12/14/2012 08:19 EST | Updated 02/13/2013 05:12 EST

How Kenney Is Killing Refugee Health Care

Rachel Adler

It's a sad day for refugees looking to Canada for protection. On Monday, Jason Kenney and the Conservative government announced a controversial list of countries that will determine who does and does not get access to healthcare in this country. This 'Designated Countries of Origin' or so-called 'safe countries' list singles out refugee claimants from certain countries fast-tracking their claims and denying almost all coverage for health care services, even in the case of a child with an emergency.

Update: Today at 10:30am, Jason Kenney announced the following countries as "safe": Austria, Belgium, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Slovak Republic, Slovenia, Sweden, UK, USA

On June 30, the first phase of changes were implemented to the Interim Federal Health Program which provides refugees with health care coverage in Canada. These changes have led to the denial of essential medicines, including psychiatric medicines for a teenager with a history of suicide attempts.

They have removed the temporary coverage given when a claim is first made, leaving a man with a cough suspicious for TB ineligible to access a chest X-ray to diagnose this life-threatening illness. Due to multiple changing versions of the cuts and poor communication, even wider negative impacts have occurred, as in the case of a woman who was 36-weeks pregnant and was asked by her obstetrician to bring $3,000 to her next visit despite having valid coverage.

On Monday, the most cruel piece of this policy comes into play effectively setting up a two-tier refugee system. From this date on, those making a claim from a so-called 'safe country' will have an impossibly short amount of time to prepare for their hearing, will not get access to the newly created Refugee Appeals Division, will have to wait much longer to consider a humanitarian claim, and to top it all off, will have practically no coverage for healthcare services.

This is what the government has facetiously called "public health and safety coverage" illuminating their limited understanding of the field of public health. These individuals are not covered for preventative care as is needed for children and pregnant women, or even emergency care in the event of a heart attack or car accident.

As a family doctor working with refugees and refugee claimants, the potential impacts of this policy are horrifying. We will no doubt see individuals left with no choice but to allow their health to worsen before seeking services. This will lead to completely preventable health consequences as well as many avoidable ER visits for conditions that could have been dealt with through prevention and early treatment.


8 Famous Refugees

This will no doubt mean extra costs to the system, and despite the name of the coverage, will also jeopardize public health as individuals are unlikely to have memorized the small list of infectious diseases for which they are covered. So it seems to me that this is a lose-lose situation.

Having heard countless stories of individuals who fled countries which we are now deeming "safe," I find this entire concept difficult to accept. The Immigration and Refugee Board, while tremendously flawed, is intended to deal with the individual nature of a refugee claim. When a woman flees domestic violence in Mexico, her claim must be assessed based on this individual situation alone. Countries are included in this list either for having large numbers of claims rejected, withdrawn or abandoned or based on the Minister's opinion that they have an independent judiciary and democratic rights.

Nowhere does this include the country's record on persecution of ethnic minorities, their views on LGBTQ rights or gender equality -- all very common reasons for refugee claims. History has taught us that what is safe for the majority and the privileged is not always safe for the minority and the marginalized.

The most outrageous case of this is Hungary, recently the largest source of refugee claimants to Canada. Those fleeing Hungary are largely Roma people known to be ethnically persecuted in this country, with public anti-Roma sentiment expressed by members of political parties, and a recent rash of ethnically-motivated murders. Declaring Hungary a "safe country" makes a mockery of the refugee process.

But protecting individual refugees or the health of the public has never been Minister Kenney's goal. The Citizenship and Immigration Minister has spoken quite loudly with both his actions and words. He has used misleading terms such as "bogus claimants" and "queue-jumpers" to divide migrants and "Canadians" while simultaneously passing increasingly harsher policies punishing migrants.

Bill C-31, which creates the two-tier system between those from "safe countries" and those not, also makes the refugee system much more difficult for all refugee claimants. While in the past, refugee claimants had months (sometimes years) to prepare for a hearing, the new process gives a maximum of 60 days (with those from safe countries getting only 30-45) until their hearing. Many refugee lawyers have called these timelines impossible to acquire the documentation needed to make a proper claim. This will set many refugee claimants up to fail without ample opportunity to demonstrate their persecution.

This same bill also creates a category of Designated Foreign Nationals. These are individuals who the Public Safety Minister deems "irregular arrivals" who are then detained (with infrequent review) and denied access to permanent residency, family sponsorship, and mobility for five years.

While the government claims this policy is in place to crack down on human smuggling, it punishes the very individuals desperate enough to be smuggled in the first place. In just the last few years, the government has also put a moratorium on the sponsorship of parents and grandparents, made it legal to pay temporary foreign workers 15 per cent less than other workers, and raided women's shelters in an attempt to deport individuals.

It is clear that this government has a much broader agenda than the 59 cents per Canadian they claim they will save from denying health benefits to refugees and refugee claimants. Providing care to this vulnerable group is becoming increasingly difficult as public policy is used to further systematically marginalize them, rather than providing them the support and services they need to flourish. I can only hope that the outrage that occurs in response to these increasingly cruel policies will be enough to reverse them and prevent those that the government no doubt has up its sleeve.