Doctors and other health-care providers are pleading with the federal Conservative government to reverse the cuts it made to refugee health coverage, saying vulnerable people are being denied care, taxpayers are paying more money, and other Canadians are being put at risk.
Health workers staged protests in 19 cities on Monday to highlight the problems they say were created a year ago when the government eliminated all medical coverage for some asylum seekers and cut the supplemental benefits – including payments for prescription drugs, eye care and vision care – of many others.
"What we are seeing in the last year as a result of these cuts is that refugees, in effect, are not able to access primary care," said Dr. Doug Gruner, a member of the group Canadian Doctors for Refugee Care.
Until federal Immigration Minister Jason Kenney directed the government to stop paying for the treatments, all 33 walk-in clinics in Ottawa were treating refugees, Dr. Gruner told reporters. Today, only nine of those clinics will see refugee patients and they demand an upfront fee of $60, which many refugees cannot afford, he said.
So "if they've got a cough, it could be tuberculosis. But we're never going to know because they're not going to the doctor," said Dr. Gruner. "But they are going to the playgrounds, the school yards and the shopping centres, putting the rest of us at risk."
Many refugees turn up at emergency departments, he said. But "it's going to increase wait times and dramatically increase the cost to the system. When you go to a walk-in clinic, the doctor charges about $40 for that visit. If you go to an emergency room, it's about $400."
So, while the federal government is saving about $20-million a year, provinces, hospitals and ultimately the taxpayers are picking up the tab, and then some, Dr. Gruner said.
According to the Catholic Register, Toronto's two large acute-care Catholic hospitals alone wrote off more than $174,000 for treating more than 800 refugee patients over 10 months.
Deb Matthews, the Ontario Health Minister, said in an e-mail on Monday that the cuts are "a serious abdication of the federal government's responsibility towards some of the most vulnerable people in our society. Because Ontario has the majority of refugee claimants in Canada, we have been disproportionately affected by these changes."
Meanwhile, doctors and pharmacists say they have had difficulties ascertaining which refugees are covered and for what.
Government-sponsored refugees receive free medical care and all supplemental benefits. Asylum claimants from countries deemed to be unsafe receive coverage on par with that provided by provincial health plans but no supplemental benefits. And those who come from a country that has been declared to be safe, or who have had their refugee claims rejected, get no coverage unless they have a disease that poses a risk to the public.
Mr. Kenney instituted the changes to deter bogus refugee claims and to ensure that failed asylum seekers cannot take advantage of Canada's free health care. The government says all people claiming refugee status are given a medical examination which would detect diseases such as tuberculosis.
And Alexis Pavlich, a spokeswoman for the minister, said those who oppose the cuts are engaging in an "irresponsible and shameful attempt to further their unreasonable demands that Canadian taxpayers foot the bill for gold-plated health care coverage for illegal immigrants and bogus asylum claimants that is better than what even Canadian seniors receive."
But Dr. Gruner said, until the cuts, refugees were receiving health-care benefits that were identical to those provided to most Canadians on social assistance.
Dr. Lindy Samson, a member of the Canadian Paediatric Society, recounted the story of one refugee family whose 12-year-old son developed a life-threatening infection and required limb amputations. Initially, none of his counselling or equipment, including his artificial limbs, was covered, Dr. Samson said.
"This story ends relatively well from a coverage perspective," she said. "This family had their hearing and were granted refugee status and eventually our patient was eligible for coverage. His treating health-care team believes strongly, though, that the delays have had a significant impact on his well-being."