Medicare (Canada) - Inter-provincial Imbalances

Inter-provincial Imbalances

The fact that health insurance plans are administered by the provinces and territories in a country where large numbers of residents of certain provinces work in other provinces may lead to inequitable inter-provincial outcomes with respect to revenues and expenditures. For example, many residents of the Atlantic provinces work in the oil and gas industry in the western province of Alberta. For most of the year these workers may be contributing significant tax revenue to Alberta (e.g. through fuel, tobacco and alcohol taxes) while their health insurance costs are borne by their home province in Atlantic Canada.

Another considerable inter-provincial imbalance is a person who is insured by Quebec and obtains healthcare in another province or territory. Quebec does not have any physician payment agreements with any other provinces or territories of Canada. As a result, someone that sees a physician outside Quebec, even in another part of Canada, must either pay the cost themselves and submit a request to the Régie de l'Assurance Maladie du Québec (RAMQ Medicare) for reimbursement (even then, expenses are often denied), or take out a third party insurance plan. The same situation also applies to a resident of any other part of Canada visiting Quebec, only they submit any claims to their respective provincial healthplan. All provinces and territories of Canada, however, do have reciprocal hospital agreements, so hospital admissions, for example, are covered throughout Canada.