Is Justin Trudeau really a Quebecer?

During the French debate on September 8, Justin Trudeau told BQ leader Yves Francois Blanchet, “You keep forgetting, I am a Quebecer. I’m a proud Quebecer, I’ve always been a Quebecer, I will always be a Quebecer.” This is not quite true. Born on December 25, 1971, at the Ottawa Civic Hospital, he attended elementary school in that city and did not move to Montreal until June 1984. Although he has represented a Papineau, Que.,riding since 2008, he sold his house in Quebec, and according to CBC, moved to Ottawa in 2013. In late May 2018, he voted in the Ontario provincial election. Read: MD as MPs: We asked some of the doctors in this federal election why they're running Trudeau has repeatedly made false claims about Erin O’Toole’s beliefs on vaccination, abortion, preservation of public medicare and enforcement of the Canada Health Act. Quebec does have a number of private diagnostic facilities, but so far Ottawa has not forced them to close. Of note is that I have, over the years, sent several patients to a private MRI facility across the river in Gatineau, Que. For about $750, the scan is performed in about 24 to 48 hours, and within a couple of days, a two-page report in perfect English is in in my electronic medical record. Patients concerned about the possibility of multiple sclerosis, a brain tumour, etc. find this quite acceptable, rather than waiting several months for a “free” MRI in an Ottawa hospital. To be emphasized is that this is perfectly legal. Healthcare is under provincial jurisdiction, and the Canada Health Act does not prohibit a person from travelling to another province or territory and paying for a private elective procedure. Read: Afghan crisis, health promises and an election called Quite different is the fact that Quebec has refused to sign the Reciprocal Medical Billing Agreement (RMBA), unlike all other provinces and territories. Under this agreement, physicians (except from Quebec) receive their normal fee by billing their own provincial health plan, which then collects from the home province or territory of the patient. Due to Ottawa’s inaction, likely hundreds of Quebec patients daily are forced to pay directly when they require out-of-province medical care. This pertains to West Quebec patients treated in Ottawa and other Eastern Ontario communities, persons who require unexpected care when on a vacation or business trip in another province or territory, and also for the first three months after a permanent move, when they are “covered” only by a Quebec medicare card that few non-Quebec MDs will accept. As Trudeau is a legal resident of Ontario, unlike his Quebec constituents, he has a fully portable Ontario health insurance (OHIP) card. Thus, when he visits a physician in Ontario or any other province or territory, he is not expected to pay out-of-pocket, and await partial reimbursement. Travel insurance is often unavailable for services supposedly covered by provincial health insurance; policies may also exclude complications of a pre-existing condition. Trudeau must know that since 1984, Quebec has been violating Section 11 of the Canada Health Act regarding portability. The CHA was passed unanimously, i.e., all Quebec MPs voted for it. He, as well as all previous prime ministers and federal health ministers have done nothing to enforce the Act. For example, in his December 13, 2019, Mandate Letter to Health Minister Patty Hajdu, he wrote, “Continue to ensure compliance with the Canada Health Act on matters of private delivery and extra billing.” Not one word about portability. Read: Saskatchewan gets flak for 'wrongheaded decision' to redeploy healthcare workers to COVID hotspots Enforcing Section 11 would benefit his “fellow Quebecers.” Sadly, they still feel like second-class citizens when they seek medical care outside of their own province. Yet Trudeau continues to be alarmist concerning the existence of a few private diagnostic facilities. For the average Quebecer, surely obtaining access to medical services across Canada without up-front payment is of far greater significance. In my opinion, for Ottawa to demand that Quebec at last provide fully portable medical benefits would not be a violation of provincial jurisdiction. We are talking about health care delivered outside Quebec. The jurisdiction of the treating physician is far more important than that of the patient. Initially, Quebec refused to sign the RMBA for fear that West Quebec physicians would protest being paid less for the same service than their counterparts in Ontario. However, the incomes of Quebec physicians doubled from 2005 to 2015. For 2018-19, according to the CIHI the gross incomes of Quebec MDs are third in the country ($414,019), exceeded only by Alberta ($446,378) and Manitoba ($418,017); Ontario ranks ninth ($350,534). These statistics undermine the previous arguments, and there is no logical reason for Quebec not to sign. Conservative leader Erin O’Toole has been softly endorsed by Quebec Premier Francois Legault. Might he persuade Legault, as a gesture of good faith, to finally sign the RMBA? This would not only benefit Quebecers who wish to travel to other parts of Canada, it would help to improve our tourism industry, which lost $24.9 billion in Ontario and $52 billion for all of Canada in 2021; this was largely due to a drop in American tourists. It might encourage many Canadians to visit Quebec, and many Quebecers to travel to Ontario, the Atlantic provinces, and the West. For him to help Quebecers to at last have fully portable health benefits would be a legacy demonstrating to all Canadians that O’Toole does indeed support our public health system. Dr. Charles S. Shaver was born in Montreal, moved to the U.S. at age 2, and returned to Canada in 1970. He is past-chair of the Section on General Internal Medicine of the Ontario Medical Association. The opinions expressed here are his own.

Is Justin Trudeau really a Quebecer?

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