Refugee health care’s coming back. Will doctors get the memo?
The six-year-old girl with an agonizing stomachache was turned away from the Montreal walk-in clinic: They only treat refugees who pay a fee first, they said.
The girl’s mom couldn’t afford the fee. So they left.
Days later she was in the emergency department with blocked intestines. She stayed in hospital for two weeks.
That girl shouldn’t have been a victim of refugee health cuts: She had full coverage, even under the more stringent program put in place by the previous Conservative government in 2012.
That program’s become so convoluted, however, that many health practitioners throw up their hands. They can’t deal with the paperwork so they simply turn all refugees away.
READ MORE: Refugee health care to be reinstated April 1
Janet Cleveland knows it. The McGill University researcher and psychologist encountered numerous stories like that in the years she’s spent tracking the 2012 cuts’ impacts on new Canadians’ ability to access care.
Cleveland and her colleagues worry this week’s announcement that the federal government’s restoring refugee health care April 1, greeted with jubilation by clinicians who’ve been contriving laborious workarounds to get their patients treatment, won’t be enough.
“So far as coverage of medical services is concerned, the April 1 [refugee health] reform changes very little. This is because the majority of refugee claimants (theoretically) have always continued to have full coverage of medical services. They never lost it,” she wrote in an email.
“Yet, as our results show, a very high percentage get charged fees or simply refused care. I find this very frustrating. …
“So much pain, suffering and waste of public resources, for somebody who (in principle) had exactly the same coverage as you or me.”
The Interim Federal Health Program gives refugees and refugee claimants about the same health coverage as people on social assistance for a short period when they first come to Canada.
It was cut in 2012, ostensibly because it was being used by “bogus” refugee claimants. A federal court called the cuts “cruel and unusual” because of the way they disproportionately hurt children and vulnerable people.
Clinicians and public health officials have argued the cuts cost more in the long run, because hospital stays are pricier than preventive care. And it’s bad for everyone when people with infectious diseases go untreated.
READ MORE: What’s the deal with refugee health care?
In December the federal Liberals made special provisions to give extended health care to people resettled in Canada as part of the government’s marquee Syrian refugee initiative. All other refugees will get health care in April.
In theory, anyway.
WATCH: Health Minister Jane Philpott on Canada’s Syrian refugee resettlement
The government has said its insurer, Medavie Blue Cross, is emailing medical associations to inform them of the change.
“Information for health-care providers is routinely provided through Medavie Blue Cross, the program’s administrator, and there will be additional communications through this channel as April 1 approaches,” Citizenship and Immigration spokesperson Michel Cimpaye wrote in an email Thursday.
“Starting April 1, 2016, health-care professionals will be able to treat patients based on their medical need, not on the category they fall into.”
Not good enough, Cleveland said.
Quebec, Ontario and other provinces set up temporary health programs of their own as stopgap measures and similar steps were taken to inform doctors of the changes but it didn’t make much difference: Some health practitioners just turned away all refugees because they didn’t know how the system worked or couldn’t stand the hassle.
In an open letter Friday, Cleveland and her colleagues in Toronto and Montreal urged the federal government to launch a more aggressive information campaign and simplify the refugee health process to ensure everyone knows how it works.
REFUGEE HEALTH CUTS: Even those who qualify get turned away
“As our study found, close to half of walk-in clinics in Montreal and Toronto charged fees (or outright refused care) to refugee claimants with full federal IFHP coverage in all cases — exactly as if they had had no coverage whatsoever,” she said.
“It’s a lot easier for most clinics just to tell the person ‘pay me $60’ instead of going through an unfamiliar and cumbersome billing process. Refugee claimants often just assume that this is the way the system works.”
A “much more intensive” public education campaign will be needed, Cleveland says, in order for anything to improve.
Otherwise, she says, new Canadians “will continue to see their right to publicly funded health care denied.”Follow @amp6