February 18, 2016 – Anna Mehler Paperny, Global News
All refugees and refugee claimants will get extended health care as of April 1 — six months after the Liberals came to office and five months after they made a special provision allowing Syrian refugees to access care.
The government is also expanding the program to cover refugees’ initial pre-departure health exam and vaccinations before they arrive in Canada.
Thursday’s announcement has been a long time coming for Meb Rashid, whoseCrossroads clinic in Toronto has spent years constructing laborious workarounds for new Canadians who’ve been left without care.
“It’s a good day — for our patients, for clinicians who serve refugees, for Canadians,” he said.
Now the hard part: implementing the new policies and communicating them to health workers who’ve given up on trying to understand Canada’s byzantine refugee health system.
Rashid knows many specialists in Toronto who now refuse to treat any refugees because the billing and paperwork burden is too much to deal with.
“There’s one person I’ve been referring to for 15 years but now they won’t accept [refugee patients]. It’s much too complicated to figure out who’s covered or who’s not,” he said.
“It’s hard to blame them. The system is impossible to navigate.”
REFUGEE HEALTH CUTS: Even those who qualify get turned away
Rashid hopes there will be enough of a concerted push to simplify the process and teach clinicians how it works that by the time April rolls around people’s needs will be met.
The feds know clinician confusion is a problem.
“Many medical professionals stopped treating [refugee health program] beneficiaries entirely rather than trying to navigate the process,” Citizenship and Immigration spokesperson Michel Cimpaye wrote in an email.
So the government’s insurer, Medavie Blue Cross, is emailing national medical associations about the health program changes, Cimpaye said.
“This is good news from a public health perspective, from a resettlement perspective and from an economic perspective, because refugees who are not previously covered would go to emergency centres of hospitals where the cost was, in fact, higher,” Immigration, Refugees and Citizenship Minister John McCallum said in Ottawa Thursday.
The previous Conservative government cut the Interim Federal Health Program in 2012, making many refugee applicants, including those who were privately sponsored or whose applications were in limbo, ineligible for care.
A federal court judge called those cuts “cruel and unusual” because of their disproportionate effect on children and vulnerable people.
And even when Ontario, Quebec and other provinces created stopgap programs of their own, it didn’t help much: The resulting administrative maze was so confusing many health practitioners gave up entirely.
READ MORE: What’s the deal with refugee health care?
“The system has been completely fragmented and chaotic — very difficult to navigate not only for refugees but also for healthcare providers,” Health Minister Jane Philpott told reporters.
“There are 15 different beneficiary categories, six different levels of care a refugee might meet.
“Some health care providers have simply said, ‘It’s impossible to negotiate this pathway forward. Therefore we’re not going to be involved with refugee care.’”
Philpott also noted that while the federal government spent millions less as a result of the cuts, provincial governments ended up spending much more.
“The cost was passed on to provincial and territorial governments who bore the burden unnecesssarily. And the costs are ultimately much higher,” she said.
Global News spoke with Philpott on Tuesday about refugee health care and other issues that have come to the fore in the rookie minister’s first 100 days in office.
READ MORE: No, Canada doesn’t spend more on refugees than on pensioners
Philpott defended the Liberals’ promise to bring in 25,000 government-sponsored Syrian refugees by Dec. 31, 2015, saying it was a “fantastic, ambitious target” even though by mid-February Canada has resettled about 21,000 Syrian refugees, the bulk of them privately sponsored.
And the government hasn’t created inequity among refugees by giving Syrians health care that other refugees don’t get — that’s on their predecessor Conservatives, who cut refugee health in 2012.
READ MORE: Some Canadian refugees are more equal than others
Here’s what she had to say:
Whats going on with refugee healthcare?
Well as you know I’ve had the privilege of being the chair of the ad hoc steering committee on refugees and one of the things I’m most proud of in our first hundred days is the incredible work Canadians have accomplished in terms of offering a place of refuge for now over 20,000 Syrian refugees.
You asked about refugee health care in general and we intend to be announcing very soon to provide proper global interim federal health programs for all refugees in Canada.
So when’s that going to happen?
Stay tuned. It is very close now.
But why hasn’t that happened? What’s the holdup?
Well Minister [John] McCallum and his department of Immigration, Refugees and Citizenship have been extremely busy. There have been quite a few pieces of the immigration portfolio that have needed some adjustment and they’ve been working very hard to respond to all of those things. And of course this project with Syrian refugees has taken an incredible amount of time.
Are you concerned at all that you’ve sort of created this inequity among refugees in Canada, that depending where they’re from they get very different levels of care?
I am very concerned that the previous government created inequity when they did a massive cut to refugee health care in 2012. And there has been inequity in the system ever since 2012. And it’s been most unfortunate for refugees themselves and it’s been a very difficult situation for health providers themselves in which to work.
But in addition to all of the other things our government has done in response to refugees, the matter of refugee health care will soon be brought back to the state that it should be.
But back in December, Minister McCallum said that this would be settled after the Cabinet meeting in January. Why hasn’t that happened yet?
Well I would refer you to Minister McCallum to get the exact details, because it falls in his department. But I can tell you it is something that has been discussed and unfortunately it’s not as simple as flipping a switch and reinstating full coverage. But I do know a lot of work is being done in the background and all that information will be available to the public very soon.
In hindsight, do you think the 25,000 number was a dumb promise?
In hindsight i think the 25,000 number was a fantastic, ambitious tatget for us to reach. And I’m proud to say as of today there are, I think, about 21,000 Syrian refugees in Canada. Our government has been bold and has really set a gold standard for the world in terms of what we have done in really going out of our way to respond to the refugee needs in the Middle East.
But you don’t think you could have done that without putting a number on it?
I think it was important for us to set a high target, a bold target, and that has allowed us to put an incredibly strong mechanism in place to invite refugees to this country.
What its also done is allow us a way to be able to do that without skipping any steps along the way. And so people from all over the world, other governments, are looking to us to see how we are able to do this. … And I think it’s something that we should be very proud of as Canadians. …
I am incredibly proud of what we have done and I know that if we had not been so ambitious in the goals that we set for ourselves we probably wouldn’t be where we are today. And it’s something that we’re going to look back on generations from now and all of us that have been part of it — all Canadians — are going to be able to say Canada stepped up to the plate and we made a home for tens of thousands of refugees. It’s a wonderful moment for Canada. It speaks to who we are.
This interview has been edited and condensed for clarity.