On 25 April 2012, Citizenship and Immigration Canada announced changes in Interim Federal Health Program coverage for refugee claimants and protected persons. The Canadian Council for Refugees (CCR) is concerned that these proposed changes unjustly discriminate against people in need and, worse, leave some people to suffer debilitating illnesses or to die without treatment.
“These changes are mean-spirited, denying essential care to individuals and families because of their country of origin or technical mistakes made during the refugee claim process,” said Wanda Yamamoto, CCR President. “Some people in need of urgent medical attention will be forced to live with chronic, untreated conditions.”
While the Minister of Citizenship and Immigration claims that the announced changes will only deny services that are not included in basic care for Canadians, in fact they cut much deeper.
The announced changes will:
1. Create a two-tier system of refugee care in Canada, discriminating between refugee claimants on the basis of their country of origin
The new rules will create serious differences in treatment available to certain refugee claimants, based on their country of origin. For example, a person from a designated ‘safe’ country needing emergency care after being hit by a car or some other traumatic incident will be refused coverage because he does not meet the test of “having a disease posing a risk to public health or a condition of public safety concern.” Those from other countries will still be eligible.
2. Deny necessary medical care on arrival in Canada to resettled refugees or accepted refugee claimants with acute health needs
Since 2002, Canada has made it a priority to resettle vulnerable refugees and those in need of urgent protection, lowering the threshold for medical admissibility to do so. While this measure helps more refugees in desperate circumstances, the announced changes will shift the costs and responsibility for this federal commitment to provincial health care services (if they agree), to volunteer private sponsors, or to the resettled refugees themselves. After resettling an amputee from a refugee camp, the federal government will deny this refugee access to a prosthetic limb, a wheel chair or life-saving medications. These changes, made without consultation, will reduce short-term costs but will incur long-term consequences by impeding successful integration.
3. Institutionalize gender discrimination
Emergency treatment will no longer be guaranteed for all. It will exclude women from designated ‘safe’ countries who have suffered domestic violence or sexual assault. Similarly, a pregnant refugee claimant will not be covered for delivery or pre- or post-natal care. The new provisions will only cover costs to prevent or treat a disease posing a risk to public health or public safety for women from countries not designated as ‘safe.’
4. Deny long-term, essential medical coverage to individuals who are living in Canada in limbo
Some individuals who cannot be removed to their country of origin (because the Canadian government has recognized that conditions are too dangerous) or who are stateless will not have access to treatment for illnesses that pose a threat to their lives or to public health. For example, persons with a life-threatening and communicable disease, who have been declared ineligible to claim asylum or who withdrew their claim following bad advice, will be eligible for no treatment whatsoever, regardless of the risks to them or to Canadian public health.
5. Offload costs to provinces
Hospitals cannot deny emergency medical care. People with no means to pay will be billed. Instead of patients being covered by the Interim Federal Health program as was previously the case, provinces will on the hook for unpaid costs. In addition, the costs for emergency care will be greater than the savings gained through routine medical treatment.
The Canadian Council for Refugees has called for solutions to the systemic, policy and operational barriers and limitations existing for refugees and health service providers in the Interim Federal Health Program. These new measures are exclusionary and dangerous.
Colleen French, Communication and Networking Coordinator, Canadian Council for Refugees, 514-277-7223, ext.1, 514-476-3971 (cell), firstname.lastname@example.org