It is hard to imagine a gesture more cynical than nickel-and-diming people who have escaped torture, rape, starvation, war and other forms of persecution and sought out Canada as the land of hope and opportunity.
Yet, the federal government is doing just that with mean-spirited cuts to the Interim Federal Health Program, which covers health costs for asylum-seekers.
The IFHP payments cost $84-million last year, a budget that will be slashed by about $20-million annually.
Currently, refugee claimants are entitled to a full range of health-care services during the waiting period for provincial health insurance (a period of about three months), and Ottawa pays the bill.
But beginning on Canada Day, the IFHP will cover only "urgent or essential" medical care and medications and vaccines that pose a "risk to public health" for protected persons (refugees invited to settle in Canada) and refugee claimants. Gone are "supplementary benefits," coverage of most medications, dental care, vision care, ambulance services and mobility devices like wheelchairs, along with routine care outside hospital.
Jason Kenney, Citizenship and Immigration Minister, has defended the cuts, saying that Canadians should not pay benefits for refugees that "are more generous than they are entitled to themselves." He even suggested that the mandatory medical examination that asylum-seekers undergo is "more preventive health care than most Canadians receive on a regular basis."
To suggest that a mandatory checkup looking for tuberculosis and intestinal worms is superior to daily access to medicare is beyond the pale. This is, at best, dishonest rhetoric.
It is true that not all Canadians have universal public health coverage for "supplementary" care like prescription drugs. But Mr. Kenney is conveniently ignoring that many do, through benefits in the workplace and various social programs for the poor, disabled and seniors. Shouldn't we be trying to improve access for all, rather than looking for new groups to exclude?
The reality too is that some people require more extensive insurance coverage precisely because of their socioeconomic circumstances. Equity does not mean providing exactly the same services to everyone. Who could be more needy than refugees – people who tend to come to Canada with little more than the clothes on their back, and too often with horrific physical and mental sequelae?
Does anyone honestly believe that refugees from hellholes like southern Sudan and Somalia are coming here to get free dental work?
Is denying legitimate refugees access to services like prenatal visits, insulin to treat diabetes and medication to treat high blood pressure really a civilized response, or even an economically sound one?
Failing to offer this type of preventive care will, at best, only result in much bigger medical bills down the road and new Canadians who are less able to be full citizens.
Of course, not all refugee claimants are created equal. Mr. Kenney said another purpose of the IFHP rule changes is to not allow "bogus refugee claimants" to get health-care services at no cost.
The new rules will be even stricter for refugee claimants from "designated country of origin" (DCOs are countries that don't usually produce refugees) or those who have had their claims rejected. They will be eligible for care only if their condition poses a risk to public safety. Asylum-seekers who have abandoned claims and those who have been ordered removed will be entitled to no care in Canada's health system, meaning they have to pay out-of-pocket.
Let's concede that there are some scammers. It is problematic that more refugee claimants come from Eastern Europe than from Asia or Africa, where the need is obviously greater. But there is no evidence that they are anything but a tiny minority of the 28,000 refugees Canada sees each year.
Dealing with faux claimants is a challenge with no easy answer, but it is a legal issue. What is clear is that the answer is not punishing legitimate asylum-seekers by cutting access to health services, particularly preventive care.
In recent days, physicians in a number of urban centres have begun to protest these measures, with increasing vehemence. On Friday, one large group of practitioners even marched into the office of Natural Resources Minister Joe Oliver, the only cabinet minister who has an office in central Toronto, to demand action.
Doctors are not typically the storm-the-barricades types. But many recognize the folly of this approach – short-term gain for long-term pain.
Further, doctors who deal with refugees know that asylum-seekers don't fit the divisive, stereotypical portrayal that the government has put forward, as evidenced by this comment from Mr. Kenney on CBC's The Current: "We don't expect people to come here and become completely dependent."
Getting some extra health benefits for a few months does not make one a societal parasite. The IFHP is not a handout, it's a hand up. It's been around since 1957 and proven its mettle, even left a lasting impression.
There are many examples but here's one: Majid Boozary came to Canada in 1980, fleeing post-revolutionary Iran, where he had been persecuted and tortured. He needed care and got it. But Dr. Boozary has given back in spades, as family physician (who has paid taxes for 30 years) and a volunteer with the Canadian Centre for the Victims of Torture.
His son, Andrew Boozary, who is a medical student, is disgusted by the rules changes, which he sees as undermining medicare. "It's an odd view of universal healthcare to say that those who want to build a life here should be treated as second-class citizens," he says.
"This cuts to the core of my identity as a Canadian. This hurts."
It's a pain we should all be feeling.
To read complete list of changes click here.
André Picard