Hi Bob,
I have long carried a Personal Locator Beacon on my PFD. This provides emergency SOS service more or less anywhere, satellite-based with no monthly fee. The downside is a fairly hefty price of about $400+ and a requirement for the manufacturer to the change battery after 5-7 years.
These are required for crew members on many, perhaps most organized ocean sailing events, after numerous tragedies in which individuals have gone overboard but were never located despite adequate buoyancy and thermal protection. I am surprised that so few paddlers use them.
PLBs don’t perform the variety of functions that the inReach has, but if what you want is a basic locator beacon that is always with you, they make sense. You can also carry them for hiking, skiing etc more or less anywhere with maybe a few satellite-dead zone exceptions.
A decent Marine VHF putting out 25 W of power through a high-gain antenna mounted on a tall mast would almost certainly reach the Rescue Coordination Centre folks (i.e. sailboat moored at N end of Stave Lk) but hand-held radios lack that punch, so unless conditions are perfect and the signal can skip out to one of the repeater towers on Salt Spring or Bowen Islands etc an emergency call from a paddler would likely go unheard unless a boater on Fraser R received the call and performed a Mayday Relay (as they are supposed to do).
I suspect (but don’t know) that a DSC call from a hand-held radio would require less power and would stand a good chance of being picked up by RCC, even from far the end of Stave Lk. It would be interesting to learn if that is so.