Introduction
This paper will discuss the origin, strengths, and weaknesses of the Canadian Interim Federal Health Program (IFHP), and propose recommendations that can enhance its performance. This paper will base its arguments on globalization and federalism themes. As such, it will discuss how globalization has contributed to an increase in the number of immigrants and how the provision of healthcare to such marginalized groups is handled in Canada. IFHP “provides limited, temporary, taxpayer-funded coverage of healthcare to protected persons, including resettled refugees, refugee claimants, and certain other groups who are not eligible for provincial or territorial health insurance” (Citizen and Immigration Canada, 2011, p.1).
Globalization is the interconnectivity of cultures and economies and a concerted attempt at the creation of free world markets. This results in readjustments in politics and national policies. This scenario results in the movement of people to new geographical areas in search of opportunities in an unpredictable fashion. Host countries may not adjust budgets to accommodate immigrants. Hence, immigrants have limited access to certain services.
Generally, immigrants have limited, if any, benefits in the provision of healthcare services.
Immigrants from a significant percentage of the Canadian population. A recent report released by Statistics Canada indicated that Canada has 34 ethnic groups (Citizenship and Immigration Canada, 2010). The report also indicated that minority groups in Canada are 16 percent of the population (Citizenship and Immigration Canada, 2010). As a developed nation with massive opportunities and a stable political system, Canada has attracted a significant number of refugees from across the globe. This environment has attracted refugees from various groups. This paper will analyze the appropriateness of this program in offering healthcare services to both refugees and minority groups.
An Overview of the Interim Federal Health Program
IFHP covers several categories of refugees. They include those who are not qualified to receive provincial or territorial health insurance and protected persons who have no access to any form of income. Such groups include private refugees, successful refugee claimants, and the majority of individuals who have received a positive decision on pre-removal risk assessment (Citizen and Immigration Canada, 2011). In addition, this program covers refugee claimants from any nation so long as the status of their Designated Countries of Origin is unknown. This means that it is not yet clear if the refugee’s country of origin is considered a country that frequently produces refugees or not. The latter discourages unfounded refugee claims. Immigrants whose immigration appeals or cases are still under review are not covered.
IFHP ensures the provision of healthcare services similar to those provided to Canadian Citizens through the Medicare Scheme. Once the immigrants have complied with the necessary legal requirements, they can access the provincial or territorial healthcare plans. IFHP ensures that beneficiaries receive medical attention for a disease symptom, complaint, or injury. Beneficiaries can access services of a hospital, a doctor, a registered nurse, a laboratory, and ambulances. Additionally, surgery, medications, and vaccines are covered (Citizen and Immigration Canada, 2011). The provision of vaccines or medications depends on the threat the beneficiary’s disease poses to the public. Thus, such services are granted in cases whereby the beneficiary’s disease poses a significant risk to the public. However, IFHP does not cover services such as home-care/long-term care, fertility, elective surgery, and cosmetic surgery (Staff Report, 2012).
Under the extended healthcare coverage, additional groups are covered. They include persons who have been illegally trafficked to Canada and have a valid temporary permit by section 24(3) of the Immigration and Refugee protection act (Staff Report, 2012). The extended health coverage scheme also covers government-assisted refugees; specific Visa Office referred refugees, Joint Assistance Sponsorship Program refugees, and people who have been resettled in Canada because of public policy or on humanitarian grounds (Citizen and Immigration Canada, 2011). The extended healthcare package applies until the beneficiary has settled any refugee cases. Beneficiaries of this scheme can get “medical attention for a disease, symptom, or injury” (Citizen and Immigration Canada, 2011). Moreover, the extended healthcare coverage package enables the individuals who are receiving government resettlement assistance to receive coverage for selected healthcare products and services. For example, these beneficiaries can access approved medications and pharmacy services, restricted visual and dental care services, prosthetics and devices to assist mobility, home care, post-arrival health assessments, and psychological counseling provided by a verified psychologist (Citizen and Immigration Canada, 2011).
MediaView Blue Cross spearheads the implementation of this program. Beneficiaries of IFHP can access healthcare services or products from any healthcare provider in the country so long as the healthcare provider is registered with MediaView Blue Cross Company (Cleveland, 2012). The process of registering healthcare providers with MediaView Blue Cross Company is very simple. Thus, even if a beneficiary of this program visits a healthcare provider who is not registered with the MediaView Blue Cross Company, the healthcare provider can simply submit his or her application and it will be speedily processed. This strategy eliminates any barriers, which hinder the provision of healthcare to the beneficiaries of this scheme.
Weaknesses of the IFHP
According to Cleveland (2012) “a refugee claimant is a person who flees to another country because she has serious reasons to fear that, if sent back to her country of origin, she would be prosecuted because of her ethnicity, religion, gender or political opinions or similar reasons”. To be accepted as a refugee, the claimant should provide enough evidence to the Immigration and Refugee Board (IRB). An example of the evidence sought by the Immigration and Refugee Board includes whether or not the applicant has suffered severe mistreatments such as rape, torture, beatings, or death threats. The application should also prove to IRB that she could not obtain protection from the police or courts in her country of origin. The applicant should also prove to IRB that she is not safe anywhere in her country of origin. According to (Cleveland, 2012), Canada receives approximately 20,000 claims per annum. Currently, the claims process takes a minimum of two years.
According to the claims statistics from the Immigration and Refugee Board, approximately 40 percent of applications are accepted yearly (Cleveland, 2012). However, during the process, the applicant enjoys several privileges. For example, an applicant is given a temporary work permit, social assistance, and healthcare. Applicants who are awaiting approval from the Immigration and Refugee Board are not eligible to access provincial health insurance. There is growing sentiment against refugees and policies inherent to them in Canada (Staff Report, 2012). Critics are proposing stricter rules to hamper refugees who are taking advantage of the program through loopholes such as a long refugee processing time. There have been proposals to introduce a new law that will increase the detention of refugee claimants and curtail their rights in countries that are designated as safe (Cleveland, 2012). The proposed law will give the Minister of Immigration the mandate to place a country on the DCO list depending on two factors: if a majority of the Immigration and Refugee Board have rejected applications from that particular country, and she is a democratic country with a well functioning, independent judicial system. The Federal cabinet is discussing this law and it is expected that this law will be in effect by the end of 2012. Lawmakers have proposed that when the new law is implemented, refugee claims, which were made before the enactment of this law, will retain healthcare coverage even if their country of origin has been listed on the DCO list. However, if a claim is made after the enactment of this new law, the claimant will be eligible to access public care coverage only for medical conditions considered a threat to public health. The services will be received after her country of origin is entered on the DCO list.
Analysis and Recommendation
IFHP program has been quite successful in providing healthcare services to refugees, refugee claimants, and protected persons since 1957. Provincial governments had no legal healthcare responsibility for this group. However, the proposed changes have sparked outrage from several quarters. Provincial governments argue that territorial abdication of this responsibility means they will have the long-term responsibility of taking care of this demographic. Additionally, medical practitioners argue that it is hypocritical for the federal government to insinuate that many refugees were bogus. This is just a reason to divest from social responsibility while loudly proclaiming that Canada is a humanitarian society. Additionally, critics who argue that immigrants have special needs inherent to their changes in the environment, and setting are refuting the federal government’s argument that ‘special care’ of refugees may be unwarranted (Staff Report, 2012).
The introduction of new stricter rules will only complicate an already delicate situation. Long processing times of immigrants may just grow longer. Long-term health problems may spread in provinces as immigrants shy away from the complex process of accessing medical care. This may lead to the spread of contagious diseases. In my opinion, the proposed changes are somewhat unfair and hard to implement in a federal state like Canada. This law will also ensure that there is no healthcare coverage to refugee claimants, whose applications are still under review. Additionally, individuals whose applications have been rejected and continue to stay in Canada illegally, and individuals whose temporary visas have expired will not get health care coverage (Citizenship and Immigration Canada, 2010).
Overall, the proposed law will have several direct negative ramifications. First, there will be no medical services for individuals whose refugee claims have been declined and individuals from Designated Countries of Origins (Staff Report, 2012). Secondly, there will be no medical care for all refugees (Staff Report, 2012). In addition, refugee applicants will have difficulties accessing healthcare to which they are entitled if their applications have been rejected. The most affected individuals will be those who require long-term care such as pregnant women, and individuals with chronic diseases (Citizenship and Immigration Canada, 2010).
Conclusion
IFHP plays a significant role in the provision of healthcare to immigrants living in Canada. This program has three main types of coverage, which include health care coverage, expanded healthcare coverage, and public safety healthcare coverage. These packages ensure that individuals who have submitted their refugee applications and those whose applications have been declined can access predetermined healthcare services. These healthcare services apply to conditions considered a threat to public health only. Immigrants who seek refuge in Canada have various reasons, which force them out of their own countries. Access to basic healthcare services is a primary need and it is important to formulate policies that enhance the provision of this essential need to all individuals regardless of whether they are refugees or citizens. It is crucial to develop an efficient mechanism of screening applications of people who want to be granted refugee status in Canada to minimize errors in the program (Israel et al., 2012). Such mechanisms should reduce the time taken to process refugee applications. In addition, such mechanisms should ensure that individuals whose applications have been declined can access some level of healthcare coverage and if not they should be deported (Israel et al., 2012).
The proposed new law, which aims at cutting the expenditure of the Interim Federal Health Program, will have significant negative effects. This approach will reduce the coverage of healthcare to only urgent or essential care (May 2012). Thus, immigrants, refugee claimants, and other individuals whose refugee status has not been confirmed will encounter difficulties in accessing basic healthcare (Miller, 2012). On the other hand, coverage will be given to individuals who have contagious diseases. This is because failure to do that may pose a significant risk to the public. Individuals whose refugee applications have been declined will not have any form of medical cover (Silove, 2000). Furthermore, the new law will grant the Minister of Immigration immense powers that enable him to select the countries to be listed on the Designated Countries of Origins (Staff Report, 2012). Such a step requires collective decision making and giving one individual the capability to make such a decision might compromise the status of some refugees. Giving one person excessive power poses the danger of a lack of objectivity. Therefore, the proposed law should not be implemented.
References
Citizen and Immigration Canada. (2011). Health Care: Refugees. Web.
Citizenship and Immigration Canada. (2010). Canada Facts and figures 2009: Immigration overview, Permanent and temporary residents. Ottawa: Citizenship and Immigration Canada Press.
Cleveland, J. (2012). Healthcare for Refugee Claimants: Impact of IFHP cut. McGill: McGill Univerity Press.
Israel, M. et al. (2012). Response to the Interim Federal Health Program Cuts and Bill C31 by Health: Professionals of McGill University Department of Psychiatry. Web.
May, E. (2012). Protecting Canada’s Immigration System Act (Bill C-31). Web.
Miller, A. (2012). Passing the Buck: Cuts to the Interim Federal Health Program will just mean greater costs for the province. Web.
Silove, D. (2000). Policies of deterrence and the mental health of asylum seekers. Journal of the American Medical Association, 284(5), 604-611.
Staff Report. (2012). Health Impacts of Reduced Federal Health Services for Refugees. Web.