A potentially legitimate refugee from a so-called safe country delivering a baby or undergoing emergency surgery for a heart attack at a Canadian hospital will have to pay for it out of pocket because of changes to the government's refugee health insurance scheme, set to take effect in July.
The NDP calls it "unconscionable." One doctor said "people could die because of this." But the government says such claimants are to have their cases heard within weeks, so the limited health coverage "is, therefore, only a short interim measure."
The change is part of a larger shakeup of the Interim Federal Health Program, a federally-funded health insurance system that temporarily pays for care for people including asylum claimants, those whose claims have already been rejected but they have not yet left Canada, and those whose claims were accepted but they are not yet eligible for provincial or territorial coverage.
Since Immigration Minister Jason Kenney announced the changes on April 25, opposition to them has gained steam. Dozens of doctors, the main anchor of protest, clad in white lab coats, rallied on Parliament Hill on May 11, taking turns at the megaphone.
Ninety physicians protested outside Natural Resources Minister Joe Oliver's riding office in Toronto. A smaller group stormed his office, demanding to speak with him (he wasn't there), but moved to the street after police arrived, according to the Toronto Star.
The changes would mean the government would no longer pay for such things as eye glasses, cavity fillings, or medication for conditions such as arthritis and diabetes for refugees whose claims have been accepted, and asylum claimants from countries the government accepts as refugee-producing.
Claimants from safe countries and those whose applications were rejected but have yet to leave Canada would only be eligible for government-funded health coverage for conditions that threaten public health or safety, such as tuberculosis, HIV, or mental disorders with psychotic symptoms.
'People could die because of this'
These safe countries, formally called designated countries of origin, have yet to be determined or entrenched in law. They would become reality once the refugee bill C-31 becomes law, which is expected before the end of June, and is implemented.
The government has a set of numbers-based and human rights-related criteria it says would guide the minister to make country determinations.
It's no secret Mr. Kenney is frustrated by what he says are large waves of people with unfounded refugee claims coming from European democracies. He is under diplomatic pressure to designate all European Union countries as safe, which would mean Canada would process claims from their citizens faster and they would have less opportunity for appeal.
People from safe countries would still get a hearing from the Immigration and Refugee Board to determine the validity of their claim. Some may be found to be legitimate refugees, despite their country's general safety.
"Knowing that potentially legitimate refugees from so-called 'safe countries' could actually be denied emergency medical coverage for the hospital delivery of a baby and even for a heart attack is unconscionable," said NDP immigration critic Jinny Sims in an email to Embassy.
"People could die because of this," said Meb Rashid, a Toronto doctor who works at a refugee shelter and also sees refugees at a clinic at Women's College Hospital.
"It's quite chilling...to see...in an official document from the Canadian government saying that if someone has a heart attack here in Canada that we won't cover them—and people who are here legally," he said.
"I never thought I would see that in a government document coming out of Canada."
Pregnant women from countries not on the safe list who give birth in hospital would have their required tests, delivery, hospital stay, and initial post-partum follow-up covered, but not any further basic medication. Someone from a safe country or whose claim was rejected would have to pay for everything in that scenario. In Toronto, the hospital fees could be in the ballpark of $1,100 said Dr. Rashid. It's far-fetched to assume asylum claimants could afford that, he said.
"Obviously they will never pay it and the provincial system will just absorb the costs," wrote Mark Tyndall, the head of infectious diseases at the Ottawa Hospital, in an email.
"I think our concerns are that people will end up staying at home. They'll have deliveries in places where they shouldn't by people who shouldn't be in a position to help them," said Dr. Rashid.
Mr. Kenney, in an op-ed to the Ottawa Citizen on May 12, wrote that the refugee health reforms go hand-in-hand with larger refugee system changes to speed up processing, meaning that safe-country claimants would have their claims heard within a few weeks, rather than the years it takes now.
"The health coverage for these claimants is, therefore, only a short interim measure," he said.
His parliamentary secretary, Rick Dykstra, also emphasized the short-term position of safe-country claimants.
"[They] will have their claims heard very quickly and either become a protected person, and become eligible for additional coverage, or a rejected claimant, and be expected to leave Canada in due course. It only makes sense to set limits on the coverage provided through this sort of program," he wrote in an email to Embassy.
The designated countries of origin scheme is used by "many other Western industrialized countries," he said, "and the United Nations High Commissioner for Refugees has recognized the validity of providing expedited processing for refugee claimants from designated countries of origin."
Justification and rebuttal
"Canadians have been telling us they don't think that smuggled migrants and bogus asylum claimants should be getting better health-care benefits than Canadian seniors and taxpayers," the Toronto Sun quoted Mr. Kenney saying.
"They won't be getting extras that Canadians don't get, like dental, eye care, and discretionary pharmaceuticals."
Doctors and groups that work with refugees dispute that refugees are getting better health benefits in some areas than their Canadian peers.
"In fact when it is a question of vulnerable groups of Canadians, there are measures in place to ensure that they receive the kind of assistance that will now be denied to refugees," said Rob Shropshire, the interim executive director of the Canadian Council for Refugees.
Basic provincial and territorial health insurance plans don't cover prescription drug coverage, but most very low income Canadians do have access to other public programs that give them free prescription medication, his group stated in a press release.
The loss of prescription coverage has been one of the most talked-about parts of the changes critics mention.
"I have a number of people who are taking insulin for their diabetes. On July 1, they'll stop taking their medications. I'm absolutely positive of it. They just don't have enough money to purchase them," said Dr. Rashid. Diabetes medication would not be covered under the new system because it's not used to treat conditions threatening public health or safety.
All claimants will receive an initial exam to screen for disease.
"This comprehensive checkup is more preventive health care than most Canadians receive on a regular basis," wrote Mr. Kenney in the Citizen.
But all other non-urgent or essential medical appointments would not be covered, say doctors.
Citizenship and Immigration Canada spokesperson Bill Brown said that's false.
"There has been some misunderstanding on what is meant by urgent or essential health care services" he wrote via email to Embassy.
Protected persons and refugee claimants from non-designated countries of origin would be covered for hospital, medical, diagnostic, and ambulance services in most cases, he said. They wouldn't be covered for "elective" services such as fertility or sterilization treatment, long-term care or home care.
"Those services are considered neither essential nor urgent," he said via email.
Mr. Kenney wrote in the Citizen that the "vast majority" of claimants would continue to have access to "the full range of basic services that all Canadians receive through their provincial health-care system, including treatment for chronic disease."
The government says the interim federal health program cost $84.6 million in the 2010-11 fiscal year. It envisions the planned changes would save $100 million over the next five years.
Dr. Tyndall, who is also a professor of medicine at the University of Ottawa, doesn't see how the reforms would save money.
"We know that preventive and primary care are what saves money," he said.
Lack of affordable access to health care may lead some patients' treatable problems to worsen until they have to go to the emergency department, at which point the cost would likely be borne by the province, he added.
"The opposite argument to that is: Well, then we should be giving all Canadians the same treatment, the same service, because if you want to speak to prevention then obviously every Canadian should be getting that same coverage," Mr. Dykstra told Embassy on May 14.
That would mean an unsustainable system, he said.
Mr. Kenney has argued that the changes would take away an incentive from people considering filing an unfounded refugee claim.
But critics have noted that while the debate has centred around taking away special benefits to discourage bogus claimants, the changes also affect government-assisted refugees and privately-sponsored refugees resettled to Canada such as Burmese people coming from Thai camps, who are deemed legitimate refugees and become permanent residents as soon as they arrive. Some of these people may have received free medication from NGOs while they were living in refugee camps overseas, but that would stop once they're in Canada, said Dr. Rashid.
The government says the changes are meant to support a fair system, discourage abuse, and save money, while safeguarding public safety and health. Critics, scoffing at each of those justifications, say they are at a loss to otherwise explain the reforms.
But they say they will keep fighting to see them scrapped.
Original Article
Source: embassy mag
Author: Kristen Shane
The NDP calls it "unconscionable." One doctor said "people could die because of this." But the government says such claimants are to have their cases heard within weeks, so the limited health coverage "is, therefore, only a short interim measure."
The change is part of a larger shakeup of the Interim Federal Health Program, a federally-funded health insurance system that temporarily pays for care for people including asylum claimants, those whose claims have already been rejected but they have not yet left Canada, and those whose claims were accepted but they are not yet eligible for provincial or territorial coverage.
Since Immigration Minister Jason Kenney announced the changes on April 25, opposition to them has gained steam. Dozens of doctors, the main anchor of protest, clad in white lab coats, rallied on Parliament Hill on May 11, taking turns at the megaphone.
Ninety physicians protested outside Natural Resources Minister Joe Oliver's riding office in Toronto. A smaller group stormed his office, demanding to speak with him (he wasn't there), but moved to the street after police arrived, according to the Toronto Star.
The changes would mean the government would no longer pay for such things as eye glasses, cavity fillings, or medication for conditions such as arthritis and diabetes for refugees whose claims have been accepted, and asylum claimants from countries the government accepts as refugee-producing.
Claimants from safe countries and those whose applications were rejected but have yet to leave Canada would only be eligible for government-funded health coverage for conditions that threaten public health or safety, such as tuberculosis, HIV, or mental disorders with psychotic symptoms.
'People could die because of this'
These safe countries, formally called designated countries of origin, have yet to be determined or entrenched in law. They would become reality once the refugee bill C-31 becomes law, which is expected before the end of June, and is implemented.
The government has a set of numbers-based and human rights-related criteria it says would guide the minister to make country determinations.
It's no secret Mr. Kenney is frustrated by what he says are large waves of people with unfounded refugee claims coming from European democracies. He is under diplomatic pressure to designate all European Union countries as safe, which would mean Canada would process claims from their citizens faster and they would have less opportunity for appeal.
People from safe countries would still get a hearing from the Immigration and Refugee Board to determine the validity of their claim. Some may be found to be legitimate refugees, despite their country's general safety.
"Knowing that potentially legitimate refugees from so-called 'safe countries' could actually be denied emergency medical coverage for the hospital delivery of a baby and even for a heart attack is unconscionable," said NDP immigration critic Jinny Sims in an email to Embassy.
"People could die because of this," said Meb Rashid, a Toronto doctor who works at a refugee shelter and also sees refugees at a clinic at Women's College Hospital.
"It's quite chilling...to see...in an official document from the Canadian government saying that if someone has a heart attack here in Canada that we won't cover them—and people who are here legally," he said.
"I never thought I would see that in a government document coming out of Canada."
Pregnant women from countries not on the safe list who give birth in hospital would have their required tests, delivery, hospital stay, and initial post-partum follow-up covered, but not any further basic medication. Someone from a safe country or whose claim was rejected would have to pay for everything in that scenario. In Toronto, the hospital fees could be in the ballpark of $1,100 said Dr. Rashid. It's far-fetched to assume asylum claimants could afford that, he said.
"Obviously they will never pay it and the provincial system will just absorb the costs," wrote Mark Tyndall, the head of infectious diseases at the Ottawa Hospital, in an email.
"I think our concerns are that people will end up staying at home. They'll have deliveries in places where they shouldn't by people who shouldn't be in a position to help them," said Dr. Rashid.
Mr. Kenney, in an op-ed to the Ottawa Citizen on May 12, wrote that the refugee health reforms go hand-in-hand with larger refugee system changes to speed up processing, meaning that safe-country claimants would have their claims heard within a few weeks, rather than the years it takes now.
"The health coverage for these claimants is, therefore, only a short interim measure," he said.
His parliamentary secretary, Rick Dykstra, also emphasized the short-term position of safe-country claimants.
"[They] will have their claims heard very quickly and either become a protected person, and become eligible for additional coverage, or a rejected claimant, and be expected to leave Canada in due course. It only makes sense to set limits on the coverage provided through this sort of program," he wrote in an email to Embassy.
The designated countries of origin scheme is used by "many other Western industrialized countries," he said, "and the United Nations High Commissioner for Refugees has recognized the validity of providing expedited processing for refugee claimants from designated countries of origin."
Justification and rebuttal
"Canadians have been telling us they don't think that smuggled migrants and bogus asylum claimants should be getting better health-care benefits than Canadian seniors and taxpayers," the Toronto Sun quoted Mr. Kenney saying.
"They won't be getting extras that Canadians don't get, like dental, eye care, and discretionary pharmaceuticals."
Doctors and groups that work with refugees dispute that refugees are getting better health benefits in some areas than their Canadian peers.
"In fact when it is a question of vulnerable groups of Canadians, there are measures in place to ensure that they receive the kind of assistance that will now be denied to refugees," said Rob Shropshire, the interim executive director of the Canadian Council for Refugees.
Basic provincial and territorial health insurance plans don't cover prescription drug coverage, but most very low income Canadians do have access to other public programs that give them free prescription medication, his group stated in a press release.
The loss of prescription coverage has been one of the most talked-about parts of the changes critics mention.
"I have a number of people who are taking insulin for their diabetes. On July 1, they'll stop taking their medications. I'm absolutely positive of it. They just don't have enough money to purchase them," said Dr. Rashid. Diabetes medication would not be covered under the new system because it's not used to treat conditions threatening public health or safety.
All claimants will receive an initial exam to screen for disease.
"This comprehensive checkup is more preventive health care than most Canadians receive on a regular basis," wrote Mr. Kenney in the Citizen.
But all other non-urgent or essential medical appointments would not be covered, say doctors.
Citizenship and Immigration Canada spokesperson Bill Brown said that's false.
"There has been some misunderstanding on what is meant by urgent or essential health care services" he wrote via email to Embassy.
Protected persons and refugee claimants from non-designated countries of origin would be covered for hospital, medical, diagnostic, and ambulance services in most cases, he said. They wouldn't be covered for "elective" services such as fertility or sterilization treatment, long-term care or home care.
"Those services are considered neither essential nor urgent," he said via email.
Mr. Kenney wrote in the Citizen that the "vast majority" of claimants would continue to have access to "the full range of basic services that all Canadians receive through their provincial health-care system, including treatment for chronic disease."
The government says the interim federal health program cost $84.6 million in the 2010-11 fiscal year. It envisions the planned changes would save $100 million over the next five years.
Dr. Tyndall, who is also a professor of medicine at the University of Ottawa, doesn't see how the reforms would save money.
"We know that preventive and primary care are what saves money," he said.
Lack of affordable access to health care may lead some patients' treatable problems to worsen until they have to go to the emergency department, at which point the cost would likely be borne by the province, he added.
"The opposite argument to that is: Well, then we should be giving all Canadians the same treatment, the same service, because if you want to speak to prevention then obviously every Canadian should be getting that same coverage," Mr. Dykstra told Embassy on May 14.
That would mean an unsustainable system, he said.
Mr. Kenney has argued that the changes would take away an incentive from people considering filing an unfounded refugee claim.
But critics have noted that while the debate has centred around taking away special benefits to discourage bogus claimants, the changes also affect government-assisted refugees and privately-sponsored refugees resettled to Canada such as Burmese people coming from Thai camps, who are deemed legitimate refugees and become permanent residents as soon as they arrive. Some of these people may have received free medication from NGOs while they were living in refugee camps overseas, but that would stop once they're in Canada, said Dr. Rashid.
The government says the changes are meant to support a fair system, discourage abuse, and save money, while safeguarding public safety and health. Critics, scoffing at each of those justifications, say they are at a loss to otherwise explain the reforms.
But they say they will keep fighting to see them scrapped.
Original Article
Source: embassy mag
Author: Kristen Shane
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