Physicians, who have interrupted a number of ministers’ press conferences in recent days, are vowing to continue to confront Conservative MPs and Cabinet members on the impacts of cuts to the Interim Federal Health Program for refugees, and Canadian Medical Association President John Haggie says the recent public protests are part of an increasing frustration with federal disengagement on health care.“We’re not going to keep quiet about it,” Dr. Haggie said of the IFHP changes. “It’s a matter of human compassion and suffering for a group of people who arrive with the clothes they stand in, regarding this as a safe place. If we’re going to take refugees, we have a responsibility to look after them. You can’t just cut them loose.”
Citizenship and Immigration Minister Jason Kenney (Calgary Southeast, Alta.) announced the changes to the Interim Federal Health Program (IFHP) on April 25. The program, which was established through a 1957 order in council, provided refugee claimants with comprehensive health coverage, including access to eye and dental care, and pharmaceuticals.
But as of June 30, the health-care provisions for asylum seekers in Canada will be radically transformed. Federally-funded eye and dental care for asylum seekers will be terminated, and pharmaceutical coverage will be restricted to illnesses that pose risks to public health and safety. Medications for refugee patients with illnesses such as AIDS, tuberculosis, and psychosis will be covered, but medications for illnesses that do not pose a public health risk such as cancer, heart disease, diabetes, and arthritis, will not be covered.
All long-term care costs for asylum seekers have also been eliminated.
When it comes to planned parenthood and maternal care, birth control will no longer be covered. Refugees from designated countries of origin (DCOs), which are countries that are classified as not “normally producing refugees,” will have no maternal care costs covered. Non-DCO refugees will be covered for delivery, but post-partum care coverage will be limited to 28 days following delivery, and drug coverage will be limited to protecting public health and safety. Maternal care for officially “protected persons” will be similarly limited.
The changes are meant to harmonize refugee health care with care provided to Canadian citizens under their respective provincial and territorial health-care plans.
“[W]e do not want to ask Canadians to pay for benefits for protected person and refugee claimants that are more generous than what they are entitled to themselves,” said Mr. Kenney when he announced the new IFHP Order in Council on April 25.
An estimated 125,000 refugee claimants receive coverage under the IFHP. According to Citizenship and Immigration Canada, costs for the IFHP have more than doubled from $40-million to $84.6-million over the last four years, and the federal government expects that the changes will save $100-million over the next five years. However, the new policy, which was part of of last year’s deficit reduction review, was implemented without consultation between CIC and health-care professionals outside of the department, a government official said last week.
At a press conference on the passage of Bill C-31 last Friday, Mr. Kenney conceded that his department did not consult with the wider medical community on the IFHP changes.
“We didn’t have formal public consultations on this, but we certainly heard from Canadians repeatedly that they didn’t think we should be providing better health benefits to refugee claimants than Canadians get,” Mr. Kenney said. “They certainly don’t think we should be providing health benefits to rejected asylum claimants who should be leaving Canada.”
The Canadian Medical Association, the Canadian Nurses Association, the Royal College of Physicians and Surgeons of Canada, and the College of Family Physicians of Canada were among nine signatories to a May 18 letter calling on Mr. Kenney to reverse the planned changes.
Reports of public demonstrations by health-care providers at ministerial press conferences have been on the rise in recent weeks. Natural Resources Minister Joe Oliver (Eglinton-Lawrence, Ont.) was forced to cut an announcement on medical isotope research short at the Toronto General Hospital on June 22, after Dr. Chris Keefer and University of Toronto medical student Faria Kamal interrupted the minister to publicly denounce the cuts.
Dr. Keefer promised that “members of the Conservative government will be disrupted from this point on by Canadian doctors across this country.”
“I don’t believe this minister deserves my courtesy, or the courtesy of any doctor across this country,” Dr. Keefer said in response to a plea from the moderator to let Minister Oliver finish his announcement.
Last week Ottawa, family physician Dr. Megan Williams allowed Health Minister Leona Aglukkaq (Nunavut) to finish making a federal funding announcement before confronting her about the impact of the changes on refugee health and on provincial and territorial health-care costs.
Minister Kenney was also targeted by protestors last week when he appeared at a golf course in Surrey, B.C., to address the Surrey Board of Trade.
On June 27, members of Canadian Doctors for Refugee Care appeared on Parliament Hill to denounce the changes to IFHP and announce plans to track the impact of the cuts on refugee health care.
“While doctors have been largely focusing on the serious health implications of these cutbacks, Minister Kenney has been focusing on divisive politics, pitting taxpaying Canadians who are dissatisfied with their own health care against some of the most traumatized people in the world,” said Dr. Mark Tyndall, chief of infectious diseases at Ottawa Hospital. “From a health care, cost and public safety perspective, these cutbacks do not make sense. You will find no one, anywhere, that can justify these cuts as a way to save money, or improve health and ensure public safety.”
Dr. Tyndall was joined by Dr. Parisa Rezaiefar, family physician at Ottawa’s Bruyere Academic Family Medicine Centre and Dr. Philip Berger, chief of family and community medicine at St. Michael’s Hospital in Toronto.
Dr. Berger said that the cuts to IFHP would have a “devastating” impact on refugee health.
“Now drugs for angina, diabetes, asthma, epilepsy, seizures and other chronic conditions are considered ‘unnecessary,’ just because Jason Kenney says so,” Dr. Berger said. “Nothing that this government says about the IFH changes can be believed. Their statements have been false and untrue.”
Dr. Berger said that physicians will be confronting government officials with instances of adverse health impacts on refugee patients, and a Refugee Health Outcome Monitoring Evaluating System would be used to track the impacts and report findings to the public and Conservative members of Parliament. Canadian Doctors for Refugee Care has also contacted coroners to be on alert for deaths that may result from the cuts to refugee care.
Last summer the Canadian Medical Association announced that it was working with Ottawa to improve refugee health care through a new electronic delivery service, but in an interview with The Hill Times last week, Dr. Haggie said that heath-care providers have become increasingly frustrated with the federal government’s disengagement on health care, and recent protests against the IFHP cuts are another expression of this frustration.
Dr. Haggie said that the April 25 order in council announcement was made “out of the blue” without any consultation or debate between the government and Canadian health-care providers.
“I think there’s a huge level of frustration about how to deal with this total lack of engagement from the federal level, and that’s what we’ve seen spilling into these meetings,” Dr. Haggie said. “They won’t talk about health care. They used some constitutional interpretation to get out of that, but they won’t even talk about health and they won’t even talk about health care for those groups that they’re constitutionally responsible for.”
Dr. Haggie said that the changes will only save the federal government money at the expense of the provincial and territorial health-care systems. He also took issue with the government’s argument that refugees should not receive better care than Canadian citizens.
“It’s like starting a race for the bottom instead of a race for the top,” Dr. Haggie observed. “[The IFHP] is actually very comprehensive, and could be regarded as a gold standard to which all Canadian systems and the federal government should aspire to.”
Original Article
Source: hill times
Author: CHRIS PLECASH
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