By Jedidja

Publié le 16 juin 2026

On a cold night in Saguenay-Lac-Saint-Jean, it is not unusual to see someone enter an emergency room simply to stay warm. They may not be in immediate danger, but they have nowhere else to go. This situation says a lot about the limits of Québec’s healthcare system. Even though the province offers universal healthcare through the Régie de l’assurance maladie du Québec, not everyone can truly access it. In reality, people experiencing homelessness are often left behind. Québec’s system may be universal in theory, but it is not fully accessible in practice. 

As a nursing student, I have learned that healthcare is supposed to be continuous and patient centered. However, this becomes very difficult when patients do not have stable living conditions. Luc is a 72-year-old man living in my neighbourhood after spending four years on the streets. He was married twice, but both of his wives passed away a long time ago. He says he is not happy because he cannot work or provide for himself anymore. He has no children and feels alone most of the time, except for occasional contact with his older sister, who is also struggling in life. Smoking has become his main source of comfort since his thirties though he claimed not being too much fan of alcohol. He told me he cannot stop, even though he is aware of the serious health risks. He said he smokes at least three packs of cigarettes a day and cannot go a single day without them. 

Many people experiencing homelessness suffer from chronic illnesses, mental health issues, and substance use disorders. These conditions require regular follow-ups and stable care. The problem is that the system depends heavily on appointments, referrals, and long waiting times. For someone who is constantly moving or struggling to meet basic needs, this model simply does not work. As a result, many patients only seek help when their condition becomes urgent, often ending up in emergency rooms. 

I also spoke with a nurse who works in community outreach, and her perspective made this issue even clearer. She told me, “We spend more time trying to build trust than actually treating medical problems.” She explained that many people avoid the healthcare system because they feel judged or misunderstood. Others cannot keep appointments because their daily lives are unpredictable. She added, “When someone is thinking about food or shelter, their health is not always the priority.” This shows that healthcare is not just about services, it is also about meeting people where they are. 

The main issue is not that Québec lacks healthcare services, but that the system is not adapted to vulnerable populations. It assumes that patients have stability, time, and resources, which is not always the case. As future nurses, we need to think beyond hospitals and clinics. Mobile care units, street outreach, and stronger connections between healthcare and social services could make a real difference. If the system does not adapt, it will continue to exclude those who need it the most. 

In conclusion, Québec’s healthcare system is built on the idea of equality, but equality does not always mean fairness. People experiencing homelessness still face major barriers to care, despite being technically covered. If we truly believe that healthcare is a right, then we must make it accessible in real-life conditions.  

As nurses and future healthcare professionals, we have a responsibility to advocate for change. Otherwise, these patients will continue to be invisible in a system that is supposed to care for everyone.  

BIBLIOGRAPHY

Research: Get surrey-UK, The Washington Law review and Lapresse.ca 

Interviewee: Mr. Luc (an Alma citizen) and a community outreach nurse (anonymous) 

www.iplusinteractif.com 

This article was polished with Copilot and Grammarly.