04 September 2015

#34 Some of Your Health Matters

How about this mean cut? An announced end to most of the health coverage for refugee claimants awaiting determination of their claims, with a few exceptions that were in themselves cruel twists on the health front.

First the program: it covers people who have claimed status, but not yet received an initial determination. Once they have some status, even if the process is ongoing, the provinces in which they live provide health coverage for them like any other resident. That the federal government, in particular Citizenship and Immigration Canada, would cut all basic health coverage, excepting only the treatment of diseases which could represent a danger to public health (i.e.: to the citizens who matter) is abusive. People with diabetes would not have access to insulin, because their dying would cause anyone else to contract diabetes, for example.

This attempt to severely limit coverage had a particularly perverse effect in the HIV field. When Canada first started mandatory HIV testing for all immigrants, long-term visitors and refugees (notably under the Liberal government of the day), there was a Ministerial undertaking that HIV would not be considered as a “danger to public health” (it isn't contagious like, for example, tuberculosis), but admission or refusal of people testing positive for HIV would be determined on the basis of an evaluation of the burden they might represent for the health care system. That determination doesn't apply to refugees, as they are covered by international treaties we have signed that require us to offer protection to them.

So therein lies the catch-22 in HIV: HIV treatments would be covered by the federal government under the Federal Interim Health Plan because HIV is a danger to public health. If we stood up to object to that characterization of HIV, we might be putting in jeopardy the coverage of certain people's treatment. If we said nothing, we might be seen as accepting that independent applicants for immigration with HIV might be excluded from the country because they represented a danger to public health.

We found out in the usual way that the government just wasn't listening anyway. We wrote to both the ministers of Health and of Immigration and got no answer from the latter and a form letter from the former telling us that this health benefit program was not in the jurisdiction of the Ministry of Health and she would not intervene.

Luckily, the courts did the job of ordering the program back into existence. Another reason for the government to hate the courts, I suppose.

Further reading here

You've come fleeing war
and what we have to offer
is war on your health

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