Health care has been largely overlooked in the debate over Alberta's potential separation from Canada, according to a new opinion piece by Charles S. Shaver in the Calgary Herald. Premier Danielle Smith has estimated startup costs for an independent Alberta at about $400 billion. On Oct. 19, a referendum will ask whether Alberta should remain in Canada. In Quebec, the PQ leader pledges to hold a third referendum on independence if he wins the October election. Anywhere from 18 to 30 per cent of people in both provinces favour separation.
Lessons from Brexit
David McLaughlin, a former cabinet secretary from Manitoba, has written about the side-effects of Brexit, including a 15-per-cent drop in imports and exports, a six- to eight-per-cent drop in GDP, and a 12- to 18-per-cent decline in investment. However, often overlooked would be the loss of portable health benefits in the rest of Canada.
Impact on Health Care Access
If a province voted to become independent, many physicians, nurses, and other health care workers would leave. Remaining citizens would no longer be protected by the Canada Health Act of 1984. They would become “non-residents of Canada” when seeking hospital or medical/surgical care in another province. After a permanent move, they would not have health coverage in their new province for three months.
Direct Billing for Non-Residents
Should Alberta or Quebec become independent, its residents would be billed directly by hospitals in other provinces. Hospitals require payment before elective surgery or discharge. For example, St. Paul’s Hospital in Vancouver charges $1,355 for an emergency department visit, $4,690 daily for a standard room, and $13,110 for an ICU bed. Vancouver General has a rate of $18,105 daily for the ICU. An urgent-care visit at Victoria Hospital in Winnipeg is $1,452; a standard four-bed room costs $3,066 per day. At Sunnybrook Hospital in Toronto, a standard room is $4,100 to $4,400, and an ICU bed $6,400 to $6,600 daily.
Travel Insurance Gaps
Alberta and Quebec currently pay a maximum of $100 daily for in-patient care outside the country. Creating new reciprocal health agreements between an independent province and each other province might take years. Meanwhile, travel insurance is often difficult to obtain, with caps on total coverage and exclusions for complications of previous illnesses such as diabetes, cardiac disease, or cancer. If even the dose of a medication has changed within 60 to 90 days, the claim may be rejected. Most policies do not cover dangerous sports or activities, especially claims for injuries if under the influence of alcohol or illicit drugs.
