LETTER

Election: travel & health coverage 

Health should be on the agenda of this election. A recent Ipsos poll revealed that 11% of voters are undecided; 32% in Ontario and 31% in Quebec, and 2/3 were women. Health was ranked at 45% - by far the most important issue. 

Health delivery is provincial, (but) Ottawa should facilitate access across Canada and in other countries. Within Canada, hospital benefits are portable (but) Quebec refuses to provide portable physician benefits. Quebec residents pay out-of-pocket to see a physician (in Ontario), and then await partial reimbursement. 

Canadians also face inadequate hospital coverage outside the country for two reasons:

Hundreds of drugs are on “back-order” (since 2010), so physicians switch to similar drugs (but these)  may have different side effects and the change could invalidate travel insurance policies.

The Canada Health Act requires that outside Canada, government insurance must cover the cost of equivalent services in a patient’s home province, but provinces have been reimbursing only token amounts. This occurs only for physician fees. 

If provinces were eventually forced to comply with the CHA, using data from the Canadian Life and Health Insurance Association, I estimate that this would require an increase of one per cent of the Canada Health Transfer. It seems affordable, considering that in the last fiscal year, Ottawa’s own revenues rose by 6.7 per cent.

Charles S. Shaver, MD

Ottawa