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January 11, 2013

Kenney breeds confusion and refugees' expense

Reuel S. Amdur

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When Saskatchewan Premier Brad Wall was confronted with the case of a refugee with cancer, one of the many cut off medical care by the federal Tories, he was outraged, and committed his province to meeting the health care needs of refugees in his province. "It is unbelievable that some of the decisions that have been taken federally are having this impact on people who are clearly the most vulnerable, refugees who are obviously fleeing something quite terrible-that's why they're refugees." And this from a man who is thought to be a potential successor to Stephen Harper as head of the federal Conservative Party.

The federal actions on refugee health care were the subject of a panel discussion at St. Andrew’s Presbyterian Church in Ottawa recently.  Members of the panel were NDP MP Paul Dewar, Doctors Mark Tyndall, Megan Williams, and Doug Gruner, Jeff Morrison, Director of Government Relations for the Canadian Pharmacists Association, and Sister Julie Daigle, who trained as a nurse and currently counsels refugees.

Panel members were united in their concern that refugees were being deprived of essential care, that the lack of medical care will lead to greater medical costs down the road, and that depriving refugees can endanger the health of the larger community.

Dewar told the audience that, when the matter is raised in the house, Immigration Minister Jason Kenney provides “baseless arguments,” such as, “We don’t allow gold-plated health care.”  “Health care for refugees is,” said Dewar, “not gold-plated.”

Tyndall, Chief of Infectious Diseases at the Ottawa Hospital, reviewed the origins of the current policy back to an April announcement.  The cut in medical care was to save money and discourage bogus claimants.  It was also a matter of not wanting to provide for refugees things that some Canadians are not entitled to get.  And finally, in order to ensure that Canadians would be safe, treatment would be provided if refugees had AIDS or tuberculosis. 

In response, Tyndall argued that if health care is not provided, it will cost more, not less.  However, the costs may be borne by the provinces rather than the federal government which has in the past covered refugee health care costs.  And rather than seeing people coming to Canada for health care, “I have never heard of a refugee coming to Canada for health care.  In fact, it is difficult to engage them into health care.”  As for AIDS and TB, if it is known that they have these conditions, they will continue to be treated but that hardly answers the problem.  If a person contracts AIDS in Canada and is not using the health care system, the Canadian public will be at risk, as his condition will not be found.  Furthermore, while refugees are tested for tuberculosis on arrival, a number of newcomers have latent tuberculosis, which can later become active, and if the person has no involvement with the medical system he is a health risk to the wider community. 

Kenney scapegoats refugees, lumping them together with “bogus claimants” and “illegal immigrants”.  Dewar reported that Kenney spoke of people coming to Canada as refugee claimants from Europe and the United States to get care here, a preposterous notion.  Sister Julie commented that many of the refugees are from racial minorities and therefore when a minority person is walking down the street the propaganda about refugees taking advantage makes them targets for prejudice and discrimination. Her word for the cuts and the propaganda justifying them—“racism.”  She shudders to think of what will happen when the Conservatives announce their list of safe countries and what that will mean to refugees from some of those countries.

As well as being bad (if not wicked) policy, the policy is utterly confusing.  Such could readily be foreseen, as the government introduced it without prior discussion with stakeholders.  Physicians and pharmacists do not know whose care will be covered.  According to Dr. Williams, just the night before the new regulation was released it was modified to continue full coverage for the category of refugees that the Canadian government itself selects overseas and invites to Canada.  “The roll-out was chaotic and confusing,” she said.  Not surprising, she noted that most refugees are hesitant to speak out on the issue.  She also noted that doctors have repeatedly asked Kenney for the chance to discuss the situation with him, to no avail. 

So what is this “gold-plated” thing all about?  Gruner said that most people have “gold-plated” plans, through work, for example.  It is the working poor, who do not, and so Kenney is pitting them against refugees.  Instead of addressing the needs of the working poor, he scapegoats the immigrants.

Sister Julie’s job involves her finding help for refugees in need of medical care.  While a certain amount can be accomplished by asking doctors to do charity, there are limits.  There are just too many cases, and “some of them are expensive.”  Premier Wall had it right in speaking of the extreme conditions from which many are fleeing.  Sister gave an example.

This man was tortured in his home country.  Among other things, they hung him for hours from the ceiling by the wrists.  They also went to work on his back.  Both shoulders were dislocated.  Now he suffers serious back pain, and all he has for the pain is Tylenol.  When she went to see him one morning, he could not move.  “He was stiff as a board.”  An ambulance was called to take him to the hospital, where he was treated and given the medicine that was indicated.  Then he was released, without access to the needed medication.  “If he does not get the help he needs, he will only end up in the hospital again.”  Contrary to Kenney’s view, she insisted that “Refugees are people in dire need of help.”

Morrison pointed out that the program gutted by the Harper government on July 1 was in force since 1957.  Tyndall reported that Kenney had blamed the agitation around the cuts to a few “activist physicians,” but Morrison explained how the charge was answered.  It is typically difficult and time-consuming to get joint statements from professional organizations, but in no time flat such a statement protesting the cuts was adopted by a number of organizations: Canadian Medical Association, Canadian Nurses Association, Canadian Pharmacists Association, Canadian Dental Association, Royal College of Physicians and Surgeons, Canadian Association of Social Workers, College of Family Physicians.  The list continues to grow.  Just a few activist physicians indeed!

One final note: Shortly, the Harper government will be closing the Ottawa office where refugees can make their claims.  Claimants will need to travel away from Ottawa and possibly out of province.  They will need to pay for travel with money that many do not have.  They will also have difficulty with Legal Aid, which will not assist out of province.

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