Expanded refugee health care coverage begins, but concerns remain over access

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OTTAWA – Expanded health-care coverage for refugees and asylum seekers was restored Friday as the Liberal government acted to end cuts that a judge called cruel and unusual.

Thousands of people claiming asylum and thousands more resettled from abroad now have their health care costs fully covered by the federal government with the restoration of the interim federal health program.

“It’s a good day for those fleeing persecution,” said Dr. Meb Rashid, the medical director of the Crossroads Clinic in Toronto who helped lead the charge against the cuts to the program ordered by the previous Conservative government.

But Rashid and others say much still needs to be done to ensure refugees and claimants have access to the care they need.

In particular, the Liberals need to be clear about the return of full coverage and early signs are not encouraging, said Dr. Philip Berger, medical director of the inner-city health program at St. Michael’s Hospital in Toronto.

“All of the doctors, and in particular refugees, who know about these changes are deeply grateful for the moral, correct and right decision the federal Liberal government has taken,” he said.

“Nonetheless, government’s record on communicating the changes, whether to front-line health professionals including doctors, hospitals, sponsorship agreement holders, private sponsorship groups, has been abysmal.”

The program covers the costs of basic health care and supplemental services like dental and vision care for refugees and asylum claimants who are not yet eligible for provincial benefits and don’t have private insurance.

It began in 1957 and was overhauled by the Conservatives to save money and deter what they said were “bogus” claimants coming specifically for health care.

Their program created over a dozen different types of coverage running from full coverage for government-assisted refugees to emergency services available only for those from certain countries.

The complex grid saw many doctors throw up their hands. A 2014 survey of 96 walk-in clinics found 45 per cent in Montreal and 47 per cent in Toronto either charged a fee or refused all patients, even those entitled to full coverage.

“It’s wonderful the government is making the changes so everybody will have full federal coverage but we’re very concerned that in practice the same problems will still be there,” said Janet Cleveland, who co-ordinates research into refugee health care for Sherpa, a research institute affiliated with McGill University.

Nancy Chan, a spokesperson for the Immigration Department said the details are on the department website and the claims administrator is also providing information. The fact all refugees and claimants are now entitled to the same coverage means a simpler program that’s far easier to administer and no delays are anticipated, she said.

“With this restoration, we will ensure that refugees can access services based on their health needs, not on the stage of their application or what immigration category they fall into,” she said in an e-mail.

The Conservative cuts led to a series of court challenges, the first resulting in a scathing Federal Court judgment saying the Tory approach violated the Charter of Rights and Freedoms, especially as it related to children.

“Denying health-care insurance coverage to innocent children as a means of affecting the behaviour of their parents and others is illogical and unjust,” wrote Justice Anne Mactavish.

“It constitutes cruel and unusual treatment.”