No Fees in Universal HealthCare!

The Migrant Students United chapter at Simon Fraser University (SFU), Sanctuary Health, BC Health Coalition, and the undersigned demand equitable access to health insurance for all study permit holders in B.C. We are writing to highlight the ongoing injustice, financial, social, and administrative burden in the current British Columbia (B.C) healthcare system, and we demand concrete and meaningful action to eliminate the exclusive, unfair, and expensive International Students Health Fee (ISHF). No fees should be required for “Universal HealthCare”!

Background:
We celebrated when the government announced that they were eliminating regressive Medical Services Plan (“MSP") premiums. This celebration turned into shock and anger, when the BC government announced a new levy known as the International Students Health Fee (“ISHF”) that increased costs for international students to $75 per month/per person. This fee was implemented without consultation with students or residents in BC.

1. Huge financial burden on families
The ISHF lacks a family plan, meaning the ISHF holder pays $75 for any dependent with a study permit even under the age of 19. Before these health fee changes, a plan existed for B.C residents where a family would pay up to $150 per month in MSP fees, with various tiers of rebates available for low-income families. This plan is no longer available, impacting students with school-age children. A household with two children on study permits now must pay an extra $1800 a year; with three children on study permits they need to find an extra $2700 a year. This represents an enormous financial burden on families with children with study permits.


2. Double-dipping on students with labour income in B.C
The government switched from collecting MSP Premiums to an employer-side percentage payroll tax called the Employer Health Tax (“EHT”). The ISHF asymmetrically impacts some international students in BC such as graduate students and students who work on- and off-campus. Their employers collect the EHT but there is no subsequent deduction counted against the ISHF. This represents double-dipping because health fees / taxes are being collected twice. A student working twenty hours a week at $15 an hour will generate approximately $25/month in EHT revenue for the BC government in addition to the income taxes and the International Student Health Fee. Higher wages will of course generate more EHT income for the government.

3. Economic impact of international students
The primary reason for the new fee provided by the B.C government stated that international students need to help fund the public health system. Analysis of the impact of international students on the economy of B.C found in 2017, aside from contributing $3.371 billion to B.C.’s GDP, international students created an additional $2.082 billion in government revenue, and $341.6 million taxes paid on labour income, an increase of 75% over five years. These numbers increased to $3.989 billion GDP, $2.454 billion labour income, and $392.9 million income tax in 2018. Additionally, international students pay millions in tolls, fees, and charges for government programs at the point of service, and indirect taxes through economic activity such as renting apartments (which generate property tax revenue).

4. International students subsidizing post-secondary education
Universities and colleges in Canada are increasingly relying on international students to manage the budget shortfalls due to the inflation adjusted decrease in public funding. This reality and the lived consequences for students is highlighted in an alarming 2021 article (The Shadowy Business of International Education). By subtracting domestic tuition fees, the provincial funding per FTE (full-time equivalent) student contribution and the international student MSP fee from international tuition fee, there is still a surplus that universities are accumulating from international students. Meaning that if the MSP fee was absorbed by universities or the province, international students would still be subsidizing post-secondary education.

Schools are seeing millions of dollars in surpluses or endowment contributions much like the one year $22 million surplus as Kwantlen cited in the article above. It is clear that the public system in Canada is benefiting enormously from the fees of international students. Coupling the economic impact cited above with this reliance on international tuition hikes in place of public funding, the explanation that international students need to “start contributing to government revenues” or “avoid becoming a drain on society” is demonstrably false.

5. Administrative
People complained the old MSP application system was too complicated to keep track of charges and payments, which led to a high non-compliance rate. The move to the EHT, a payroll tax system, was intended to remove this administrative burden on individuals and instead assign it to the accounting systems along with many other longstanding deductions and fees like CPP, EI, union dues, etc. However, the ISHF replicated the original problems with MSP, an issue exacerbated by the confusing rollout of the policy. If the administrative burden of MSP was too inconvenient to keep around, the same should be true of the ISHF. Moreover, the sudden and unplanned implementation of the policy has resulted in ambiguities and incongruences in its implementation causing concerns and confusion among study permit holders, new work permit holders, and study permit holders with dependents, etc.

Conclusion:

$900, $1800, or $2700/year in health fees is a considerable amount for the inhabitants of the province, especially Greater Vancouver, who have been facing a serious affordability problem for years. International students and parents of school-age children live with extremely tight budgets. The principle of universality of the Canada Health Act requires that “all residents of a province or territory be entitled, on uniform terms and conditions, to the publicly funded health services covered by provincial/territorial plans.” The ISHF is a clear violation of this principle and is negatively impacting international students who are already vulnerable residents. We urge the B.C government, Ministry of Health, and Ministry of Education, and Ministry of Finance to take swift action to abide by the Human Right to “Universal Healthcare” in Canada and remove the unfair and irrational ISHF. There should be No fees in “Universal Healthcare”!