The revelation comes as criticism of the government's approach to refugee health care has ballooned. Doctors wearing white lab coats have protested on Parliament Hill, while others have occupied a Toronto Conservative MP’s constituency office, and some have disrupted ministers' press conference.
On July 18, a Cabinet-approved order made on June 28 was released in the government’s official newspaper, the Canada Gazette, detailing last-minute changes to the government's earlier planned revamping of the refugee health coverage system—and why bureaucrats at Citizenship and Immigration Canada were pushing for them.
The document suggests that the UN referral drop, and a lack of private-sponsor support, could have left Canada unable to resettle as many refugees as it had planned.
The immigration department also said the originally proposed changes would have had a “serious impact” on the department’s ability to put in place part of the 2012 budget.
And the planned changes would have taken away coverage of psychological counselling for victims of human trafficking, something Citizenship and Immigration Canada said is “important” to support them.
An email and call to Immigration Minister Jason Kenney’s press secretary were not immediately returned July 18 before deadline.
‘Unintended impact’
On April 5, the government, through a Cabinet order approved by the governor general, made changes to its 1957-era interim federal health program, which gave temporary health-care coverage to refugees and asylum claimants to Canada who weren’t yet eligible for provincial health plans and weren’t already covered privately.
The government decided to cut some coverage to some recipients. It would end coverage of “supplemental benefits,” such as medications, dental and eye care for all beneficiaries. It would also take away all coverage for rejected refugee claimants and claimants from so-called safe countries, other than for treatment needed to protect Canadians’ safety and health, such medication for tuberculosis.
It would continue to give recognized refugees and some refugee claimants hospital services and visits to the doctor. But it would only cover their medication if needed to treat a disease that could put public health or safety at risk.
Those changes were to begin June 30, and save the government about $70 million in the first three years, and $15 million per year after that.
People who work with refugees and various national professional medical groups denounced the changes, including the Canadian Medical Association.
But two days before the start date, Cabinet passed another order to revise the new rules and give back coverage to some people who were set to have it taken away.
The government made the changes quietly, simply changing its website to reflect the new rules.
Based on the website changes, the Ottawa Citizen first reported July 2 that the government “may backtrack” on the proposed changes, by allowing refugees resettled from abroad by the government and privately-sponsored refugees who get federal income support to receive “supplemental benefits” such as medications, eye and teeth care.
The Citizen reported that “the minister’s press secretary firmly denied there had been any change and said government-assisted refugees were never expected to lose supplemental benefits.”
Mr. Kenney's press secretary, Alexis Pavlich, reiterated that in an email to Embassy at the time: "Minister Kenney has said repeatedly that these people, who arrive in Canada as permanent residents and not as asylum claimants, will continue to receive comprehensive health care coverage...This ensures, for example, that this limited number of people do not lose coverage for any drugs they had covered by the UNHCR while living in a refugee camp.
"The original criteria did not make this intention clear which is why the language of the policy has been modified."
The new changes would restore coverage for medications, eye care, assistive devices, emergency dental care, psychotherapy by registered clinical psychologists, home care, and long-term care for government-assisted refugees, privately-sponsored refugees, and people let in to Canada for public policy and humanitarian and compassionate reasons, such as Afghan interpreters who helped Canadian government officials, if they are getting income support from the federal or Quebec government. It would also restore that level of coverage to victims of human trafficking.
The department recommended Cabinet make changes to “address the unintended impact” of the earlier order on a 2012 budget commitment. The department said the originally proposed changes would “have a serious impact” on Citizenship and Immigration Canada’s ability to implement the government’s budget promise to convert 1,000 government-assisted refugee spaces earmarked in its immigration levels plan to the same number of privately-sponsored refugee spaces with some income support.
“This initiative is dependent on private sponsors coming forward to sponsor the 1,000 [United Nations High Commissioner for Refugees]-referred refugees selected by the Government of Canada. While it is expected that sponsors will cover health costs for their current caseload which is primarily family-based, sponsors have indicated that they are not prepared to cover unknown health costs for strangers,” read an explanatory note for the order.
It went on to say that “[i]t has become clear” that the planned changes would affect the UN refugee agency’s ability to refer refugees to Canada.
“UNHCR would try to identify and avoid referring refugees likely to need health care not covered by the IFHP. In the absence of private sector support and given the expected impact on UNHCR referrals, Canada’s refugee resettlement immigration levels might not be met.”
The explanatory note also said that the original order would have taken away coverage of psychological counselling given by registered clinical psychologists, “a health benefit that is important for supporting victims of human trafficking.” The revised order would give those victims “expanded benefits,” which would include services of health care professionals licensed in Canada.
The department said the coverage boost would mean the government would have to shell out $1 million to $2 million more a year.
It also made clear to note that the focus of the original order was still in place: tightening the reins on costs, and “promoting fairness” while still protecting Canadians’ health and safety.
“The amended 2012 [order-in-council] maintains the Government’s commitment to ensuring that IFHP beneficiaries do not receive benefits that are more generous than what Canadians receive through government-funded benefit programs,” read the explanatory note.
NDP immigration critic Jinny Sims said the fact that the government revised its own planned changes two days before they were to be implemented shows that the government is “making it up as they go along, on the back of a napkin.”
This isn’t the first time the government has backtracked its own proposed policy. When it was noted earlier this year that its legislation to change the refugee system could have allowed the government to deport a person who came to Canada as a refugee if their home country had since become safe, the government agreed to change that part of the bill.
Ms. Sims said she thought the government made a small improvement to its planned health-care changes because of the high public pressure.
The government’s suggestion that the UN refugee agency wouldn’t send Canada refugees who wouldn’t get health-care coverage shows the “inhumanity” of what was originally proposed, she said.
“Here you have people who are living in camps, who are diabetic, who are being controlled through insulin. And suddenly, what you’re saying is ‘Canada is not going to cover those costs.’ Why would the UNHCR people put these refugees’ lives in danger?”
But she said she’s still concerned about other categories of people whose coverage is still limited by the changes, such as asylum seekers from so-called safe countries and some privately-sponsored refugees.
Original Article
Source: embassy mag
Author: Kristen Shane
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