SJD student Y.Y. Chen - "Ontario right to fix Ottawa's mistake on refugee health care"

On Tuesday, Dec. 10, when the world celebrated Human Rights Day, refugees in Ontario had rare cause to celebrate an important human rights success. Just a day before, the Ontario government announced that it will join Alberta, Manitoba, Saskatchewan, Nova Scotia and Quebec in providing health care to refugee claimants starting in January 2014.

The new provincial program is designed to fill a health care void created by cutbacks to the Interim Federal Health Program (IFHP) in June 2012 by the federal government. As critics of the IFHP cuts forewarned, the federal policy change has had a negative impact on the wellbeing of medically indigent refugee claimants and on the health care system in general.

Frontline healthcare practitioners have observed multiple incidents of avoidable emergency room visits by uninsured refugee claimants who developed acute medical conditions as a result of forgoing primary care or not being able to afford medications. There are also occasional reports of refugees being denied treatment or asked to pay for services upfront despite still qualifying for the IFHP. Other media reports point to a growing number of the uninsured showing up at community health centres and volunteer clinics, whose capacity was already over-stretched.

These barriers to timely diagnosis and treatment often come at a cost, a large percentage of which will be borne by taxpayers at the end of the day. If we factor these extra expenditures into the cost-benefit calculation, it is debatable whether the IFHP cuts will ultimately result in less spending for the health care system.

When the IFHP cuts were first proposed, one of the rationales provided by the federal government was that the policy change would generate savings that total $100 million over five years, or an average of $20 million yearly. However, at a health ministers’ meeting this October, Ontario, Quebec and Manitoba suggested that they alone have incurred a combined $25.7 million in additional health care spending annually under the new IFHP.

Although the point may be trite, in the context of health care policy, sometimes it is indeed necessary for governments to spend money in order to save money in the long run. Ontario’s decision to step up to the plate and provide temporary health care to refugee claimants likely will not only reduce the suffering of a highly marginalized population, but also improve the long-term fiscal sustainability of the health care system.

Opponents of health care provision to refugee claimants tend to view such a policy through a zero-sum lens. That is, they argue, public spending on refugees’ health care is taking away precious resources from needy Canadians. This us-versus-them logic, however, is simplistic.

It is not possible to neatly delink the wellbeing of one group of Canadian residents, including refugees, from the wellbeing of the rest. For example, increases in emergency room visits by the uninsured could exacerbate the problem of emergency department overcrowding, which would affect Canadians and refugees alike. Therefore, even from a purely self-interested perspective, supporters of cutting refugees’ health care ought to acknowledge the deleterious consequences that such policies could have for the Canadian public as a whole.

More importantly, as enshrined in the Universal Declaration of Human Rights, every individual has the right to a standard of living that is adequate for his or her health and wellbeing, including access to medical care. With this year’s Human Rights Day fresh in our minds, let us remember and renew our commitment to this aspiration. Let us celebrate and honour the legacy of the late Nelson Mandela, who once said: “To deny people their human rights is to challenge their very humanity.”

The provision of health care to refugees in Canada, both in terms of public policy and ethical obligations, is simply the right thing to do.