Health-care coverage for heart attacks. None. For pregnant women and their babies. None. Chemotherapy for refugees with cancer. None.
“When Citizenship and Immigration Canada (CIC) first announced the cuts to refugee health care, refugee doctors across Canada warned the government of the punishing consequences to refugee claimants and their families,” said Dr. Philip Berger, a founding member of Canadian Doctors for Refugee Care (CDRC).
The Interim Federal Health Program (IFHP) provided temporary health-care coverage - similar to what is provided through a provincial or territorial health insurance plan - to eligible protected persons, refugee claimants and others who do not qualify for provincial or territorial health insurance plans.
The IFHP also provided coverage for supplemental health-care services, including pharmaceutical care, dentistry, vision care and mobility assistive devices.
But as of July 1 last year, supplemental health-care benefits were eliminated.
On December 14, Immigration Minister Jason Kenney complicated matters more by naming 27 countries he deemed "safe" for the purposes of dealing with refugee claims in Canada.
Refugee claimants from those countries are now only eligible for public safety health-care coverage to diagnose, prevent or treat a disease posing a risk to public health or to diagnose or treat a condition of public safety concern.
For months, the CDRC has documented an increasing number of refugees being denied care - even those entitled to the IFHP coverage.
Berger said pregnant women, children and those with chronic diseases are not showing up for appointments at clinics due to the prohibitive costs.
In some cases, doctors are providing some coverage free of charge.
“In others, ministerial mismanagement has caused dozens of IFHP eligible claimants to go without care,” said Berger.
Clinics and doctors, said Berger, have lost complete confidence in CIC’s ability to administer the IFHP program and have refused to see “bona fide” refugee claimants.
Out of 30 Toronto walk-in clinics surveyed last fall by the CDRC, only five were accepting IFHP covered refugees.
Nine national health associations, including the Canadian Medical Association, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada, have written Immigration Minister Jason Kenney on three separate occasions requesting a meeting to discuss the cuts.
But Kenney has failed to respond.
So doctors and medical students took the unprecedented step of hitting the streets last summer and fall to protest on behalf of refugees.
But to no avail.
“Now CDRC is impelled to join a charter challenge in order to defend the health interests of our patients,” said Berger.
During a press conference Monday morning at Women's College Hospital in Toronto, Canadian Doctors for Refugee Care (CDRC), the Canadian Association of Refugee Lawyers (CARL), and three individual patients, announced the launching of a lawsuit asking the Federal Court of Canada to declare that the cuts to refugee health care are unconstitutional and illegal.
“There are refugee children in this city who are sick and cannot obtain care because of changes to their insurance coverage,” said Dr. Meb Rashid, a founding member of CDRC.
“There are sick people who are being turned away from care because of changes to their health insurance.
There are pregnant women who don’t know where they will deliver their babies. And it doesn’t have to be this way.”
But it is.
A 7-year-old girl recently arrived in Canada with a fever and cough but couldn’t get the proper workup to rule out tuberculosis.
A man with a mass in his colon was denied the appropriate tests to rule out a possible life-threatening cancer.
A woman with cardiac arrhythmia was turned away from care.
A young child was sent to hospital to rule out malaria. But after receiving a $700 bill, the family didn’t show up to their appointment the next day.
“Daily we’re hearing stories of people, sometimes with life-threatening illnesses, that are being cut off from medical care,” said Rashid.
“They will not save money. They will not save lives.”
Yet the federal government refuses to take the situation seriously. Implying that doctors and medical organizations are wrong.
“But as health-care workers we do understand,” said Rashid. “We hear the stories daily.”
The stories of not being to get health-care for their sick children. For their pregnancies. For their serious illnesses.
“Mr. Kenney, health-care workers will not stand by as health-care is used as a leverage for an immigration policy that you feel is flawed,” said Rashid.
“We’ll continue to advocate for those who have no voice.”
Audrey Macklin is a professor at the Faculty of Law at the University of Toronto. Her teaching areas include criminal law, administrative law, and immigration and refugee law.
“Laws are passed in this country in our name,” said Macklin.
“(So) it’s important to understand that in our name Jason Kenney believes that Canadians would rather see children die because they don’t get insulin, rather see children hit by a car die than get emergency care and rather see people drop dead of a heart attack than get care at public expense.”
As if it reflects Canadians’ values.
“And it is on that basis that we challenge this under the Charter of Rights and Freedoms,” she said.
Section 7 of the Charter protects the right to life, liberty and protection of the person.
“The government’s actions have put life and security of the person directly at risk. They have inflicted cruel and unusual treatment by virtue of Section 12 of the Charter.
And finally, they have acted in a way that is discriminatory, drawing arbitrary distinctions on whether somebody’s life is worth anything or any amount of health-care based on their country of origin.”
Macklin also argued that no other country with a publicly funded health-care system has adopted these kinds of policies.
“Indeed the EU explicitly prohibits it under one of its asylum directives,” said Macklin.
In the meantime here in Canada, refugees without health-care coverage won’t see a doctor because they can’t afford the bill.
Others will end up in emergency rooms and face bills they’ll never be able to pay.
“Each person who is confronted with a situation will have to deal with it on an ad hoc basis,” said Lorne Waldman, president of the Canadian Association of Refugee Lawyers (CARL) and lead counsel for the court case.
“In the process, a lot of people are going to find their health in serious jeopardy.”
And when will somebody die as a result of these cuts to refugee health-care?
“Our goal is to prevent a death from happening,” said Berger.
“We don’t want to have to come and say we have our first death. The purpose is to prevent that from happening.”