Persuaded by Pulitzer-winning health writer Laurie Garrett, I’ve always believed it would take at least three years to prevail over COVID. To get back to some semblance of what we once had.
Personally, I’m amazed that I haven’t gotten it yet. Truly. At the start, I said publicly (and say again) that I would not be placed on a ventilator. That I was determined to die differently.
I still feel that it is going to catch up to me. It’s been nipping at my heels, and I can feel it’s icy breath, and I’m pretty sure it will catch me.
Whenever and whatever happens, it will not beat me. It will not beat you, either. It will not beat us.
I have no science or reports or columns of statistics to show you, to convince you. I just believe that we will prevail, in the end, because we must. Because we have no choice. Because we have to live. We have to keep going.
That is not a resolution for 2022. That is not a prayer. That is my prediction for the twelve months that lay ahead of us, which are already looking like a battlefield.
We will win. We will beat this. Believe it.
And you and we will meet at the other end – me maybe in spirit – and we will have a drink together, and we will toast our resilience and our strength and our determination and our grace.
— Warren Kinsella was special assistant to Jean Chretien