All visitors to Canada should carry some health insurance
System can’t afford to provide free care, Charles Shaver says.
Much has been written about the failing system that has permitted an influx of refugees and illegal migrants especially via Quebec and Manitoba. While awaiting a decision on their status (which may take two years), they are covered by the Interim Federal Health Program. Yet the issue of health coverage for temporary visitors has been largely overlooked.
Two main groups are involved. The first is persons visiting for a few days. The second is relatives staying for many weeks or months.
Canada does not require medical insurance for a regular visitor visa, only for a super visa. Of note is that such insurance is required by Abu Dhabi and Dubai, Aruba, Belarus, Bulgaria, Cuba, the Falkland Islands, Latvia, Lithuania, Slovakia, and Russia, and possibly soon by Thailand. It is mandated for cruise passengers to Antarctica, and for those requiring a visa to the 26 countries that make up the Schengen zone of Europe.
Should Canada require insurance? After all, the number of overseas tourists is predicted to increase by 6.7 per cent this year. Vancouver saw a three per cent increase in tourism over 2016, including a 20 per cent increase in those from Australia, 15.4 per cent from Germany, and 12.9 per cent from Mexico.
Health insurance is increasingly needed to cover visitors injured unexpectedly in auto accidents, fires, floods, bridge collapses, and other disasters, and in the remote event of random shootings and other acts of terrorism. Consider a crash on Highway 401 south of Ottawa in early June that injured 37 Chinese tourists (three died), or the German tourist shot in the head west of Calgary in early August.
Because of the recent dispute with Saudi Arabia, the University of British Columbia may lose 20 medical residents and 24 clinical fellows. In Montreal, the impact is much greater, as 20 per cent of medical residents in hospitals come from Saudi Arabia. Not only would this cause a manpower shortage with longer waiting times for patients, but Canadian medical schools have been receiving about $100,000 for each Saudi. Hospitals and health professionals can now hardly provide free care to visitors.
Vancouver Coastal Health billed non-residents of Canada $43 million last year, but failed to collect from 20 per cent. Mandatory travel insurance would likely reduce the number of “bad debts.” The Canada Health Act precludes physicians from charging wealthier patients more to make up for those who are uninsured.
Admittedly, there are major limits to such insurance. It generally does not cover routine office visits to monitor hypertension, diabetes mellitus, et cetera. It is generally unavailable to those with pre-existing medical conditions, especially if there has been any change in medications within the previous three to six months.
Canada’s larger cities have become increasingly multicultural. Many new Canadians may wish to arrange for parents, grandparents, and other relatives from overseas to visit for weeks or many months. Yet many of these temporary visitors have pre-existing conditions that preclude the purchase of adequate health insurance. People who invite relatives to come to Canada are legally responsible for their support and for any hospital or physician bills incurred by them.
How can these problems be resolved? First, the Government of Canada should widely publicize by various media in many languages the fact that visitors to this country should purchase travel health insurance. Perhaps, despite its limitations, it should even be mandated for a stay of over a few days.
Second, possibly a company such as Medavie Blue Cross (which handles the RCMP and the military) could expand its coverage to include some of these high-risk visitors for critical illnesses requiring hospitalization. The relatives would be charged a significant premium per week. To contain costs, there should be a large deductible, and routine office visits and elective surgery would be excluded. This might mitigate the cost to these relatives, but also encourage them to keep the total length of stay of relatives to a shorter period of time.
It is Ottawa that allows all temporary visitors to enter the country. It owes health providers and hospitals the assurance that they will be fairly and promptly remunerated should any visitor require unexpected treatment while here.