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Changes to health care for refugees have denied care and threatened lives

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Another June 16 is upon us and we're once again offering our support and solidarity to incredible organizations like Canadian Doctors for Refugees who are organizing yet another day of rallies and protest against the racist and discriminatory cuts to the Interim Federal Health Program (a.k.a. health care for refugees).

This June 16, the Council of Canadians will once again join health-care professionals, lawyers, students, labour brothers and sisters, and civil society to yell "shame!" at a government that feels no shame in denying thousands of people basic and even emergency health care.  

Since I last wrote about the cuts to the IFHP in late January 2014, new and important reports have been released showing that refugee children and pregnant women are at a much greater risk since changes to the IFHP.

One of these reports by Dr. Caudarella and Dr. Evans made headlines in May when it showed that hospital admissions among refugee children at Toronto's Sick Kids hospital had doubled since the changes to the IFHP (the full report can be read here).

Currently Ontario hospitals and doctors submit bills for the care and treatment of refugee patients to Blue Cross, the government's health insurance company. Dr. Caudarella and Dr. Evans discovered that while prior to IFHP changes 54 per cent of ER bills submitted by SickKids to Medavie Blue Cross went unpaid, after the IFHP changes, 93 per cent of bills are now upaid. Caudarella and Evans suggest that further study is needed to understand what is happening in smaller access points, such as walk-in clinics, that might not have the funding to cover these costs. Would refugee children be denied care?

Another report by Kandasamy et al., finds that refugee women are a higher-risk of "adverse obstetric and perinatal outcomes." The study found delays in receiving prenatal care were five-fold greater for refugee women than non-refugees (Kandasamy et al., 300). The report concludes "with the recent changes to the IFHP including the decrease in obstetric services covered under the program, as well as the decrease in preventive health coverage to certain populations (such as those from designated countries of origin), inequities and lack of access to care within our system are likely to increase than in non-refugee control."

Lastly, a third discovery, this one by Doctors for Refugee Care, shows the complications and delays that are now occurring as a result of the IFHP changes and the federal government's desire to deny refugee claimants the care they need: "This process (of submitting bills to Blue Cross) usually takes at least four weeks. If the claim is rejected, it is sent back to the billing hospital or doctor who must then resubmit the same billing claim, to the same insurance company, for the same service but directed to the OTHP branch of Blue Cross. The Conservative Government has prohibited Blue Cross staff from walking down the hall and transferring the rejected claim to the OTHP. More work is created for hospital and administrative staff, more taxpayer funds are being spent on federal Government mandated Blue Cross inefficiency, and confidence in OTHP is being eroded by the federal Government's interference in a provincial program."

For those who are more fond of anecdotal evidence, here's a sampling of cases verified by Canadian Doctors for Refugee Care of harm that has been caused as a result from the IFHP cuts:

  • A woman with a history of being sexually assaulted presents with symptoms of a sexually transmitted infection. She has no health insurance for investigations or treatment as she awaits the initiation of her health insurance.
  • An elderly woman from a Designated Country of Origin (DCO) country with an existing heart condition (previous heart attack) cannot have the appropriate investigations. On a subsequent visit, she has worsening chest pain and has to be sent to the Emergency Room.
  • A three-year-old child with vomiting has no insurance to see a health-care worker because her family comes from a DCO country. 
  • A pregnant woman in her third trimester with DCO coverage is denied prenatal care and rescued by a midwife collective who agrees to provide care for free.
  • A six-year-old child has no health insurance to assess or treat her symptoms of a urinary tract infection as her family awaits the initiation of her health insurance.
  • A recent refugee who was repeatedly raped in her country of origin presents with abdominal pain that is likely related to the assaults. The woman cannot receive investigations into her pain until her health coverage has been initiated.
  • A pregnant woman with vaginal discharge has no access to health care as she awaits her health insurance to be initiated.
  • A man with a life-threatening inflammatory disorder fails to show up for follow-up appointments to his specialist because of limited IFH coverage.
  • A woman followed by an obstetrician for her pregnancy is turned away for care at 36 weeks once she is denied her refugee status.

These stories and others can be found at: http://www.doctorsforrefugeecare.ca/

Please join us and our allies on June 16 in cities across Canada to oppose these harmful and life-threatening health-care cuts to one of our most vulnerable populations.

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