Provincial independence means loss of portable health benefits

During the many decades that I practised internal medicine, at times I would warn patients about the potential adverse effects of medications or procedures. No one accused me of scare-mongering. [...]

To continue reading, please subscribe: Digital Subscription One year of digital access for only $205* - Enjoy unlimited reading on winnipegfreepress.com - Read the E-Edition, our digital replica newspaper - Access News Break, our award-winning app - Play interactive puzzles To continue reading, please subscribe: Add Free Press access to your Brandon Sun subscription for only an additional $1 for the first 4 weeks* During the many decades that I practised internal medicine, at times I would warn patients about the potential adverse effects of medications or procedures. No one accused me of scare-mongering.

Most thanked me for spending the time so that they could make an informed decision. Similarly, Albertans and Quebecers need a full discussion of all the risks of amputating themselves from Canada. On Oct. 19, Albertans will vote on whether to have a referendum on independence.

Also, if the Parti Québécois wins the early October election, Paul St-Pierre Plamondon has promised to hold a third referendum on Quebec independence, likely toward the end of his mandate. An Ipsos poll found that 15 to 18 per cent of Albertans were committed to separation. Meanwhile, CTV and Global polls found that 26 to 29 per cent of Quebecers favoured separation, a historic low.

About 62 to 71 per cent rejected having a third referendum. Alberta Premier Danielle Smith estimated that start-up costs would be about $400 billion. The Calgary Chamber of Commerce warned that Alberta would forego $10 to 15 billion in investment in the first year.

Few have mentioned the effects on access to health care within an independent province or elsewhere in Canada. A vote for independence would cause many physicians, nurses, and health professionals to flee, for they are quite mobile. CBC reported on June 27 that from October 2025 to June 2026, the College of Physicians and Surgeons in New Brunswick granted 47 licences and received 156 applications from Quebec physicians.

Also, between late October and mid-November 2025, nearly 300 Quebec physicians applied to work in Ontario; over half were family physicians. Moreover, after independence, residents would no longer be under the protection of the Canada Health Act. They would be treated as “non-residents of Canada” when seeking health care in another part of Canada.

After a permanent move, they would not be covered by their new provinces for three months. Since 1984, the Quebec government has ignored Section 11 of the Canada Health Act, and is the only province that has refused to sign the reciprocal medical billing agreement which covers out-of-province medical/surgical care for most Canadians. Sadly, Ottawa has refused to enforce the law.

As a result, last year, Quebecers paid out-of-province MDs $12.6 million but were reimbursed only $2.3 million. This is because physicians in the rest of Canada legally charge Quebecers the same rate as “non-residents of Canada.” Residents of an independent Alberta would suddenly also be charged fees two to five times those in the schedule of benefits by physicians in other provinces and territories.

Moreover, should Quebec or Alberta become independent, its residents would then be billed as foreigners by hospitals in other provinces with payment required prior to discharge or before elective surgery. I recently obtained these rates for “non-residents of Canada.” 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. At Sunnybrook Hospital in Toronto, a standard room is $4,100 to $4,400 and an ICU bed, $6,600 to $8,400 per day. The Queensway-Carleton Hospital in Ottawa bills $1,242 for an emergency or outpatient clinic visit, plus $4,005 for a standard room and $15,642 for the ICU.

Developing new reciprocal health agreements between an independent province and each other Canadian province could take years. Travel insurance is often difficult to obtain, with caps on coverage and exclusions for complications of previous illnesses such as diabetes, congestive heart failure, coronary disease or cancer. If one has even changed the dose of a medication within 60 to 90 days, a claim may be rejected.

In the 524-page PQ blueprint document, there is no mention of the cost independent Quebecers would incur for hospital care in the rest of Canada. The PQ invites the 20,000 members of the Canadian Armed Forces in the province to join a new Quebec army. It fails to warn them that they would lose their “spectrum of care” health coverage, which covers hospital, medical/surgical care and is fully portable in Canada.

Albertans and Quebecers should recognize the many advantages of Canadian citizenship, where everyone is entitled to portable hospital care, and non-Quebecers to medical/surgical care as well — usually with minimal out-of-pocket charges — a benefit that Americans will likely never enjoy. As Premier Wab Kinew recently stated on CBC: “I think the best thing is if just there was no referendum at all. And we just focused on Canada and focused on fighting Trump and focused on continuing to be the best country out there.”

Retired Ottawa physician Dr. Charles S. Shaver was born in Montreal. He moved to the U.S. at age 2, lived in Ohio and Kansas, graduated from Princeton University and Johns Hopkins School of Medicine, and returned to Canada in 1970. The views here are his own.