annex F provides a concrete example of the inconsistent, variable, erratic and

unpredictable lag effect between processing, enrolment, eligibility and arrival dates
using the Prince Edward Island micro-data for new residents. The enrolment processing
periods used are April 2006 and March and April 2007.
This lag effect phenomenon is also evident in the greater-than-one ratios found with the
quarterly numbers – a large influx of new residents in provinces in the summer months
mean that more data have to be processed which may cause a backlog and not be
processed at the same time as people applying for health cards who came from another
province or territory. Processing maybe done at a later date especially with data entry
staff going on summer vacation; hence, the ratio greater-than-one for the October to
December period when new registrants are less and there is time to enter in the backlog
of records (as what had happened in British Columbia in 2005). This pattern is, on the
whole, consistent if one were to examine those ratios with a value over 1.0 in Table 5.
As well, there are those who are new to a province/territory but do not bother getting a
health card so we would have no record that they are there unless they have a reason
to seek medical attention and are discovered to not have a valid card.
The critical detail of out-migration is not available. Manitoba does give us cancellations
(equivalent to out-migrants) but they are not complete and would not correspond exactly
with the timing for the in-migrants (in order to calculate net migration).
Most provinces (except for Quebec) and territories provide reports to each other as to
the number of new residents who had arrived into their province/territory from other
provinces/territories. It may prove useful to tap into this source to get a measure of out
migration. However, the timing there is once more an issue when looking at sub-annual
data and trying to calculate net migration figures.
Based on this present analysis, it would not be feasible or viable to substitute the
provincial and territorial health registration records for our present data sources at this
time. As was stated by Rémillard,
« it should be kept in mind that the health insurance file is basically an administrative file
and not a population register. It is designed to meet certain needs which are not
primarily demographic in nature. 13 …
For the health insurance files to be fully usable, it will be necessary for the players
involved to agree on definitions, the population covered, standards, the format of the
files, and procedures. Such agreements are not easy to conclude, especially in fields
that are under provincial jurisdiction 14 »
Progress has been made (e.g. more provinces and territories are now providing us with
data) but there are still gaps
in coverage, completeness, consistency, timeliness, reliability, details, uniformity
and accuracy.
As stated earlier, it would also be useful to check the quality of our population estimates
through having access or a link to all of the provincial/territorial health care registrations
on a monthly basis.