Canadian Health Coalition

Cuts to Refugee Health Care

CBC News (November 22, 2012)
Saskatchewan’s Wall slams federal cuts to refugee health

CBC News/YouTube.com (June/July 2012)
In Video: Conservative’s summer of refugee doctor discontent

Globe and Mail (July 7)
Nobel laureate joins Rabbi group in condemning refugee health care cuts

The Spectator (July 20, 2012)
Doctors crash federal event to protest refugee health cuts

Ottawa Citizen (July 15, 2012)
Doctors interrupt Conservative cabinet ministers to protest cuts to refugee health benefits

Canadian Press (July 14, 2012)
Teen gets removed while asking minister a question during Tory BBQ

CBC News (July 13, 2012)
Cabinet’s summer of refugee doctor discontent

CBC News (July 12, 2012)
Kenney’s refugee bill could deport young, mentally ill

HealthyDebate.ca (May 30, 2012)
Ten Reasons why the Refugee Health Care Cuts Are a Bad Idea

Letter to Minister Kenny from Health Professional (May 18, 2012)
Click here to read the letter (PDF)

CBC Radio’s “The Current” (May 14, 2012)
We’re well-known for protecting refugees, but Harper wants to deny these people healthcare

CBC News (May 11, 2012)
Doctors stage sit-in over refugee health cuts

Rabble.ca (May 11, 2012)
Stop cuts to refugee health

CBC News (May 11, 2012)
Doctors demand changes to proposed refugee health policy
Ottawa plan would cut medical services to many vulnerable refugees, including victims of torture

National Post (May 7, 2012)
Cuts to refugee health insurance dangerous, inhumane, doctors say

Yahoo News (May 8, 2012)
Cuts to refugee health care are a ‘disgrace to Canada’: watchdog

Ottawa Citizen (May 9, 2012)
Op-ed by Mark Tyndall: An attack on vulnerable refugees

Coalition canadienne de la santé / Canadian Health Coalition (May 7, 2012)
Media Release / Communiqué de presse
Harper’s Cuts to Refugee Health Care: A violation of medical ethics and a disgrace to Canada
Les coupes de Harper aux soins de santé aux réfugiés : une violation de l’éthique médicale et une honte pour le Canada

CBC News (April 25, 2012)
Refugee health benefits scaled back by Tories


RELATED:

Doctors for Refugee Health Care Website, Facebook Page and Twitter Stream

Joint letter sent by national health professional organizations to the Federal Minister of Health


 
CBC News/YouTube.com (June/July 2012)
Conservative’s summer of refugee doctor discontent
ER… Excuse Me! Interuptions caught on video

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Globe and Mail (July 7)
Nobel laureate joins Rabbi group in condemning refugee health care cuts
By Gloria Galloway

Holocaust survivor and Nobel Peace Prize winner Elie Wiesel has joined leading members of his Jewish faith in denouncing cuts to the funding of refugee health care introduced by the Conservative government of Prime Minister Stephen Harper, which has spent years courting the voters in that community.

The challenge to the rollback of health benefits is the latest attack against the measures that were part of a sweeping slate of reforms to Canada’s immigration system. Eight of Canada’s leading health associations have condemned the reductions. Doctors threaten to keep account of the harm done. And the Canadian Medical Association Journal is publishing an article on Monday that will say that the new rules are potentially damaging to the psychiatric health of vulnerable people.

The Toronto Board of Rabbis wrote to Mr. Harper asking him to abandon the changes. It was an unusual step for a religious group that is rarely political, and which represents a segment of the population that the Harper government has actively pursued in its efforts to win support among Canada’s ethnic and religious groups. Significant numbers of Jewish voters have migrated to the Tories from the Liberals since 2006 as a result of Mr. Harper’s strong support for Israel.

The backlash against the changes to refugee health coverage is one of the few times that a core constituency of the Conservatives has spoken out strongly against a central plank of the government’s policy – although there have been other instances, including seniors’ anger over changes to the taxation rules around income trusts and Old Age Security.

Mr. Wiesel, who survived the Auschwitz death camp to become a renowned scholar and political activist in the United States, said this week in a written statement obtained by The Globe and Mail that he stands in solidarity with the Toronto Rabbis. The rabbis said it is wrong for the government to designate some countries as being “safe” and to deny payments for medical treatments obtained by asylum seekers from those places.

“As a former refugee, together with the Toronto Board of Rabbis, I feel morally compelled to remain on the side of other uprooted men and women everywhere,” said Mr. Wiesel, who was a keynote speaker two years ago at a conference on anti-Semitism in Ottawa that was organized with the help of Immigration Minister Jason Kenney, the minister behind the refugee reforms. “Today, as yesterday, a nation is judged by its attitude towards refugees,” Mr. Wiesel wrote.

Shimon Fogel, the CEO of the Centre for Israel and Jewish Affairs, said his organization agrees with many of the changes the Conservative government has made to refugee policy and with the goal of preventing bogus claims. But, with regard to the health benefits, “we have some concerns, and we have registered some of them with the government.”

But the Harper government does not appear swayed by the response, even if it is coming from a community that it has worked hard to bring into the party fold. A spokesman for Mr. Kenney said those criticizing the reforms do not understand them.

The government believes most Canadians would find it shocking that the number one source of refugees to Canada is a country in Europe, the spokesman said. “Right now, nearly 95 per cent of people who come here from the European Union and claim asylum either withdraw or abandon their own claim,” said the spokesman, because they cannot make a legitimate case for asylum. He added that 100 per cent of people who come from the European Union register for welfare.

The top country of origin for refugee claimants in Canada is Hungary, and the majority of those refugees are Roma, a group that has had a strong bond with the Jews dating back to the Second World War.

“The special relationship is that we found ourselves during the Shoah being together in Auschwitz and being persecuted at the same time,” said Nate Leipciger of Toronto, a former co-president of the Canadian Jewish Holocaust Survivors of Canada. When Canada turned away more than 900 Jews on board the MS St. Louis in 1939 and sent them back to the horrors of pre-war Germany, the government considered Germany safe, Mr. Leipciger said. “It was safe for Germans, just as Hungary is safe today for Hungarians. It not safe for Roma.”

Under the rules that took that took effect a week ago, all benefits and payments for treatment formerly provided under the Interim Federal Health Program will be denied to refugees who come from a country that Canada declares to be safe. That list of countries has yet to be announced but it is expected to include Hungary.

Refugees who come from countries that are not on the safe list, and who are not among the relatively small number of claimants brought to Canada directly by the government, no longer qualify for supplemental health benefits, including payments for prescription drugs, vision care and dental coverage. They are entitled to medical health coverage only if it is of “an urgent or essential nature.”

Mr. Kenney says that the moves, which will save the government about $20-million annually, were necessary because refugees were receiving better health benefits than ordinary Canadians were getting. But doctors point out that people seeking asylum in Canada are often very poor and, under the old system, were getting the same benefits that hundreds of thousands of impoverished Canadians receive through social assistance.

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The Spectator (July 20, 2012)
Doctors crash federal event to protest refugee health cuts
By Joanna Frketich

Hamilton doctors crashed a federal health announcement to protest cuts to refugee care that took effect this month.

They told the story of a seven-year-old epileptic boy who was refused his anti-seizure medication at an area pharmacy because his mother couldn’t pay for it. He went on to have a prolonged seizure that required emergency care. His mom called 911, he was taken by ambulance to McMaster Children’s Hospital and admitted for two days.

“I would like to ask the minister if that makes financial sense given that the medication to prevent this costs pennies a day,” said internist Dr. Christian Kraeker.

Health Minister Leona Aglukkaq thanked the four doctors, one medical student and a nurse for raising their concerns during her first visit to Hamilton to announce money for bone research at McMaster University Thursday.

“Individuals coming into Canada will have the same coverage as all Canadians and individuals rejected will no longer be covered by Canada’s health-care system,” she said in response to their questions. “I think that’s fair to Canadians and I think Canadians will accept that.”

She didn’t address concerns about cuts to care for refugee claimants waiting for a decision. Those who come from countries deemed to be safe by the federal government have no health coverage at all except for issues of public safety such as tuberculosis.

However, the government hasn’t yet publicly released the list of safe countries. As a result, it’s not clear to health-care providers which refugee claimants are covered. The doctors say the boy was a victim of this confusion because his drug should still have been covered. They also talked about a refugee claimant from Hungary who is 35 weeks pregnant and having difficulty getting prenatal care.

The cuts to the interim federal health program have been opposed by virtually every type of health-care provider. At the urging of the Canadian Doctors for Refugee Care, physicians have been interrupting federal announcements to protest the cuts since they took effect June 30.

“We have grave concerns,” said internist Dr. Tim O’Shea during the event. “These cuts are putting the lives and the health of our patients at risk. As a group we are desperate to see these cuts reversed.”

O’Shea pointed out to the minister that the federal government has refused to meet with health-care providers to hear their concerns so that is why they disrupted the event. The doctors interrupted the announcement twice, once in the middle and once at the end. Both times they waited until key speeches were done, made their points respectfully, thanked the minister for listening and sat back down. They also held up signs during the event.

“I don’t think we were able to get our full point across and that’s one of our main frustrations,” said O’Shea after the funding announcement. “None of us want to disrupt meetings — especially for our colleagues — but we really feel we have no choice.”

Aglukkaq said the country’s doctors’ have a right to free speech so she doesn’t have a problem with her events continually being disrupted. However, she made it clear that she disagrees with the doctors.

“We plan for our health-care system with our population. What we don’t do is plan for a health-care system of non-Canadians,” she said after the event. “I think this is about fairness to Canadians and Canadians would expect that.”

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RELATED: Hamilton doctors protest at federal announcement, The Spectator, July 20, 2012

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Ottawa Citizen (July 15, 2012)
Doctors interrupt Conservative cabinet ministers to protest cuts to refugee health benefits
By Joanna Smith

OTTAWA—Dr. Mark Tyndall rarely wears his white lab coat while working at the hospital, but he knew it would make an impression when he barged onto the race track.

“It’s symbolic. It’s the only time I wear it,” Tyndall, head of infectious diseases at the Ottawa Hospital, said with a chuckle Friday morning shortly after interrupting a Conservative government photo op to protest recent cuts to health benefits for refugees.

Bal Gosal, the federal minister of state for sport, had just wrapped up announcing $4.7 million for Athletics Canada — Olympic and Paralympic track-and-field athletes lined up nicely in front of a poster advertising the Economic Action Plan — at an Ottawa race track with a hearty “Let’s go, Canada!” when he looked up from his notes on the podium.

Tyndall had made his entrance.

Over the past few weeks, a handful of doctors and medical students associated with the group Canadian Doctors for Refugee Care have interrupted ministerial announcements to raise awareness about recent changes to the Interim Federal Health Program, which provides temporary costs of medical coverage to refugee claimants.

Gosal alone was interrupted at three different events last week and his spokeswoman did not respond to a request for comment.

“There is a new way of thinking in medicine, which is that doctors, because of their stature, privilege and expertise, have a duty to speak out and cannot remain silent when the government places conditions on patients that make them sick,” said Dr. Philip Berger, chief of family and community medicine at St. Michael’s Hospital in Toronto, who had heckled Gosal during a Pan Am Games announcement at Nathan Phillips Square on Tuesday.

Still, there is a difference between organizing a news conference and crashing one, and these interrupting doctors confess to feeling some unease over doing something so bold.

“It’s not a comfortable situation for me to be doing this, but we feel that we have been left with few other choices and nobody’s listening,” Tyndall said Friday.

A government source said that while Immigration Minister Jason Kenney has not met Canadian Doctors for Refugee Care, he has discussed the issue with other medical organizations.

Canadian Doctors for Refugee Care stage the protests by sharing the publicly available details of ministerial announcements and photo ops on a listserv and asking for volunteers in the area to show up.

They know they have to be concise and work quickly.

“I know that I’ll have like two lines before I’m shuffled away, so I want to make my quick sound byte that this is a very big concern for us who are treating refugees,” Tyndall explained.

There are also some rules of engagement.

Family physician Dr. Doug Gruner, for example, pointed out he avoided interrupting triathlon champion Simon Whitfield, who last Thursday was revealed as the Canadian flag-bearer for the 2012 Olympic Games in London.

Berger said the group also decides on a case-by-case basis how and when a particular announcement should be interrupted and if it is about help for seniors or abused children, for example, it might not be interrupted at all.

Steve Outhouse, director of communications for federal Health Minister Leona Aglukkaq, said he appreciated it when a family doctor in Ottawa, waited until the minister had finished speaking when she came to an announcement about funding for health-care data on June 27.

“She was very respectful,” Outhouse said of Dr. Megan Williams, who waited for the minister to finish and for reporters to ask their questions before rising to ask her own.

Outhouse said preparing for the protesting doctors is not much different than preparing for the possibility of any other unexpected interruption.

“There had been a couple of other incidents so we knew it was a possibility, but you go into any event knowing it’s always technically a possibility anyway and the minister was ready to talk about our position,” Outhouse said.

“There will be more of these to come, by the way, so watch out,” Berger said Friday.

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Canadian Press (July 14, 2012)
Teen gets removed while asking immigration minister a question during Tory BBQ
By Rob Drinkwater

A protester who made it into a Conservative party barbecue in Edmonton says he was dragged out of the event and arrested by police when he tried to ask Immigration Minister Jason Kenney a question.

Bashir Mohamed, 17, planned to confront Kenney about the federal government’s cuts to refugee health care.

Mohamed said he was born in a refugee camp in Kenya and came to Canada with his parents when he was three.

He said he stood up and began to ask a question while Kenney was speaking, but was quickly grabbed by four men who pulled him outside.

He said police arrested him, but he was later released without charges.

“The police were very nice. They just wanted to figure out what was going on. I have nothing against the police,” Bashir said shortly after he was released.

Steven Dollansky, the president of the Edmonton Centre Conservative Association and a member of the group that organized the barbecue, explained that the protester was removed because he interrupted the minister in the middle of his speech.

“He stood up and screamed at the minister during his speech. That was not the appropriate time to speak and he was asked to leave,” Dollansky said.

Dollansky said there was some physical contact as the protester was removed, but he said it was difficult to avoid in such a situation.

The event, attended by close to 400 people, was held Saturday evening inside a hangar at the Alberta Aviation Museum.

Mohamed, wearing a tie, said he got in by buying a $40 ticket in advance to the barbecue. He said he posed as a young conservative and ate with the rest of the attendees while he waited for Kenney to speak.

He said he stood up as Kenney was speaking and began to explain that he’d come to Canada as a refugee, but he said it wasn’t long before he was grabbed and led out. He said he shouted, “Jason Kenney is killing compassion with his health care cuts,” as he was pulled outside. He said he fell along the way, but wasn’t hurt.

The people who pulled him outside, he said, told him he’d be charged with assault.

“I was expecting I’d be charged with mischief. I was shocked when they said assault because I didn’t assault anyone,” said Mohamed.

The policy, which strips refugee claimants of access to pharmaceutical, dental and vision coverage and also limits other forms of coverage, was announced in April and is projected to save the government $20 million a year for the next five years.

Originally, it divided refugee claimants into two groups based on the status of their claim and country of origin. Neither would receive extended benefits.

Those whose claim is rejected or who are from a yet-to-be defined list of countries would only receive health care if there was a public health or safety risk.

The government has since amended the policy to provide for a third group of refugee claimants who are covered by a federal program that provides financial and other assistance.

They will receive the extended benefits as long as they are covered by that program.

As people arrived for Saturday’s barbecue, about two dozen demonstrators sold lemonade at a makeshift stand outside the museum. The price of a cup was 59 cents, which the group said is what it would cost per Canadian to end the cuts to refugee health care.

The stand was kept away from the entrance, so Kenney’s arrival wasn’t noticed by the demonstrators. His car pulled up to the museum entrance and he entered the venue without a confrontation.

Dollansky said the museum called police to the scene after the demonstrators twice refused requests from the facility’s director to move to the edge of the property.

It wasn’t the only action taken by those against the refugee health cuts this weekend.

A handful of protesters attended a rally Sunday at a downtown Toronto park. They called on health care professionals to upload their photo to an online petition as a way to show opposition to the change.

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CBC News (July 12, 2012)
Kenney’s refugee bill could deport young, mentally ill
Bill C-43, introduced June 20, would deport more criminals faster, without the right to appeal

Professionals who work with immigrants and refugees are raising concerns that new federal legislation unfairly punishes the young and the mentally ill.

Immigration Minister Jason Kenney introduced a bill on June 20 that allows the government to deport non-citizens who are convicted of serious crimes carrying a sentence of six months or longer, with no right of appeal.

Currently, there is no right to appeal deportations for anyone sentenced to two years or more. Kenney has said the tougher rules are necessary to protect Canadians against foreign criminals.

The head of the Canadian Somali Congress, Ahmed Hussen, believes the new bill will drastically increase the number of young immigrant males who are deported without appeal, including Somali refugees raised mainly in Canada, who have little or no connection to the land of their birth.

“The net will be cast wider and it will capture even more people,” Hussen says.

One big mistake on the part of these young men could see them sent to a dangerous place they know nothing about, he says.

“For the people that are likely to be captured by this new law, we feel that a good number of them are first-time offenders who, if given a chance, would most likely reform and change their behaviour,” he says.

Michael Bossin, a refugee lawyer in Ottawa, says that in his experience, these young offenders “learn their lesson when they’re in jail. They get a job, they get responsibility, they get a family… They are no longer a danger to the public.”

Bossin says that when a deportation is stayed, it works like a probation for young immigrants and often spurs them to change their ways. In his view, the changes could see Canada exporting its social problems abroad, without addressing the root causes of their crimes.

Mental health concerns

Jean Lash, an immigration and refugee lawyer with South Ottawa Community Legal Services, says the changes will affect many people who suffer from psychiatric problems.

“We see a lot of people with mental illnesses who are criminalized. And I think it’s well known there are many people with mental illnesses in the criminal justice system,” she says.

Kenney’s new bill would remove any discretion for a judge to consider the nature of the crime and the context in which it was committed, including potential mental illness in refugees from war-torn countries.

“Those people in many cases commit crimes when they’re not being treated,” says Bossin.

“They commit a crime that gets them into a system that gets them treatment, and they get their medication. They get in a program, they have family support, they have community support, they are in no way by the wildest imagination any threat to anyone any more,” he says.

Bossin believes the mentally ill will face undue hardship if they’re deported to countries where mental illness is often stigmatized and punished.

Earlier this week, a commentary published in the Canadian Medical Association Journal said the government’s omnibus refugee legislation, which became law on June 28, could also have a negative impact on the mental health of refugees.

New provisions allow the minister to detain any arrivals over the age of 16 designated as “irregular arrivals,” even when it means separating refugee children from their families.

Medical professionals are concerned about the higher levels of psychiatric symptoms found in detained refugee claimants, and the potential long-term effects of depression, anxiety and post-traumatic stress disorders exacerbated by the detention period.

Other changes that took effect June 30 removed the supplementary health care benefits previously available to refugees when they arrived in Canada.

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CBC News (July 13, 2012)
Cabinet’s summer of refugee doctor discontent
By Janyce McGregor

Doctors threatened to show up and disrupt events featuring Conservative MPs and cabinet ministers all summer long. Turns out, they meant it: at least if Amateur Sport Minister Bal Gosal’s past week is any indication.

The medical community and others who work with and advocate for refugees are upset about the Harper government’s decision to cut the interim federal health program for refugees as of June 30.

The program provided extended health care benefits for things like prescriptions, dental care or optometrist visits that Canadians without private health insurance pay for out of pocket. Cutting it off for all but government-sponsored refugees is estimated to save some $100 million.

Doctors say they’ve tried to consult with the Harper government but neither Immigration Minister Jason Kenney nor anyone else will engage. So they’ve decided to be a thorn in the government’s side instead.

Our CBC cameras captured this first at a Toronto press conference featuring Natural Resources Minister Joe Oliver, when a doctor and a medical student hijacked a medical isotope research funding announcement, engaged in some verbal sparring with the minister and eventually caused the event to be moved to another room.

Tuesday, it was Gosal’s turn, during an event to promote Toronto as the host of the Pan Am Games in 2015. When the doctors representing another ad hoc advocacy group started yelling, Toronto Mayor Rob Ford stepped up to the podium, hitting pause on Gosal’s remarks until security escorted the dissenting doctors away.

Things didn’t end there for Gosal. On Thursday, during his remarks at the Parliament Hill event to announce Simon Whitfield as Canada’s Olympic flag bearer, Dr. Doug Gruner, who participated in earlier protests and spoken to the media earlier this spring about the cuts, started yelling at Gosal near the end of his remarks.

Gruner is a family physician at the Bruyere Medical Centre in Ottawa. He works with a program that helps introduce refugees to the medical system, and he’s done several stints working with refugees in third-world countries.

He told reporters he didn’t want to insult Whitfield or take anything away from the Olympic announcement, but doctors feel they have no other choice but to take this confrontational approach to get their message across to a government that won’t listen to them.

On Friday, Gosal was dogged again by an angry doctor intending to deliver the same message at an event to announce government sports funding with members of Canada’s track team.

Dr. Mark Tyndall is the head of infectious diseases at the Ottawa Hospital and teaches medicine at the University of Ottawa. He’s been complaining about the cuts since early May, telling the CBC last month that Kenney’s cuts were divisive, “pitting taxpaying Canadians who are dissatisfied with their own health care against some of the most vulnerable people in the world.”

Tyndall went beyond that Friday after being escorted away from Gosal’s event, getting personal about Gosal’s background as an immigrant and accusing Kenney of hurting multiculturalism in Canada by cutting extended health care for refugees, an “experiment in human misery.”

“If Minister Kenney believes that all Canadians inhabiting our country should be short, round and white, then I think that’s the kind of message that he’s giving people,” Tyndall told reporters.

Alexis Pavlich, Kenney’s media spokesperson, wrote to CBC News that Tyndall’s Friday remarks constituted “an obscene comment from a special interest activist with an axe to grind.”

“It says much more about his credibility than it does about Mr. Kenney,” Pavlich wrote, touting Kenney’s record as immigration minister, during which “Canada has maintained the highest sustained levels of immigration in Canadian history, and the highest per capita levels in the developed world, with some 90 per cent of newcomers arriving from Asia, Africa, Latin America, and the Caribbean.”

“Mr. Kenney is increasing by 20 per cent the number of resettled refugees invited here to start new lives, making [Canada] the world leader in refugee resettlement,” Pavlich continued.

“These newcomers come to Canada to make our country a better place and, unlike Tyndall, are too busy working and too polite to spend their days heckling people.”

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HealthyDebate.ca (May 30, 2012)
Ten Reasons why the Refugee Health Care Cuts Are a Bad Idea
By Naheed Dosani & Ritika Goel

In 2011, Su-Yun Kim and her husband arrived in Canada hoping for a better life, as many refugee claimants do. In North Korea where they were born and raised, Su-Yun’s husband was involved in political activity, necessitating that they flee from their loved ones and their home for safety. With difficulty, they managed to escape through China and arrived in Canada, a foreign land with unfamiliar faces, new customs and a different language. We met this couple not long after these events at a refugee shelter which houses and supports refugee claimants. Su-Yun was pregnant when she arrived and required initial prenatal care, which we provided her through the help of an interpreter. Although we could never directly communicate in the same language, the gratitude in this young couple’s eyes and gestures was clearly evident. After fearing for their lives and traveling halfway around the world, they were overwhelmed to find a team of health professionals who cared about their total well-being. No matter where people have come from, the stories of refugees and refugee claimants are often remarkably similar. These are people who have traveled long and far, often to escape war and persecution. They are here not to scam a system, but because they had no choice but to leave their homes. Unfortunately, this is not the picture that has been painted by Jason Kenney, Canada’s Federal Minister of Citizenship, Immigration and Multiculturalism.

Recently, Minister Kenney has proposed drastic changes to the Interim Federal Health Program (IFHP), the very program that allowed us to provide Su-Yun with her prenatal care. This program provides healthcare services for refugees who have been accepted by Canada through refugee camps, as well as those who arrive at our doors for asylum, like Su-Yun and her husband. These cuts would deny all refugees and refugee claimants access to essential medicines. It would also deny regular healthcare services to refugee claimants deemed to come from ‘safe countries’, a questionable classification given the unique situation of each refugee claimant. Understandably, healthcare providers and the public have been outraged over these cuts by staging demonstrations across the country and even a public letter signed by major health provider organizations such as the Canadian Medical Association. Here, we seek to systematically highlight ten reasons why the proposed cuts to the IFHP are a poor policy decision.

1. Worse health outcomes for refugees.

Numerous health organizations and health professionals have expressed their concern over the impact of proposed cuts on the health status of refugees. A Wellesley Institute Health Equity Impact Assessment conducted on the policy change noted that it will likely create more barriers for refugees to receive basic care. The report notes that women and children will be at particular risk, especially if they are victims of physical and emotional abuse. It further states that decreasing access to prenatal care and early childhood interventions could lead to developmental problems for children of refugees, many of whom will be born as or eventually become Canadian citizens. Finally, it predicts that the prevalence of chronic conditions, both physical (e.g. diabetes) and mental (e.g. depression), will increase due to inadequate primary care and monitoring. A particularly striking example of the health effects of this policy is that refugees from countries labeled as ‘safe’, would not even be treated for heart attacks! Among public health experts, there is little doubt that these policy changes will increase the health disparity gap in an already vulnerable subset of the population and worsen the health of refugees in Canada.

2. A threat to the health and safety of Canadians.

Many healthcare professionals believe that the IFHP cuts are not in the best interests of Canadian safety. Without ongoing care from primary care providers, dangerous conditions can go undiagnosed for long periods of time. While the policy purports to provide care for conditions threatening public health, these conditions, such as the highly contagious and deadly tuberculosis, are likely to remain undiagnosed until it is too late. How are refugee claimants to know that they can see a doctor because they now have a disease of concern to public health? Such a disease is often diagnosed in primary care via screening chest x-rays and dealt with before it becomes a threat to public health. By not providing basic care, we are only increasing the health and safety risk posed not just to refugees themselves, but also to the Canadian public.

3. Refugees are not here to abuse Canada’s healthcare system.

The government has attempted to justify the IFHP cuts by painting a very misleading image of refugees and refugee claimants as people who aim to abuse Canada’s generosity via our healthcare system. Not only is it unfair to imply that refugee claimants come to Canada simply to gain access to healthcare services, but this also ignores the fact that individuals selected by our very own government for immigration (government-assisted refugees), are also having benefits cut under these changes. If anything, given the cultural and language barriers, healthcare professionals are often unable to reach refugees and refugee claimants as much as they would like, to provide the kinds of services that they need. As Dr. Meb Rashid of the Crossroads Clinic said, “I’ve seen over 2000 refugee claimants and I can’t recall more than a handful who strike me as being wealthy or here for adventure. The government is painting them to be bogus and cheating the system. That really hasn’t been my experience.”

4. Costs will increase and burden provinces and community groups.

While the primary stated motive behind the government’s proposed cutbacks to the IFHP is to save taxpayer dollars (approximately $20 million annually), this argument doesn’t really hold much weight. A robust body of research supports the notion that timely, organized and prevention-focused primary care, can significantly decrease healthcare costs. Without ongoing treatment of diabetes, hypertension, mental illness and access to prenatal care, refugees who have already endured great personal strife will only get sicker and present to emergency rooms with expensive complications. This will increase wait times at Emergency Departments and some also believe that these associated costs will be shifted to the provinces. Numerous preventative cost-saving measures that occur in primary care will no longer be available and as a result, taxpayers will conversely pay more for hospitalizations due to preventable complications.

5. Inconsistent with Canadian values.

Not only will these cuts be bad for the health and wallets of refugees and Canadians, they are inconsistent with Canadian values. The Canada Health Act, our federal legislation that enacted Canada’s cherished universal public healthcare system states “the primary objective of Canadian health care policy is to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.” The Act clearly exemplifies how Canadians have chosen to protect the health of all those within our borders, and not just its citizens. As Dr. Philip Berger stated, “Canadians are fair-minded people that would never accept turning anybody down, whether refugee or tourist or citizen, when they’re suffering from a heart attack.”

6. Inhumane, unjust and in contravention of human rights.

What has struck many who have denounced these cuts is the mean-spirited nature of the proposed changes. Refugees and refugee claimants are among the most vulnerable members of our society. Given the frequently urgent reasons for their departure, often refugees and refugee claimants arrive with few belongings to a country with no friends and family and a head full of traumatic memories. To then deny this population access to essential medicines, or even basic healthcare services, is simply cruel. The Universal Declaration of Human Rights, adopted by the UN General Assembly in 1948, clearly states, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services.”

7. Perpetuating the cycle of poverty.

Many refugees come to Canada for a better life for their families after fleeing war and/or persecution. As part of this process, refugees are statistically much more likely to live in poverty than non-immigrant Canadians. Income level is the most important determinant of one’s health, and on top of acclimatizing to a new culture and society, the stress of living in poverty can be very detrimental to the health of this population. In turn, it is crucial to ensure that access to healthcare services is available for this marginalized group rather than exacerbating their challenges. Furthermore, without primary healthcare, refugees will not receive the kind of support, counseling and connection to social services that has shown to benefit successful incorporation into Canadian society. How can we reasonably expect refugees to productively contribute to society if they are living in poverty and not able to receive treatment for their medical conditions?

8. Canada’s international reputation is at stake.

In the grand scheme, the proposed cuts reflect a change in the way Canada is being viewed internationally. In 2010, for the first time in history, Canada lost its bid for a seat on the UN Security Council. This was largely believed to be the result of a shift in Canada’s foreign policy and a lack of action on climate change. At such a sensitive time on the world stage, it is not in our nation’s best interest to be seen as unsupportive of our most vulnerable populations and accusing them of abusing our services. Dr. Mark Tyndall, a physician in Ottawa, also felt these “unfair and unethical” cuts would reflect poorly on Canada, by “taking the most disadvantaged and traumatized human beings on Earth and telling them we have been too generous for too long.”

9. Unsustainable for our healthcare system.

Canadians cherish their universal public healthcare system, and yet, the proposed cuts are threatening its sustainability. There is no doubt that chronic medical conditions are best managed in primary healthcare settings. Not only are diseases more easily diagnosed in primary care but this model has been shown to be cheaper for taxpayers. As Rachel Bard, CEO of the Canadian Nurses Association, has stated, “A system based on acute care and emergency treatments cannot work. Preventive approaches are critical to the sustainability of the system and the health of our population.” Cuts to refugee health benefits will only decrease the amount of preventative care available and will lead to increased usage of our hospitals and emergency rooms. We must all work together to ensure our healthcare system is sustainable, for everyone.

10. Refugees are not currently getting MORE than most Canadians.

Recently, Minister Kenney has widely promoted the notion that the IFHP provides services beyond what is available to Canadian citizens in order to justify the proposed cuts. The services he is referring to (coverage for essential medicines and minimal coverage for urgent dental care & eyeglasses) are similar to what is covered under provincial public plans for those living in poverty. The refugee and refugee claimant population frequently arrive in Canada with little to no money and would only be accessing the same benefits available to Canadians in the same financial bracket. Furthermore, the IFHP actually denies some preventative services (such as stool testing for colon cancer) and has extra paperwork that makes care cumbersome for clinicians.

Ironically, these changes will take effect on our nation’s anniversary, Canada Day (July 1, 2012). For Su-Yun, her husband and her newborn baby, this Canada Day will forever signify a change in attitude towards her family and people like her. A change away from the Canada that accepted her with open arms and cared for her throughout her pregnancy, to one that will now take away her essential medications and her access to health care. This is not the Canada she came to for a better life and this is not the Canada we want.

Naheed Dosani is a Family Medicine Resident with the Department of Community and Family Medicine at the University of Toronto and is training at St. Michael’s Hospital in Toronto.

Ritika Goel is a Family Physician in Toronto who cares for refugees and refugee claimants and is a Public Health Professional.

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CBC Radio (May 14, 2012)
Canada’s well-known for protection of refugees. Now the Harper gov’t wants to deny these people health care if they get sick …
From “The Current” with Anna Maria Tremonti

CLICK HERE TO LISTEN

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CBC News (May 11, 2012)
Doctors stage sit-in over refugee health care cuts
Government plan would cut services to refugee claimants
By Maureen Brosnahan

About 80 doctors staged a sit-in at the Toronto office of federal cabinet minister Joe Oliver Friday, with the activists demanding to meet with the minister to raise concerns about changes to health care for refugees and refugee claimants.

“I just cannot understand how my government can take the most vulnerable of people and decide it’s appropriate to make them more vulnerable,” said Dr. Paul Caulford, a Scarborough, Ont., family physician, who has worked with immigrants and refugees for decades.

The local doctors chose Oliver’s office because he is the cabinet minister who represents Toronto.

Under the plan, some refugee claimants would only be entitled to urgent care — others would be denied all care unless they have a disease that would be a risk to the public, such as tuberculosis. Immigration Minister Jason Kenney says the plan is to ensure refugees don’t get better health care than ordinary Canadians. He said the move would save the government about $100 million over the next five years.

Oliver was not at his office but about 60 of the doctors occupied it for about half an hour before police arrived and asked them to leave. They continued their protest outside on the street for another two hours.

Patients worried about being cut off medications

Waving placards and using a megaphone, doctor after doctor decried the proposal, calling it short-sighted and contrary to Canadian values.

“If Canadians knew what was happening they would be outraged,” said Dr. Meb Rashid, director of The Crossroads clinic at Toronto’s Women’s College Hospital, which provides care for refugees.

He said his patients are already worried that under the plan, they will be cut off from life-saving medications such as insulin and hypertension drugs.

The new policy is set to take effect at the end of June. It means many refugee claimants will only be treated if they have an infection or disease that poses a risk to public health.

“Does this mean it’s OK that a person seeking refuge in Canada dies from heart disease or from untreated diabetes, as long as they don’t infect the rest of us with tuberculosis?” asked Dr. Tatiana Friere-Lizama, a perinatologist at St. Michael’s Hospital in Toronto.

Friere-Lizama came to Canada as a refugee from Chile when she was seven. She said her family came with nothing but benefited from the country’s generosity.

“These changes to refugee health are an attack on our beliefs,” she said. “As doctors, we’ve got to speak up for our refugee patients. They deserve to land in a Canada that cares about them.”

Designed to deter fraud

The government says the move is also designed to deter fraudulent refugee claimants from coming to Canada for free health and dental care.

But Dr. Philip Berger, chief of family medicine at St. Michael’s Hospital in Toronto, calls that absurd.

“Someone coming out of a camp somewhere, having lost their husband and with two kids, is not going to be running for a teeth cleaning when they set foot in Canada.”

A spokesperson for Oliver said in a statement that the minister was out of the office on business, adding that had the doctors made a request in advance, he might have agreed to meet them.

The move was one of several protests held across the country by doctors who say denying health services to refugees is mean-spirited and counter-productive.

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Rabble.ca (May 11, 2012)
Stop cuts to refugee health
By Jesse McLaren

Today doctors across the country took action against proposed cuts to refugee health. There were occupations of Tory offices in Winnipeg and Toronto, a rally in Ottawa and press conferences in other cities.

On April 25, Citizenship and Immigration Minister Jason Kenney announced drastic cuts to the Interim Federal Health Program. These cuts, which are scheduled to take effect on June 30, are cruel, costly and a threat to public health. According to the Canadian Council for Refugees (CCR), the cuts to the Interim Federal Health Program (IFHP) will have the following impact:

– Create a two-tier system of refugee care in Canada, discriminating between refugee claimants on the basis of their country of origin.

– Deny necessary medical care on arrival in Canada to resettled refugees or accepted refugee claimants with acute health needs.

– Institutionalize gender discrimination.

– Deny long-term, essential medical coverage to individuals who are living in Canada in limbo.

– Offload costs to provinces.

As CCR President Wanda Yamamoto summarized, “Thousands of people now receiving medication for everything from epilepsy and childhood respiratory illnesses to cancer and AIDS will no longer have access as of 30 June 2012. Will it take some deaths for the government to change its mind?”

Bogus arguments

The Tories justify the cuts by claiming that they will promote fairness, save money and protect public health. But these arguments are bogus. Denying basic and medically necessary health care for people who have been forced to leave their countries to escape war, rape, torture and persecution is not fair, it is inhumane.

Furthermore, as the CCR points out, “the government’s own figures show that the per capita cost for refugee claimants under the IFHP is only about 10 per cent of the average per capita cost for Canadians.” Refugees are not a drain on the system, and depriving of them of basic health care needs will not save money. Instead, denying people cost-effective preventive care will force them to suffer complications of untreated conditions, which is costly and a threat to public health.

As infectious disease specialist Dr. Mark Tyndall wrote, “there is not a health economist in the world who would tell you that restricting primary and preventive care is a cost saver. In fact, waiting until people require urgent care before intervening is contrary to everything we know about sound health economics. Does Immigration Minister Jason Kenney really believe that we shouldn’t treat someone’s high blood pressure, diabetes, depression or arthritis or offer pre-natal care to expectant mothers?”

The real purpose of these cuts are to scapegoat refugees for the austerity agenda. Just a few months ago the Harper government announced $21 billion in cuts to Medicare, part of a prescription for privatization.

To distract from that, they are blaming the very modest $84 million IFHP. As Dr. Tyndall wrote, “It is reprehensible that Minister Kenney is pitting Canadians who are dissatisfied with their own medical coverage, against refugees, as depicted in a shameless petition posted on his official website.”

Cutting refugee health is the sharp end of the wedge to cutting public health care. According to Michael McBane from the Canadian Health Coalition, “The dismantling of one of the oldest parts of Canada’s public healthcare system –health care for displaced persons who arrived in Canada following World War II — is symptomatic of the Harper government’s approach to health care. ‘Cut and run’ is their motto and changing the hearts of Canadians from compassion to contempt is their goal.” This goal is also being pursued by criminalizing refugees with Bill C-4 and Bill C-31.

A broad coalition of groups — migrant justice groups, labour and student groups, health and health care provider groups — will be necessary to stop these harmful cuts to refugee health.

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CBC News (May 11, 2012)
Doctors demand changes to proposed refugee health policy
Ottawa plan would cut medical services to many vulnerable refugees, including victims of torture
By Maureen Brosnahan

Doctors across Canada are outraged that the federal government plans to eliminate health care services for some refugee claimants and limit the care provided to others. Many are now talking about taking action to protest against the move.

The plan, introduced by Citizenship and Immigration Minister Jason Kenney, means refugees fleeing unsafe countries would only be entitled to “urgent or essential services.” Some refugees would be denied all care, unless they have a disease such as tuberculosis, which would pose a risk to public health.

The move is scheduled to take effect at the end of next month.

“This is a dramatic change,” says Dr. Meb Rashid, director of The Crossroads Clinic at Women’s College Hospital in Toronto.

The clinic, which is affiliated with the University of Toronto, opened its doors about five months ago specifically to provide health care to refugees. It now has about 300 patients, who come from dozens of countries.

No access to medications

“My biggest concern is they won’t have access to medications,” Rashid says. “Some people will get very sick and we hope no one dies from this, but it is certainly a possibility.”

The Interim Federal Health Program offers basic health coverage to protected persons, refugee claimants and others who don’t qualify for provincial or territorial coverage. Last year it cost $84 million. The government says scaling it back will save about $100 million over the next five years.

The plan means some refugees will be denied all health services, except in cases where public health is at risk, according to Ana Curic, spokesperson for Jason Kenney. Still others will no longer receive supplemental benefits such as medications, dental care, vision care and mobility devices.

Pay or go without

That means refugees who are diabetic or who require medicine for chronic diseases or to treat infections will have to pay for it themselves or go without.

“There’s a tremendous irony in that we’ve had patients come from refugee camps where they’ve had access to NGOs [non-governmental organizations] who’ve been able to give them diabetic medication or hypertension medications and then we invite them here, and what happens? They don’t have access to medications,” Rashid says.

In a news release, Kenney rationalized the move by saying Canadians should not pay benefits for refugees that “are more generous than what they are entitled to themselves.”

He added the move would also deter fraudulent refugee claimants from coming to Canada.

Mean-spirited move

But Rob Shropshire, interim director of the Canadian Council for Refugees, based in Montreal, calls the move “mean-spirited.”

“It’s picking on vulnerable people who are coming here to escape torture, persecution, war and they are coming here to try to find safety and build a new life,” he says.

He says Kenney appears to be pitting Canadians against refugees.

“It fans misunderstanding of who refugees are and why they come here,” he adds. “It promotes an image that refugees are bogus fraudsters and in fact that is not the case.”

Dr. Wendell Block has worked with refugees and with the Canadian Centre for Victims of Torture in Toronto for more than 25 years. He says many suffer from Post Traumatic Stress Disorder, have lost their families, faced torture, rape and other kinds of trauma.

He said they need both physical and mental health care to heal and start a new life here.

‘It’s going to be very, very difficult,” says Block. “The folks I see are going to be set back by this policy, no doubt, no doubt about it.”

Patients will become sicker

He predicts the plan will backfire, adding that those who are denied health care and drugs will become sicker, making it difficult for them to integrate into Canada and become productive citizens.

“If you are sick or in chronic pain, and you cannot get help when you arrive, you are not going to be able to do the jobs that require physical labour,” he says, adding that over time, many will deteriorate and eventually require hospitalization.

Shropshire says it’s unclear whether provincial governments will be asked to cover off some of the costs. He says he plans to meet with federal officials next week to get more details on just how the plan will roll out.

Block and Rashid say they will continue to treat patients as best they can, but the problem comes when they can’t refer them to specialists or order laboratory or diagnostic tests.

Meanwhile, Rashid and Block and dozens of other doctors across Canada are considering collective action to raise awareness of the issue across Canada.

“I think many of us feel the need to step up and inform people of the consequences,” Rashid says.

“These are folks who have lived through unimaginable trauma,” he says. “Just from a point of decency, to cut those people off from the care that they need just doesn’t seem like the Canada that I know.”

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National Post (May 7, 2012)
Cuts to refugee health insurance dangerous, inhumane, doctors say
By Gemma Karstens-Smith

OTTAWA — Looming cuts to refugee health benefits are inhumane, unethical and won’t save the government money, say some Ottawa doctors.

A program providing temporary health insurance to refugee applicants who aren’t eligible for provincial or territorial coverage will be pared back starting June 30, Minister of Citizenship and Immigration Jason Kenney announced last month.

The Interim Federal Health Program will no longer include vision, dental or supplemental health benefits for current and future asylum seekers. Most pharmaceutical benefits will also dry up.

Some claimants will still have access to hospital services, doctors and nurses, ambulances and medications or vaccines in urgent or essential situations.

Others, including those whose claims have been rejected, will have access to services only to “prevent or treat a disease posing a risk to the public health or a condition of public safety concern.”

Dr. Mark Tyndall, head of infectious diseases at The Ottawa Hospital, said the changes create a serious threat to public health.

“If we are only allowed to offer care to someone when they are spitting up blood in the emergency room, they will most certainly have already infected others (with tuberculosis),” Tyndall said Monday at a news conference held by the Canadian Health Coalition.

The changes will save an estimated $100 million over the next five years, according to a release announcing the changes.

The program cost $84.6 million in 2010-11 fiscal year, with approximately 96,000 people receiving at least one benefit, according to a spokesman from Citizenship and Immigration Canada.

But Tyndall said the cuts will actually cost money, not save it.

“There is not a health economist in the world who would tell you that restricting primary and preventive care is a cost-saver. In fact, waiting until people require urgent care runs contrary to everything we know about sound health economics,” Tyndall said, explaining that the changes will create emergency room visits and hospitalizations that could have been avoided — all at a cost to the government.

Saving money wasn’t the only rationale behind the looming changes, however.

“With this reform, we are also taking away an incentive from people who may be considering filing an unfounded refugee claim in Canada,” Kenney said in a news release. “These reforms allow us to protect public health and safety, ensure that tax dollars are spent wisely and defend the integrity of our immigration system all at the same time.”

Refugees don’t come to Canada for health care, Dr. Stephen Kravick said at the news conference.

“They don’t come to get their hips replaced or their teeth straightened,” said Kravick, a doctor at The Ottawa Hospital and professor at the University of Ottawa. “They come to Canada fleeing for their lives and trying to provide a better world for their children.”

Kravick said the “inhumane” changes will injure or kill refugees.

The “unfair and unethical” cuts will reflect poorly on Canada, Tyndall said.

“With these cutbacks, we are essentially taking the most disadvantaged and traumatized human beings on Earth and telling them we have been too generous for too long and there needs to be a correction,” Tyndall said.

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Yahoo News (May 8, 2012)
Cuts to refugee health care are a ‘disgrace to Canada’: watchdog
By Andy Radia

Looming cuts to refugee health benefits are inhumane, unethical and a disgrace to Canada, according to a Medicare watchdog.

Last month, citizenship and immigration minister Jason Kenney explained that Ottawa would no longer foot the bill for prescription drugs, dental care and eye care for citizens of other countries who are in Canada awaiting a refugee hearing.

That was a no-brainer. After all, why should refugee claimants get free benefits that Canadians have to pay for?

But according to the Canadian Health Coalition, the Harper government’s cuts go much deeper.

Indeed, as outlined at the Citizenship and Immigration Canada website, as of June 30, most refugee applicants will be denied basic health services unless it’s “of an urgent or essential nature” or “to treat a disease that is a risk to public health.”

The coalition says that means refugees in Canada will be cut off from preventative or primary care including treatment for chronic diseases such as hypertension, angina, diabetes, high cholesterol, and lung disease.

At a press conference Monday, coalition member and Ottawa Hospital Doctor Mark Tyndall said the changes are short-sighted.

“There is not a health economist in the world who would tell you that restricting primary and preventive care is a cost-saver,” he said according to the National Post.

“In fact, waiting until people require urgent care runs contrary to everything we know about sound health economics.”

Canadian immigration attorney Michael Niren says the move reflects badly on Canada.

“If Canada is to maintain its reputation as a humanitarian nation, depriving refugees of health care pending their claims, really amounts to a form of misrepresentation,” he told Yahoo! Canada News.

“On the one hand, we are saying come to our shores and seek protection. On the other hand, we are saying, but don’t get sick because then you are on your own.”

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Ottawa Citizen (May 9, 2012)
Op-Ed: An attack on vulnerable refugees
By Mark Tyndall

Since the federal budget was announced in March, Canadians have been inundated with funding cut announcements. On cue, Citizenship and Immigration Canada released a sweeping restructuring of the health benefits provided to refugees under the Interim Federal Health Program.

Beginning July 1, health coverage will only be provided for urgent health services (i.e. heart attacks), or for conditions deemed to pose a risk to public safety (i.e. tuberculosis). That’s it. No primary care, no treatment of chronic illnesses and, essentially, no medications. We are being told that these changes are needed to save taxpayers’ money and to discourage bogus refugee claimants from coming to Canada, neither of which is true. As an added bonus, the minister’s press release said that these changes would “ensure fairness and protect public health and safety.”

This statement is not only false, but the changes actually also create inequity and pose a serious threat to public health in Canada.

Just so we are all talking about the same issue, a few refugee facts. Canada offers refugee protection to people who fear persecution or whose removal from Canada would subject them to a danger of torture, a risk to their life or a risk of cruel and unusual treatment or punishment. These are real people coming from horrendous situations. In 2011, there were 28,000 applications in Canada, and this number has been relatively steady over the past decade. The United Nations High Commission for Refugees reports that there are 43.7 million refugees globally, so our contribution to dealing with this global disaster is modest at best.

The justifications for these cutbacks are based on two main arguments: saving money and preventing abuse of the system. First, there is not a health economist in the world who would tell you that restricting primary and preventive care is a cost saver. In fact, waiting until people require urgent care before intervening is contrary to everything we know about sound health economics. Does Immigration Minister Jason Kenney really believe that we shouldn’t treat someone’s high blood pressure, diabetes, depression or arthritis or offer pre-natal care to expectant mothers? These are proven health interventions that are offered to all Canadians because they not only prevent individual suffering, but they are also extremely cost-effective and save taxpayers money.

Secondly, we are told that refugees are abusing our health care system and that our generous health benefits are encouraging people to seek asylum. The reality is the exact opposite. As a physician dealing with refugees and other stigmatized groups, the main challenge is to connect them with health care services, especially prevention and primary care. Refugees do not come to Canada because they want better health care. In comparison to escaping starvation, torture, and rape, receiving health benefits is never the motivation.

In addition to these two false justifications, the minister evokes fairness and enhanced public safety as other “benefits.” The fairness argument appears to relate to the “extended” benefits that were previously being offered to refugees including vision care, dental care and mobility devices. Although it is true that not all Canadians enjoy this basic coverage, it is a very small part of the severe restrictions that are being imposed. We are actually talking about denying people treatment for diseases such as diabetes and heart disease or denying children a puffer for their asthma or not paying for pre-natal checkups. It is reprehensible that Minister Kenney is pitting Canadians who are dissatisfied with their own medical coverage, against refugees, as depicted in a shameless petition posted on his official website. The fact is Canadians do have access to primary health care and most have some coverage for medications through their employer, social insurance, disability, or drug plans for senior citizens. Refugees are not eligible for any of these plans and generally have no money to pay for medicines or other health services. Do Canadians really feel that refugees are getting away with something?

Perhaps the most serious misconception around these changes in coverage relates to the impact on public health and safety. Contrary to the minister’s statement, we are endangering public health by denying basic health care services. People pose a risk to public health if they are not properly engaged in health care. Most diagnosis of tuberculosis, for example, are made by health care workers who pick up the disease through screening chest X-rays. This requires engagement in the health care system and relationship building.

Does the minister really think that, if we cut people off from health care services, we are miraculously going to find the person who is spreading tuberculosis to his neighbours? If we are only allowed to offer care to someone who is spitting up blood in the emergency department, he will most certainly have already infected others. Primary health care provision is directly related to public health, and taking this away will most certainly result in increased transmission of infectious diseases.

With these cutbacks we are essentially taking the most disadvantaged and traumatized human beings on Earth and telling them that we have been too generous. These are people who cannot vote, cannot legally work, and are often isolated and traumatized.

The changes to refugee health coverage are cruel, unethical, ineffective and entirely unnecessary. They will further marginalize legitimate refugees, increase health care costs, and threaten public health and safety. Physicians and health care professionals across Canada are not prepared to let this disgraceful and misguided attack on refugee health go unchallenged.

Mark Tyndall is a professor of medicine at the University of Ottawa and chief of infectious diseases at the Ottawa Hospital.

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Voir version française ci-dessous

Canadian Health Coalition Media Release (May 7, 2012)
Media Release PDF
Harper’s Cuts to Refugee Health Care: A violation of medical ethics and a disgrace to Canada

OTTAWA – The Canadian Health Coalition (CHC) denounced the cuts recently announced to refugee health services by Minister Jason Kenney because they put vulnerable people at risk.

As of June 30th refugees in Canada will be cut off access to treatment for chronic diseases including hypertension, angina, diabetes, high cholesterol, and lung disease. No other Canadians are denied these treatments.

“The changes are being justified using three flawed arguments. First, we are told that refugees are abusing our health care system. The reality is the exact opposite. Our challenge as physicians is to engage vulnerable people with the health care system, especially prevention and primary care, not turn them away. I have never met a refugee who came to Canada because they wanted better health care. In comparison to starvation, torture, and rape, getting vision care is never the motivation. Second, they say they are doing this for public safety. Actually, they are endangering public safety by denying basic health care services. People only pose a risk to the public if they are not properly engaged in health care. For example, if a person with tuberculosis is only offered care after they are spitting blood, they will have already infected others. Third, the Minister claims this is about saving taxpayers money. When you stop providing preventive care you wind up with repeated emergency room visits and preventable hospitalizations that cost a lot more money,” said Dr. Mark Tyndall, Head of Infectious Diseases at the Ottawa Hospital and Professor of Medicine at the University of Ottawa.

“This new refugee health care policy violates my ethical obligations as a physician. It is unethical and a disgrace to Canadian society. The Minister’s claim that this ‘ensures fairness, and protects public health and safety’ is Orwellian,” said Dr. Tyndall.

The Canadian Heath Coalition sees the cuts to refugee health care services as part of a broader pattern emerging from the recent federal budget. Other cuts that affect the health of vulnerable Canadians include: mental health services for soldiers at Petawawa; systematic spending cuts to aboriginal health programs; the elimination of Health Canada’s Bureau of Food Safety Assessment and food safety inspection at the CFIA.

“The dismantling of one of the oldest parts of Canada’s public healthcare system –health care for displaced persons who arrived in Canada following W.W. II – is symptomatic of the Harper government’s approach to health care. ‘Cut and run’ is their motto and changing the hearts of Canadians from compassion to contempt is their goal,” said Michael McBane, Executive Director of the CHC.

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For more information:

Michael McBane, Executive Director
Canadian Health Coalition
2–251 Bank Street, Ottawa, ON K2P 1X3
Tel: (613) 277-6295
Email: mike@medicare.ca
Web: www.healthcoalition.ca
Twitter: @michael_mcbane

 

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Coalition canadienne de la santé (May 7, 2012)
Communiqué de presse PDF
Les coupes de Harper aux soins de santé aux réfugiés : une violation de l’éthique médicale et une honte pour le Canada

OTTAWA – La Coalition canadienne de la santé a dénoncé les coupes annoncées récemment aux services de santé aux réfugiés par le ministre Jason Kenney, parce qu’elles représentent un risque pour la santé des personnes vulnérables.

À partir du 30 juin, les réfugiés au Canada n’auront plus accès au traitement des maladies chroniques, dont l’hypertension, l’angine, le diabète, le cholestérol élevé et les maladies pulmonaires. Ces traitements ne sont refusés à aucun autre Canadien.

« Les changements sont expliqués par trois arguments infondés. Premièrement, on nous dit que les réfugiés abusent de notre système de soins de santé. La réalité est l’exact contraire. Notre défi en tant que médecins est d’intégrer les personnes vulnérables dans le système de soins de santé, notamment en prévention et en soins primaires, et non de leur refuser l’accès. Je n’ai jamais rencontré un réfugié qui est venu au Canada parce qu’il voulait de meilleurs soins de santé. En comparaison à la famine, à la torture et au viol, obtenir des soins de la vue n’a jamais été un motif. Deuxièmement, le gouvernement justifie cette mesure pour la sécurité publique. En fait, il met en péril la sécurité publique en refusant l’accès à des services de santé de base. Les personnes posent un risque au public seulement si elles ne sont pas intégrées de manière appropriée aux soins de santé. Par exemple, si une personne ayant la tuberculose reçoit des soins qu’après avoir craché du sang, elle aura déjà infecté d’autres personnes. Troisièmement, le Ministre prétend qu’il s’agit d’épargner l’argent des contribuables. Lorsque vous cessez de fournir des soins préventifs, vous vous retrouvez avec des visites répétées à la salle d’urgence et des hospitalisations évitables qui coûtent beaucoup d’argent, » a déclaré le Dr Tyndall, chef des maladies infectieuses à l’Hôpital d’Ottawa et professeur en médecine à l’Université d’Ottawa.

« Cette nouvelle politique en matière de soins de santé aux réfugiées viole mes obligations éthiques en tant que médecin. C’est contraire à l’éthique et c’est une honte pour la société canadienne. La prétention du Ministre voulant que cette mesure ‘assure l’équité, et protège la santé et la sécurité publiques’ est orwellien », a déclaré le Dr Tyndall.

La Coalition canadienne de la santé considère les coupes aux services de santé aux réfugiés comme faisant partie d’une tendance lourde qui émerge du récent budget fédéral. D’autres compressions qui touchent la santé des Canadiens vulnérables portent aussi sur : les services en santé mentale aux soldats de Petawawa; des réductions de dépenses systématiques aux programmes de santé pour les Autochtones; l’élimination du Bureau d’évaluation de la salubrité des aliments de Santé Canada et l’inspection de la sécurité des aliments de l’ACIA.

« Le démantèlement de l’un des plus anciens éléments du système public de soins de santé au Canada – les soins de santé aux personnes déplacées qui arrivèrent au Canada après la Seconde Guerre mondiale – est symptomatique de l’approche du gouvernement Harper en soins de santé. ‘Effectuons des coupes et défilons-nous’ est sa devise, et transformer la compassion des Canadiens en mépris est son objectif », a affirmé Michael McBane, directeur exécutif de la CCS.

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Pour obtenir de plus amples renseignements :

Michael McBane
Coalition canadienne de la santé
2–251 Bank Street, Ottawa, ON K2P 1X3
Tel: (613) 277-6295
Email: mike@medicare.ca
Web: www.healthcoalition.ca/fr
Twitter: @michael_mcbane

 
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CBC News (April 25, 2012)
Refugee health benefits scaled back by Tories
By Meagan Fitzpatrick

The federal government is putting an end to paying for certain health-care benefits for refugee claimants, Citizenship and Immigration Minister Jason Kenney announced Wednesday.

“Canadians are a very generous people and Canada has a generous immigration system,” Kenney said in a news release. “However, we do not want to ask Canadians to pay for benefits for protected persons and refugee claimants that are more generous than what they are entitled to themselves.”

The Interim Federal Health Program (IFHP) gives basic health-care coverage to protected persons, refugee claimants and others who don’t qualify for provincial or territorial coverage. The program cost $84 million last year. The program also covers the costs for supplemental health services: medications, dentistry, vision care and mobility devices.

Those services aren’t covered for most Canadians through their provincial and territorial health plans, and that’s where the government is making the cuts.

Coverage for the supplemental services will end in June and medications and immunizations will only be covered where there is a risk to public health. Services and health products will only be covered if they are of “an urgent or essential nature.”

The government says by scaling back the program it will save about $100 million over the next five years.

“With this reform, we are also taking away an incentive from people who may be considering filing an unfounded refugee claim in Canada,” Kenney said. “These reforms allow us to protect public health and safety, ensure that tax dollars are spent wisely and defend the integrity of our immigration system all at the same time.”

The announcement was met with criticism from the opposition parties.

“It’s scandalous behaviour,” NDP Leader Tom Mulcair said. Depriving refugees of health care coverage shows there “is something very wrong with the values of Conservatives,” he said.

Interim Liberal leader Bob Rae accused the government of trying to “whip up hostility to refugees.”

“I think the government has to recognize that for all of its rhetoric around this issue, there are people who come to Canada with legitimate claims of being regufees,” Rae said.

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