Note: In November 2014 due to the Federal Court of Canada decision declaring the cuts to the Interim Federal Health Program unconstitutional, the federal government introduced a temporary health program which provides some coverage for some refugees. More information is available on the Government of Canada website at: http://www.cic.gc.ca/english/refugees/outside/summary-ifhp.asp.
In late April 2012, the federal government announced a series of sweeping changes to the Interim Federal Health (IFH) program (http://www.cic.gc.ca/english/refugees/outside/arriving-healthcare.asp), the health insurance program for refugees in Canada. The changes came into effect on June 30, 2012. On June 29th the federal government announced after significant public pressure that government assisted refugees would not be impacted by these cuts.
The previous IFH program provided access to medical care, diagnostic services and laboratory testing very similar to what is provided by provincial health plans. It also provided access to medications, emergency dental care and vision care similar to what is available to people on provincial social assistance plans.
To understand these changes it is important to recognize the different types of refugees in Canada and the previously available coverage.
1. Privately Sponsored Refugees-these are people who are identified as refugees pre-migration to Canada. They are provided provincial health insurance upon arrival but rely on IFH for access to medications, vision and emergency dental care. They receive federal income assistance usually for one year (monthly amounts similar to social assistance) and as such cannot apply for provincial social assistance programs.
2. Refugee Claimants-they are people who make their refugee claim after arriving in Canada. They are given a work permit but if working cannot receive social assistance. They do not qualify for provincial health insurance. They access physicians and obtain laboratory and diagnostic testing through IFH. They will be able to access medications if on social assistance. The government has divided this group into two categories:
i) people from designated countries of origin (DCOs)-refugee claimants that originate from countries \the
Minister feels should not be producing refugees
ii) people from all other countries
Changes to IFH
1. All refugees (excluding government assisted refugees) lost access to medication coverage, vision and dental care through IFH
2. People from DCO’s no longer have health coverage including for urgent or essential care except for #3 below
3. All refugees are covered for the following conditions (including medications)
i) Issues of public health concern-these are infections that are on the Public Health Agency of Canada notifiable diseases list and involve human to human transmission (note this does not include common infections such
as pneumonias, pyelonephritis etc. or even conditions such as malaria)
ii) Issues of public security concerns-this is defined as psychotic conditions where a person has been identified as being a danger to others (this does not include suicidal intent)
Rationale for these changes
1. Cost- the government has said the changes will save 100 million dollars over five years. Many suspect that there will be costs to untreated illnesses that are not factored in this calculation. These include Emergency room visits and complications arising from neglected illnesses. Also 35-45% of refugee claimants will become Canadian citizens and there may be costs incurred by neglecting health conditions because of a lack of health insurance
2. Deterrence-it has been stated by government officials, that some refugees come to Canada to get health care. They feel that limiting access to health care will deter refugees from coming. It is unlikely that access to quality health care is top of mind for refugees fleeing war, famine or violence
3. Equity-The government has argued that refugees receive health care that is superior to that received by others in Canada. However, refugees previously received nothing more than what the lowest income Canadians who receive social assistance do. They now have much less. The equity argument also pits Canadians against refugees and denies the tremendous hardship experienced by most refugees
Implications of the cuts
1. Privately Sponsored Refugees-they have access to physician visits, diagnostics and laboratory testing through their provincial health coverage. They have no access to medications, vision or dental care
2. Refugee Claimants
i) from DCO’s - they have no coverage even in the case of emergencies, pregnancy or ill children. IFH will only cover cases of public health or public safety concern. They have drug coverage if on social assistance
ii) from non DCO countries - they have coverage for urgent or essential care. This includes physician visits, laboratory and diagnostic testing. They have medication coverage if on social assistance
Health care workers across the country have organized to oppose these cuts and advocate for their reversal. Many feel that resettled refugees are suffering or will suffer tremendous hardship by not being able to access medications. They are at risk of severe complications. Health care workers are also deeply concerned that people from DCO’s are unable to access care for even life threatening conditions. Many have also suggested that the cuts will only result in increased costs.
In late April 2012, the federal government announced a series of sweeping changes to the Interim Federal Health (IFH) program (http://www.cic.gc.ca/english/refugees/outside/arriving-healthcare.asp), the health insurance program for refugees in Canada. The changes came into effect on June 30, 2012. On June 29th the federal government announced after significant public pressure that government assisted refugees would not be impacted by these cuts.
The previous IFH program provided access to medical care, diagnostic services and laboratory testing very similar to what is provided by provincial health plans. It also provided access to medications, emergency dental care and vision care similar to what is available to people on provincial social assistance plans.
To understand these changes it is important to recognize the different types of refugees in Canada and the previously available coverage.
1. Privately Sponsored Refugees-these are people who are identified as refugees pre-migration to Canada. They are provided provincial health insurance upon arrival but rely on IFH for access to medications, vision and emergency dental care. They receive federal income assistance usually for one year (monthly amounts similar to social assistance) and as such cannot apply for provincial social assistance programs.
2. Refugee Claimants-they are people who make their refugee claim after arriving in Canada. They are given a work permit but if working cannot receive social assistance. They do not qualify for provincial health insurance. They access physicians and obtain laboratory and diagnostic testing through IFH. They will be able to access medications if on social assistance. The government has divided this group into two categories:
i) people from designated countries of origin (DCOs)-refugee claimants that originate from countries \the
Minister feels should not be producing refugees
ii) people from all other countries
Changes to IFH
1. All refugees (excluding government assisted refugees) lost access to medication coverage, vision and dental care through IFH
2. People from DCO’s no longer have health coverage including for urgent or essential care except for #3 below
3. All refugees are covered for the following conditions (including medications)
i) Issues of public health concern-these are infections that are on the Public Health Agency of Canada notifiable diseases list and involve human to human transmission (note this does not include common infections such
as pneumonias, pyelonephritis etc. or even conditions such as malaria)
ii) Issues of public security concerns-this is defined as psychotic conditions where a person has been identified as being a danger to others (this does not include suicidal intent)
Rationale for these changes
1. Cost- the government has said the changes will save 100 million dollars over five years. Many suspect that there will be costs to untreated illnesses that are not factored in this calculation. These include Emergency room visits and complications arising from neglected illnesses. Also 35-45% of refugee claimants will become Canadian citizens and there may be costs incurred by neglecting health conditions because of a lack of health insurance
2. Deterrence-it has been stated by government officials, that some refugees come to Canada to get health care. They feel that limiting access to health care will deter refugees from coming. It is unlikely that access to quality health care is top of mind for refugees fleeing war, famine or violence
3. Equity-The government has argued that refugees receive health care that is superior to that received by others in Canada. However, refugees previously received nothing more than what the lowest income Canadians who receive social assistance do. They now have much less. The equity argument also pits Canadians against refugees and denies the tremendous hardship experienced by most refugees
Implications of the cuts
1. Privately Sponsored Refugees-they have access to physician visits, diagnostics and laboratory testing through their provincial health coverage. They have no access to medications, vision or dental care
2. Refugee Claimants
i) from DCO’s - they have no coverage even in the case of emergencies, pregnancy or ill children. IFH will only cover cases of public health or public safety concern. They have drug coverage if on social assistance
ii) from non DCO countries - they have coverage for urgent or essential care. This includes physician visits, laboratory and diagnostic testing. They have medication coverage if on social assistance
Health care workers across the country have organized to oppose these cuts and advocate for their reversal. Many feel that resettled refugees are suffering or will suffer tremendous hardship by not being able to access medications. They are at risk of severe complications. Health care workers are also deeply concerned that people from DCO’s are unable to access care for even life threatening conditions. Many have also suggested that the cuts will only result in increased costs.
