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"A Question Of Equity": Quebec Announces "Significant" Anti-Vax Tax

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Dr. Katie Spalding

Katie has a PhD in maths, specializing in the intersection of dynamical systems and number theory.

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(Montreal, April 2021) Only one in ten Quebecers are still unvaccinated, but they take up nearly half of ICU beds. Image: Marc Bruxelle/Shutterstock

Quebec, the second-most populous province of Canada, has announced a new measure aimed at quelling the spread COVID-19: a health tax on the unvaccinated.

Provincial Premier Francois Legault said in a news conference on Tuesday that Quebecers who refuse to get vaccinated without a valid medical justification “will have a bill to pay” – a move which he described as “a question of equity.”

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“There are consequences on our health-care network and it's not up to all Quebecers to pay for this,” the premier said.

“Right now, these people, they put a very important burden on our health-care network. And I think it's normal that the majority of the population is asking that there be a consequence.”

While the exact details have yet to be decided, Legault said that a tax of CA$50 or CA$100 ($40-$80 US) would “not [be] significant” enough in his view. Residents with a medical exemption would not face the tax, but otherwise it would apply to all adults in the province who fail to get their first dose of the vaccine within “the next few weeks,” the premier said.

The announcement has already proven controversial, with Prime Minister Justin Trudeau saying Wednesday that Ottawa was watching the development “with interest.”

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Not only would such a tax be “one of the strictest COVID-19 health measures in Canada,” per local media, but experts have also raised concerns that it could violate a key principle in Canadian law: the idea that everyone should have equal access to healthcare, without facing financial (or any other) obstacles.

“I've not seen anything like this in Canada before,” Danyaal Raza, a doctor with Unity Health in Toronto and former chair of Canadian Doctors for Medicare, told Reuters. “I'm worried about the precedent it would set.”

Others doubt that the plan will work as intended. Speaking to CTV News on Wednesday, bioethics professor Vardit Ravitsky said she was concerned that the tax would backfire and increase inequalities already sharpened by the pandemic.

“From an ethical perspective, we're trying to select public health interventions that are the most equitable and just possible,” she said. “This… does not respect this principle.”

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“I think it would be more equitable to increase the pressure to vaccine passports than to target again individual's pockets,” she added. “$100, $500 may mean almost nothing for some families and may be an incredible burden for other families.”

Nevertheless, as Canada faces the rapid spread of the Omicron variant, Quebec’s health system is starting to feel the strain – and the province has already had to take drastic measures to try to cope with the surge.

While only around one in ten Quebecers are now unvaccinated, they make up nearly half of those in intensive care units, according to provincial data.

“We've gotten to a point where it's become very difficult to get that final sort of 10 or 15 percent of people across the finish line,” said Canadian Medical Association president Dr Katharine Smart in an interview with CTV News.

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In that respect, at least, the plan may already be a success: more than 7,000 Quebecers registered to receive their first dose of the vaccine after the plan for an anti-vax tax was announced on Tuesday.

“Our highest in several days,” Quebec Health Minister Christian Dubé tweeted after the figures were announced. “This is encouraging.”


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