Like Albertans, but unlike most Canadians, British Columbians pay premiums for health care. Since health care is something that everyone uses, let's call premiums what they really are: user fees on Medicare. There is a tantalizing logic behind user fees on Medicare. Since everyone requires health care at some point, everyone should have to chip in to help pay for it. And what could be more egalitarian than asking everyone to pay the same amount (in BC, $54 a month or $648 a year)? After all, in the doctor's office we are all equal. There are no barriers of race, education or class that sickness cannot cross. If we all use health care equally, why shouldn't we have to pay for it equally?