MONTREAL -- The idea of a 'health contribution' for unvaccinated people launched by François Legault on Tuesday goes “against the fundamental values of public health” according to the public health director of the Gaspé region.

Dr. Yv Bonnier-Viger, a renowned epidemiologist and specialist in public health and preventive medicine, is asking Quebec to "think seriously" about the repercussions of such a measure.

These are not measures that correspond to public health values," says Dr. Bonnier-Viger.

The expert has serious reservations about the measure presented by Premier François Legault, who wants to impose what he calls "a health contribution", or a tax, on people who have not been vaccinated.

“I think that we would be completely forgetting our system of coverage and universal health insurance. We know that about 40 per cent of illnesses are preventable. If we start taxing all the sick people for the bad decisions they made at some point in their lives, we're going off the rails," noted the doctor.

“There are plenty of lifestyle habits that lead to disease. But often, underneath that, there's a lot more,'' adds Bonnier-Viger, who has been in charge of public health in the Gaspé region since 2016, and of the Cree Board of Health and Social Services of James Bay for the past few months.

“Instead of forcing, we need to go and see what’s behind it for those who are not currently vaccinated," explained Bonnier-Viger.

“There are people who are really afraid of being vaccinated, who have all sorts of beliefs! It's not rational not to get vaccinated. We have to understand where it comes from, how it is maintained and solve the problem at the source,” he said.

According to him, the punitive approach being put forward is more political than scientific, as it "moves away from the fundamental values of public health."

“The general attitude in our field is much more one of empowering an individual and a community through the values of education and solidarity. They should take precedence over restrictive measures,” he said.

Bonnier-Viger welcomes the debate initiated by the announcement but asks Quebec to take the time to weigh the impact of implementing such a measure:

"It's a good debate, but we must think about the concrete impacts,” he said.

LOGIC USED BY PRIVATE INSURANCE COMPANIES

In an open letter published by Médecins québécois pour le régime public, an independant advocacy group, health-care professionals warned of what it called a "slippery slope" towards the commodification of health.

In an interview on Wednesday, the organization's spokesperson, Dr. Mathieu Isabel, said that unvaccinated Quebecers are not homogenous, and many of them face barriers to vaccination sites and access to information.

Those people include homeless people, those with mental health problems, and immigrants who do speak neither French nor English.

"We made the choice as a society, several decades ago, to ensure a universal and public health system. For us, we are opening an excessively dangerous breach by introducing taxation according to individual risk,' said Dr. Isabel.

The new measures are more in line with insurance company calculations, rather than public health objectives, according to Dr. Isabel.

"We could undermine the fundamental principle that people will be treated the same, regardless of individual behaviors," he continued. 

"One of the things that particularly worries us ... is this logic of focusing on the level of risk (in one's lifestyle). It opens the door to market logic in the health and social services system -- a logic used by private insurance companies,' Dr. Isabel said.

Moreover, Bonnier-Viger says Quebec should do more to mitigate the hospital network's vulnerability to strain.

"Is it really the 10 per cent of unvaccinated patients that explain the problems we are seeing at the moment? To ask the question is to answer it," he said.

Bonnier-Viger said he was never consulted on the measure during meetings with other regional directors, otherwise he would have given his opinion without hesitation.

“As far as I know, we were not consulted on this measure. If someone has decided to launch this measure in a press conference, even if he is the premier, it must be discussed."

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This article includes additional files from The Canadian Press, originally published in French on Jan. 12, 2021.