“You keep forgetting, I am a Quebecer. I’m a proud Quebecer. I’ve always been a Quebecer, I will always be a Quebecer.” – Justin Trudeau
The Liberal leader uttered these words to BQ leader Yves François Blanchet on Sept. 8, during an animated exchange in the French debate.
They are far from 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, Quebec 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.
The debates are over, and voting will occur on Election Day. Canadians expect the new Prime Minister to exhibit honesty and the ability to relate to the average person. Trudeau has been lacking in both areas. As Navigator CEO Jaime Watt wrote in the Toronto Star, “If the debates confirmed anything, it’s that this campaign is boiling down to one thing: trust.”
His credibility is undermined by multiple broken promises from his last mandate. These include clean drinking water for all Indigenous communities by late March 2021, pharmacare, affordable housing, electoral reform, and a balanced budget (even before the pandemic occurred).
Quebec has refused to sign the Reciprocal Medical Billing Agreement (RMBA), unlike all other provinces and territories. Under this agreement, physicians in Alberta would receive their normal fee by billing their own ministry of health, which would then collect from the home province of the patient. Due to Ottawa’s inaction, likely hundreds of Quebec patients daily are forced to pay directly when they require medical care in another part of Canada.
Inasmuch 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, he is not expected to pay out-of-pocket, and await partial reimbursement.
He must know that since 1984, Quebec has been violating Section 11 of the Canada Health Act regarding portability. The CHA was passed unanimously, ie all Quebec MPs voted for it. For Ottawa to demand that Quebec provide fully portable medical benefits would not intrude on provincial jurisdiction, as this concerns care delivered outside Quebec. 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, from 2005-2015, the incomes of Quebec physicians doubled. For 2018-19, according to the CIHI, gross incomes of Quebec MDs are third in the country, and Ontario ranks ninth.
Trudeau, as well as all previous prime ministers and federal health ministers have done nothing to enforce the federal law. For example, in his December 13, 2019 Mandate Letter to Federal 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. Ironically he did mention implementing pharmacare – another promise that has dropped off the radar.
Enforcing Section 11 of the CHA would benefit his “fellow Quebecers.” Sadly, they still feel like second-class citizens when they seek medical care outside of their own province. Unlike Trudeau, most do not have the financial resources to pay out-of-pocket for urgent care in another part of Canada. Also, unlike Trudeau, they do not have a fully-portable medicare card. For the average Quebecer, obtaining access to medical services across Canada without up-front payment would be far more important that permitting a few private facilities to exist in their province. No wonder that a recent Leger poll found that 30 per cent of voters agreed that Trudeau “seems out of touch with the concerns of ordinary Canadians.”
The Federal Conservative Party has been softly endorsed by Quebec Premier Francois Legault. Might Erin O’Toole possibly persuade Legault, as a gesture of good faith, to sign the RMBA? For him to help Quebecers to at last have fully portable medical benefits would be a legacy demonstrating to all Canadians that O’Toole does indeed support our public health system.
Ottawa physician Dr. Charles S. Shaver was born in Montreal. He is past-chair of the Section on General Internal Medicine of the Ontario Medical Association.