Quebec’s plan to tax people who remain unvaccinated against COVID-19 faces serious legal and logistical hurdles, according to researchers and civil liberties advocates.
Announced with few details on Tuesday, the policy would charge a “significant” fee to those who haven’t received their shots, as compensation to the province for their disproportionate rate of hospitalizations and to encourage vaccination, Premier François Legault said.
Critics accused the government of endangering Quebeckers’ Charter rights and choosing a punitive, inefficient way to get people inoculated. Other provinces have ruled out similar moves.
There is some evidence Quebec’s campaign to make life difficult for the unvaccinated is having an effect. Health Minister Christian Dubé tweeted on Wednesday that about 7,000 people made appointments to get their first dose on Tuesday, up from about 5,000 the day before.
First-dose appointments also increased after Quebec announced last week it would require vaccination passports to enter provincial liquor and cannabis stores. Mr. Dubé has promised to expand this to other non-essential retail, such as hair salons, in the coming weeks.
Quebec is under a strict lockdown and a 10 p.m. curfew as Omicron infections overwhelm hospitals. The unvaccinated make up about 10 per cent of Quebec’s adult population and 50 per cent of its intensive-care admissions, Mr. Legault said on Tuesday.
Legal scholars and activists attacked the principle of making Canadian residents pay for declining a form of medical treatment, even if doing so imposes a cost on others.
“We don’t tax people, or penalize them, for example, for cirrhosis of the liver because they drink too much or engage in self-destructive behaviour,” said Pearl Eliadis, associate professor at the Max Bell School of Public Policy at McGill University. “The Canada Health Act was made with this idea that there is no moral culpability attached to your behaviour and therefore to your access to the system. And that includes behaviour that could endanger other people.”
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The tax will not be charged at hospitals in exchange for health care, the Premier said, but will be more like the premium Quebeckers pay for public prescription drug insurance, which is collected through income tax returns.
Miguel Ouellette, an economist with the Montreal Economic Institute, an independent conservative public policy think tank, said shaping financial contributions to the health care system based on the characteristics of individuals isn’t completely far-fetched. The same principle is the foundation of insurance.
But he said the measure as it’s currently articulated seems “superficial and ill-advised.” The health contribution of unvaccinated individuals should not be determined based on an arbitrary measure but according to actuarial calculations of risk, he said. And to be consistent, billing based on risk would have to be applied to other cases, for example, smokers or people who take part in extreme sports.
The Canadian Civil Liberties Association pointed out that the Charter of Rights and Freedoms recognizes people’s individual autonomy over their bodies and medical decisions. Cara Zwibel, acting general counsel for the association, said she wondered how the government would enforce the policy.
“If people don’t pay, do people end up in jail because they refuse to be vaccinated?”
Prime Minister Justin Trudeau declined to comment on Quebec’s plan, saying he needs more information. Mr. Trudeau said at a news conference on Wednesday in Ottawa that the goal of any such policy should be to encourage vaccinations and be in line with the values of the Canada Health Act.
“The details are important. We need to know exactly the measures being put in place, and there’s work to be done on that,” Mr. Trudeau said. “... We need to understand how this proposal from Quebec will work, so that we can be assured that it will be effective, that it’s doing the right thing and that it’s in line with our values.”
Federal parties avoided making direct comments. The Bloc Québécois said the matter is within provincial jurisdiction. The New Democrats said they hadn’t yet reviewed the policy with their full caucus, and the Conservatives did not respond to a request for comment.
Ontario’s Chief Medical Officer of Health, Kieran Moore, ruled out a Quebec-style policy on Wednesday in Toronto.
“We have not made that recommendation to government ever throughout this pandemic. It’s not one that we would bring forward. It does in my mind seem punitive,” Dr. Moore said.
British Columbia will not follow Quebec, the province’s Health Minister, Adrian Dix, said on Tuesday.
“I can say, definitively, we will not be proceeding with a similar measure in B.C.,” he told reporters at a briefing.
He said B.C.’s vaccination campaigns have been “exceptionally successful.”
With a report from The Canadian Press
Editor’s note: An earlier version of this story misidentified Pearl Eliadis's position at McGill University.
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