Free Health Care?

Occasionally in some of the classes that I taught we discussed the social determinants of health (I never called it that - it would have driven too many of them away). I started off my conversation by asking each of  the classes if health care was free for individuals in Canada. All students thought the answer was yes. Occasionally a few students would add to the conversation by reminding me that free health care was what made us different to those to the south of us.  I would then ask "how long have Canadians had free health care". While the answers to this question were much slower in coming than for the first question, the consensus was "forever" or at least nearly that long.

The students were surprised to find out that universal health care in Canada is, relatively speaking, a fairly new thing. I suspect some if not most were surprised and perhaps disbelieving when I informed them that my mother, while my birth in a hospital had not cost my parents money, visiting the doctor had. Perhaps surprised is the wrong word. My students by that point in the school year had decided that not only was I of a different generation to them, I had in all likelihood been born on an entirely different planet.  Most of them flat out thought I was wrong when I said that some Canadians had to pay a monthly premium to get "free" health care.

In Ontario, Alberta and British Columbia, health insurance premiums are funded in one of three ways. If your income is below a certain level - the province pays, if you are employed by a company,  the company pays, and if you are self-employed or retired but make above a certain amount - you pay directly. In B.C the monthly premiums are $75.00 or $900.00 a year.

I have just filled out the forms to get BC coverage. Because the government use Revenue Canada data from the previous tax return, I have to use my net income from 2014 - the last year I worked. The fact that I have been retired for 14 months and that my income is one third of what it was in 2014 is not relevant. Next year I may be eligible for assistance, but for the next 10 months I will have to pay the full amount. If I had migrated in May or June, I would have been able to use 2015 data and my cost would have been substantially reduced.

I am not complaining (or at least not too much) about having to pay a bit of money for my health care. I, and my extended family have used more than our share of hospitals and doctors in the past 30 years. But my sense of fairness is disturbed by the fact that if I had moved to anyone of the other seven provinces or the territories,  or if I had migrated a few months later and thereby been able to use 2015 data, my costs would have been different. It seems to me that universal health care should mean that everyone not only has access to good health care, provided in a reasonable time frame, but also that we all share the burden equally.

I have always taken some pride that at least on paper the richest person in Canada and I have the same opportunity to access medical care. The only difference is - if that rich person lives in one of the seven other provinces - they don't have to pay for it and I do!