Overwhelmed by inflation, rising costs, more Quebecers need help to cover medical travel

Every few months, Nicole St-Jean and her nine-yearold son, Vincent, fly to Que‐ bec City from their home in Sept-Îles, Que., to see spe‐ cialists for issues related to his severe gastric reflux, asthma and allergies.

Their visits often last two weeks because Vincent can tolerate only one or two ap‐ pointments a day. He has autism spectrum disorder and is sensitive to sensory overload, said St-Jean.

All that time away is ex‐ pensive and requires a lot of planning.

A few years ago, a hospi‐ tal social worker connected St-Jean with Hope Air, a na‐ tional charity that provides free air travel to patients in fi‐ nancial need.

Since then, the charity has covered all of their flights and travel expenses.

Without Hope Air's help, St-Jean says it would be unaf‐ fordable for her to go back and forth to Quebec City.

"We'd have to cancel some (appointments) and try to prioritize which ones to go to," said St-Jean, who has four other children. "But it would be hard."

It's a predicament faced by many Quebecers who need to get medical treat‐ ment that is not available in their region.

Although the province re‐ imburses some travel ex‐ penses, patients need to pay upfront.

"When you leave, you don't necessarily have that money in hand," said St-Jean. "You get it when you come back, but the province does‐ n't reimburse the full cost."

In 2023, Hope Air provided over 400 return flights for patients in Quebec as well as hotel stays, meals and ground transportation.

In flights alone, that "rep‐ resents close to a 30 per cent increase, year over year," said Mark Rubinstein, Hope Air's CEO.

Founded in 1986, the charity helps patients access treatment for a wide range of issues, including cancer, heart disease and Alzheimer's. More than a third of the patients are chil‐ dren who have to travel be‐ cause of serious health prob‐ lems.

In Quebec, the charity typ‐ ically relies on donations and corporate sponsorship, but growing demand means that without an investment from the province, it may need to suspend or reduce its pro‐ grams, said Rubinstein.

"We know from our own surveys that well over a third of patients, if Hope Air didn't exist, would simply cancel or postpone their appointmen‐ ts," he said.

WATCH | Nicole St-Jean explains how Hope Air helps her family:

Travel policy compli‐ cated, time-consuming

Most of the patients Hope Air helps come from RouynNoranda in Abitibi or SeptÎles on Quebec's North Shore.

Rubinstein says patients typically fall into two groups: people who have trouble making ends meet on a week-to-week basis and those who are struggling with the rising cost of everything from rent, to mortgages to food.

"When you think about the fact that you have over 800,000 people in Quebec using a food bank on a regu‐ lar basis just to feed them‐ selves," said Rubinstein. "And then when you're faced with thousands of dollars in med‐ ical travel expenses, that sim‐ ply becomes unaffordable."

The travel policy for Abitibi's regional health au‐ thority doesn't cover flight costs and on Quebec's North

Shore, the province only pays for airfare if the patient lives in a remote area such as An‐ ticosti.

Most patients have to dri‐ ve but there's a 200-kilo‐ metre deductible for mileage.

"We're talking about a six-, seven-, eight-hour drive and in winter conditions, even longer," said Rubinstein.

Hotels and meals are also more expensive than the amount allocated by the gov‐ ernment, said Véronique Morneau, general manager of the Côte-Nord's complain‐ ts and assistance support centre, which fields com‐ plaints from patients who are dissatisfied with health-care services.

Just filling out all the nec‐ essary paperwork and get‐ ting the right approval can be complicated and time-con‐ suming, said Morneau.

Once the patient returns, they need to provide sup‐ porting documents from both their referring doctor and the doctor they consul‐ ted as well as all their receip‐ ts.

It can take weeks to be re‐ imbursed.

"Over the last few years, the increase in the cost of liv‐ ing is huge," said Morneau, who isn't surprised Hope Air has seen a surge in demand.

Throw in the added cost of taking time off work and organizing child care and

some patients decide it's not worth it.

"Many residents in our re‐ mote areas refuse certain treatments outside their re‐ gion," said Morneau.

$300K-$500K investment needed

Aside from donations and corporate sponsorships, Hope Air has funding part‐ nerships with most of the other provinces it operates in, such as Newfoundland, Saskatchewan and British Co‐ lumbia.

Last fall, the charity con‐ tacted local officials in both Abitibi and Quebec's North Shore and sent a letter to Health Minister Christian Dubé to discuss a similar arrangement, but it did not hear back.

The Quebec Cancer Coali‐ tion is now working with Hope Air to arrange a meet‐ ing.

"We know that we have a big issue with regional equi‐ ty," said Eva Villalba, the ex‐ ecutive director of the coali‐ tion, a non-profit patient ad‐ vocacy group dedicated to improving the Quebec health-care system for peo‐ ple affected by cancer.

"If we look at not just the incidence of cancer but more importantly, the mortality rates of cancer, they are poorer in more remote and rural regions of Quebec," said Villalba.

She believes the province's medical travel policy is outdated and does‐ n't reflect many people's cur‐ rent financial reality.

Villalba also doesn't think it's realistic or compassionate to ask people to spend hours driving to a medical appoint‐ ment.

"What if you have inconti‐ nence issues? What if you're tired? What if you're in pain?" asked Villalba. "A flight is a way better option, but obvi‐ ously, it's not accessible to all."

Rubinstein estimates Hope Air would need be‐ tween $300,000 to $500,000 from the province to meet the current level of demand in 2024.

The Ministry of Health said it does not have an agreement with Hope Air, nor are discussions under‐ way.

"If a request is submitted, it will be rigorously ana‐ lyzed," said Marie-Pierre Bli‐ er, a ministry spokesperson.

In an email, Blier said con‐ trary to what other provinces have in place, Quebec has a program that provides finan‐ cial support to users, regard‐ less of their income.

Last spring, Health Minis‐ ter Dubé announced that pa‐ tient travel allowances would be indexed annually to better reflect economic changes, said Blier.

Patients can also receive a tax credit to help them pay for certain expenses associ‐ ated with care obtained in another region.