Amazon’s Departure from Québec: An Unexamined Hypothesis?

Many assume that Amazon’s decision to cease operations in Québec was driven solely by the unionization of 200 employees at its DXT4 warehouse in Laval last spring. While this explanation is widely accepted, a critical question remains unasked: Could there be other contributing factors?

One overlooked possibility is the financial burden imposed by Québec’s workplace healthcare system, particularly the excessive costs associated with CNESST claims. Based on years of experience managing these claims for Québec employers, we believe this issue warrants serious consideration in Amazon’s decision-making process.

A Troubling Pattern in Workplace Healthcare

To understand this potential correlation, one must look at a concerning trend in Québec’s workplace rehabilitation practices. In 2009, La Presse exposed the HTB Rehabilitation Clinic for administering hundreds of unnecessary treatments, violating established rehabilitation guidelines. The clinic was subsequently sued by the CSST and the SAAQ and eventually shut down.

Yet, rather than ending, this pattern of overtreatment seems to have proliferated across both large corporate clinics and smaller physiotherapy centers. Our detailed review of 11 recent CNESST claims, using the Reed Group MD Guidelines—a globally recognized standard for effective treatment—revealed staggering discrepancies:

• Total number of treatment sessions: 2.5 to 68 times the recommended standard.
• Total duration of treatment: 2.1 to 9 times longer than necessary.
• Frequency of treatment sessions: 1 to 8 times the suggested rate.

The impact of this overtreatment is devastating. Injured workers suffering from musculoskeletal conditions—such as sprains, strains, and minor fractures—are subjected to excessive therapy, often worsening their conditions and resulting in chronic pain, permanent disabilities, and diminished quality of life.

For employers, this translates to prolonged work absences, soaring CNESST premiums, costly accommodations for disabled employees, and administrative burdens—all of which increase the financial strain of operating in Québec. For society, these unnecessary treatments lead to long-term healthcare and social costs, while reducing the employability of affected workers.

The Business Impact: Was This a Factor for Amazon?

Given these realities, it is reasonable to question whether Amazon, a data-driven corporation with a relentless focus on cost efficiency, factored these systemic issues into its decision to exit Québec. While unionization may have been a major factor, could the province’s burdensome workplace healthcare system have been the final straw?

If so, this raises urgent questions for Québec’s economic future:

• Could other foreign corporations follow Amazon’s lead, especially amid rising U.S. tariffs that could add further financial pressures?
• Should the Québec government launch an inquiry into unnecessary healthcare costs that inflate the cost of doing business in the province?

It is time to move beyond speculation and start a real conversation. MedExtra is prepared to work with the business community to shed light on the extent of this issue and propose solutions to mitigate the risks associated with Québec’s workplace healthcare system.

The departure of a global giant like Amazon should serve as a wake-up call. Québec cannot afford to ignore the structural challenges that may be driving businesses away.