Quebec’s vax tax will widen the inequality gap

Advocates working with Black and Indigenous communities say a proposal to make unvaccinated adults pay a financial penalty risks further entrenching inequalities in Canada’s pandemic response and adding another burden to the marginalized.

Quebec Premier François Legault announced Tuesday that the province is working on a health care “contribution” that would be charged to all adults who refuse to be vaccinated against COVID-19.

The plan landed as provinces try to navigate their response to the record number of cases, fueled by the more transmissible Omicron variant, which doctors warn threatens to overwhelm hospitals.

Legault’s government is still working out the legal issues, but the prime minister said the financial penalty will be “significant.”

That could be a problem for people who have been hesitant to get the vaccine because of historical and current injustices, or who face systemic barriers to accessing the vaccine, said Black Health Alliance CEO Paul Bailey.

“We know that that can further undermine public trust in governments or just trust in the vaccine, period,” Bailey said in an interview.

As of January 1, 2022, 87.6% of Canadians over the age of 12 had received two doses of the COVID-19 vaccine.

A report by the Black Opportunity Fund, the African-Canadian Civic Engagement Council and the Innovative Research Group found a 20-point gap between black and white Canadians who had received at least one dose of the vaccine between May 18 and June 4. 2021, according to a survey. of 2,838 respondents.

Because this was an online survey, a margin of error cannot be calculated.

“In parts of the country, say places like Toronto and Montreal, there are particular populations — black, racialized, low- and very low-income — that have a high COVID burden and lower COVID vaccination,” Bailey said.

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“We know that they are already living with the specter of poverty and many other inequities, whether it be food insecurity, housing insecurity. And so, for this specific population, taxing them only further entrenches those inequalities.”

Provinces do not keep socioeconomic or race-based data on who has or has not received a complete list of vaccinations. Several health equity experts say there is evidence that some have gone unnoticed.

Caroline Lidstone-Jones, executive director of the Ontario Indian Primary Health Care Council, said regardless of province, First Nations, Inuit and Métis populations have a history and real-life examples of mistreatment within of health systems, which must be addressed.

More recently, he pointed to the case of Joyce Echaquan, a 37-year-old Atikamekw mother of seven, who died in a hospital near Montreal of pulmonary edema related to a rare heart condition.

Before she died, Echaquan filmed herself on Facebook Live as a nurse and the nurse said insulting things about her, actions that were investigated as part of a forensic investigation that found systemic racism played a role in her death.

Lidstone-Jones said that when it comes to meeting the needs of underserved populations, it’s not that simple to announce vaccine availability because people don’t always have access to the Internet, where much of the education and health resources are located. .

“How do you tell someone who is worried about meeting their basic needs, that now I’m going to charge you because you can’t even meet your basic needs, you know, clothes, food, shelter?” she said Tuesday.

“That’s a really hard sell when someone may be worried about being out on the streets and being able to feed themselves or their families instead of having access to a vaccine.”

Dr. Nazeem Muhajarine, a professor of community health and epidemiology at the University of Saskatchewan, said the goal should be to help those on the fringes of society see that they belong in the medical system and that getting vaccinated protects not just them. but their families.

He said the policy of imposing a financial penalty on unvaccinated adults risks backfiring on those with low incomes and those who distrust the system.

Speaking more broadly, Muhajarine said it’s unclear how many vaccine hesitant will be forced to get a shot because of a new fee and said the policy has the potential to make people even more stubborn and blame the government. to behave as a “nanny state”. . “

Canadian Medical Association President Dr. Katharine Smart said the Quebec proposal speaks to how strained the health system is in parts of the country as leaders look for ways to protect hospital capacity long-term.

“None of these are things anyone wants to be doing.”

This Canadian Press report was first published on January 11, 2022.

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