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Immigration Minister Tells Ontario: Pay for Refugees' Health care Yourself

january 9, 2014

A week after Ontario began providing health care to many refugees, the federal government has firmly closed the door on either restoring the program it cut 18 months ago, or helping to pay for it.

Ontario Health Minister Deb Matthews has said she will present the federal government with a bill for the program the province set up to fill gaps after federal cuts to refugee health care. But the message from Immigration Minister Chris Alexander’s office is blunt: If you want it, pay for it yourself.

Canadians don’t want “failed asylum claimants and asylum claimants from safe countries receiving better health care benefits than Canadian taxpayers,” said Alexander’s press secretary Alexis Pavlich.

“If the Ontario government thinks that failed asylum claimants, for example, deserve these services, they are free to pay for it themselves.”

Doctors working with refugees say the federal government is misleading Canadians about the situation — at the expense of refugees. The result, they say, has been anxiety and confusion among refugees and health workers, sick patients not getting the treatment they need, more costs for taxpayers as refugees turn to emergency rooms rather than doctors’ offices, and a hit to Canada’s international reputation as a place of refuge.

“The tone from the (federal) government is that refugees are getting better health care than ordinary Canadians. That is just not true,” said Meb Rashid, a Toronto family physician and one of the founders of Canadian Doctors for Refugee Care.

Rashid said the federal government has — for decades — offered refugees the same level of health coverage as low-income Canadians. Most, he said, arrive in Canada with little money in their pockets and few clothes and are in no position to buy health insurance, which means a variety of refugees, including pregnant women and children, were without coverage after the federal government’s cuts. That includes refugees fleeing trauma, war and other situations that compromised their health. Rashid says the vast majority will end up becoming Canadian citizens and untreated health issues will be costlier down the road.

“We have seen children with fever and we are worried about malaria but they cannot get care. We have seen pregnant women denied care, we have seen people with chronic illness unable to get medication,” said Rashid.

“If that is what this government thinks Canadians want, I would disagree with them. That has not been my experience. Canadian refugee policy has always been a source of pride for Canadians.”

Ontario Health Minister Matthews said the refugee health cuts put doctors “in an untenable position, forcing them to choose who receives treatment based on complex rules. The fact remains that refugee claimants are in our country, and until the federal government determines their status, many refugee claimants including sick children and pregnant women will require care.”

Ontario announced it would set up a temporary program to offer health care to refugees at a provincial health ministers’ meeting in the fall in which all 10 provinces condemned the refugee health cuts.

Rashid, a family physician who works at a Toronto clinic that serves refugees, said his clinic began to see refugees who feared they would have to deliver their babies alone because they were unable to afford the cost of a hospital birth. The changes affected all kinds of refugees, he said, not simply failed asylum seekers, as the federal government implies.

“We are showing the world that Canada is not the place it used to be. We are no longer a haven.”

Doug Gruner, a family physician at Ottawa’s Bruyere Family Medicine Centre, said the federal government has simply downloaded the cost of caring for refugees to provinces without a real discussion about the costs.

Although the federal government says it has increased transfer payments to provinces, health and provincial officials say there has been no real conversation about costs of the program.

Gruner calls the unilateral move by the federal government “un-Canadian.”

“This has created confusion and chaos. Innocent people got affected,” he says.

Nor, says Gruner, has the move saved money. “What these cuts have done is essentially forced refugees away from primary care into emergency departments at 10 times the cost.”