“Today, as yesterday, a nation is judged by its attitude towards refugees.”
Elie Wiesel, Nobel laureate, Globe and Mail, July 7, 2012
On June 30, 2012, the federal government implemented cuts to its Interim Federal Health Program (IFHP), which covers basic health care for refugees, refugee claimants and certain other non-citizens.
The cuts have led to:
- Confusion and anxiety for refugee claimants and others affected
- Confusion for health care providers about patients' entitlements
- Some people left without any health care coverage, including those waiting for an appointment in order to make a refugee claim
- Some people left without any means of paying for necessary medications
- The loss of psychological support services for refugees who are survivors of torture, rape or other organized violence
The CCR is also concerned that the cuts have been accompanied by extremely divisive rhetoric that pits Canadian citizens against refugees.
The CCR believes that all who reside in Canada should be entitled to an acceptable level of healthcare and that Canadians are at their best when they treat refugees fairly and with an open heart.
Impacts of the cuts
Some people are left without health care coverage
Since the IFH cuts, some people are without any coverage for health care. This includes people waiting for an appointment to make their refugee claim, and people seeking Canada's protection through the Pre-Removal Risk Assessment, having been denied the right to make a refugee claim.
Example: An Iranian man who is waiting for a Pre-Removal Risk Assessment is without any coverage, either federal or provincial. He has some serious health problems. He is unable to afford the medications he needs, leading to such a significant deterioration in his health that he is no longer able to work.
Many people are left without coverage for medications
Refugee claimants in some provinces have no coverage for necessary medications.
Example: A man who has been in Canada three years waiting for his refugee hearing was recently diagnosed with cancer. The drugs are not covered, so he has sold all his possessions to pay for his chemotherapy.
As part of the cuts to IFH, coverage of psychotherapy for survivors of torture has been eliminated (for anything other than public safety concerns). This leaves deeply traumatized refugees without specialized support as they get back on their feet.
Example: Because of the IFH cuts, a Congolese pastor who was imprisoned for his political opinions is not able to receive therapy. While in jail he was whipped and beaten, and he now exhibits signs of Post-Traumatic Stress Disorder (PTSD) and high anxiety. He fears for the family members he was forced to leave behind when he fled the country.
"I can say that the people referred to us are not regular Canadian citizens. A citizen has not been tortured and subjected to violence." John Docherty, RIVO, La Presse
Difficulty getting access to health care services that are covered by IFH
It has become more difficult for people with IFH coverage to get access to the services they are entitled to, as there is confusion over who is entitled to what, and some health care providers find it too complicated to deal with.
The Canadian Doctors for Refugee Health have published information from a survey conducted on impacts of the cuts.
For more on the impacts of cuts to the Interim Federal Health Program, read Refugee Health: Impacts of recent cuts
Interim Federal Health Program, Res. 1, June 2012
- Anyone who resides in Canada should be entitled to an acceptable level of healthcare;
- The Canada Health Act enshrines the principle of universality;
- Preventative healthcare is both more humane and more economical than curative healthcare; and
- The International Covenant on Economic, Social and Cultural Rights recognizes that everyone has the right to “the highest attainable standard of physical and mental health” and that States have a duty of non-discrimination in the realization of that right.
That the CCR oppose the reductions to the IFHP announced in April 2012 and advocate:
- For the cancellation of the announced reductions,
- Against any other reductions in IFHP coverage, and
- Against any differentiation in coverage based on category of refugee or claimant, or stage of processing (e.g. claimant, accepted refugee, refused refugee, government-assisted refugees, privately-sponsored refugees).
- Government information on refugee healthcare changes is misleading, may be fatal, 3 May 2012
- Changes to healthcare for refugee claimants and protected persons inhumane, 27 April 2012
Canadian Medical Association Journal editorial, Canada owes refugees adequate health coverage, 20 January 2014
The heads of eight prominent health-care groups signed an open letter:
The Canadian Association of Optometrists
The Canadian Medical Association
The Canadian Nurses Association
The Canadian Association of Social Workers
The Canadian Dental Association
The Canadian Pharmacists Association
The College of Family Physicians of Canada
The Royal College of Physicians and Surgeons of Canada
More from the Canadian Medical Association:
- Eight groups, one message: restore health coverage for refugees, 24 May 2012
- CMA, MDs renew call for reinstatement of care for refugees, 16 July 2012
More from the Canadian Pharmacists Association: Cuts to Refugee Benefits: CPhA Leads the Fight
Canadian Association of Community Health Centres:
- Canada's health centres call on federal government to reverse dangerous health care cuts, 15 May 2012
- Cuts to refugee health care a race to the bottom: Docs and CHCs, 4 June 2012
Wellesley Institute, The Real Cost Of Cutting The Interim Federal Health Program, October 2013
- Canadian Doctors for Refugee Health
- 59 cents campaign
- Canadian Centre for Policy Alternatives
- Centre for Research on Inner City Health, St. Michael's Hospital
Understanding health care entitlements
Despite the cuts, the IFHP does provide many health care benefits to refugees. In addition, coverage is sometimes available from the province. For information about entitlements, see http://ccrweb.ca/en/ifh-practical
The Order respecting the Interim Federal Health program, 2012, provides the full legal details.
The Canada Gazette, April 25, gives the order as well as explanatory text.