Introduction
People move from one place to another in search of better standards of living. It is practically impossible to deter people from entering any country. Arguably, countries which are seen as being economically well off get the highest number of immigrants. Canada being among the economic powers of the world, the number of immigrants both legal and illegal that enter the country each year is very high. Besides the economic benefits that the immigrants bring to the country, they face various issues while in the country. Among the problems that emerge due to the issue of immigration is access to health care. It is sometimes challenging for the government to provide quality health care for the immigrants. As a result, there have been many efforts directed towards enhancing the provision of health care to immigrants. It should be noted that immigrants face several difficulties regarding access to health care in Canada.
Problems Facing Non-Natives
To begin with, poverty is one of the reasons why many people leave their country. Immigrants, especially refugees, set off from their native country mostly without enough money to sustain them for long. As a result, affording good health care becomes a challenge especially for people from developing economies. It should be noted that getting employment might take quite some time leading to depletion of any savings that the immigrants might have (Spitzer 231). As a result, lack of enough cash limits the choices that immigrants and refugees have regarding access to health care facilities because they have other expenses to cater for.. Moreover, almost every new immigrant looks for affordable housing. This is done in order to reduce expenses at least until one is able to get a job. In many instances, one unit holds more than one family thus compromising sanitation of the houses.
Notably, a major issue facing non-natives in Canada is the lack of medical coverage. The process of obtaining medical coverage takes some time. The problem is compounded if the immigration is illegal therefore barring some immigrants from qualifying for medical insurance. Some do not have work permits while others simply do not have the required documents to qualify for medical coverage due to being in Canada illegally (Raphael 111). In this regard, several immigrants usually wait for several years before they can access medical insurance. It becomes a tricky issue especially when uninsured immigrants require emergency medical attention. For legal immigrants, the case is a bit simpler since they can easily get medical cover compared to refugees.
The lack of social connections in the community is also another issue. Being in a new country, some immigrants do not have anyone close to them to guide them on how to access various services. The result is difficulty in accessing social amenities, leading to isolation and sometimes depression. Though not always, some immigrants also face discrimination in various places. This may affect the services offered to immigrants at various health facilities (Fierlbeck 123).
Policies Addressing Immigrants’ problems
The main aim of any health care policy should be to assist citizens and residents of any country to access affordable and quality health care. In this regard, Canadian health care policy was tailored to ensure that people stay in good health and that their contribution to the economy is not hindered by bad health. Consequently, a universal health care insurance system was introduced. The Immigration and Refugee Protection Act is the only act that regulates the stay of immigrants in Canada (Bryant 46). Various specific issues affecting immigrants like declining income levels are not addressed. While the act outlines the expected treatment of immigrants, when it comes to employment and other public as well as private places, it fails to explain how the immigrants’ access to health care will be addressed. The health policy of Canada also concentrates on insured individuals while uninsured people are left out.
The Canada Health Act which is the main act that addresses payment for health care services in Canada has universality, comprehensiveness, portability, accessibility and public administration as its core principles. Notably, the Canada Health Act, which also caters for health needs of immigrants, deals only with the funding aspect of the health system. It outlines what criteria should be met before money is released from the federal government to the provincial governments (Bryant 75). On the same note, the Act ensures that as many people as possible have medical coverage. However, the Act does not explicitly highlight how the health services should be organized or even delivered to residents.
The act just states that there should be no financial barriers to access of health for any person in Canada. Nonetheless, the act is not clear on what services should be categorized as insured services. Private insurance coverage is also not allowed to include some important services. Therefore, private insurance cannot be very helpful. It is also important to note that paying for medical services out of the pocket is expensive than doing so using medical coverage.
Notably, when one is applying for admission to Canada, he or she is supposed to undergo medical examinations. Those people who have health conditions that are defined by Canadian laws as leading to excessive demand of health services are denied entry into Canada (Spitzer 154). Initially, the health policies had been very strict as regards the medical examinations one had to undergo when one wanted to apply for medical cover. Passing all tests was mandatory. The main rationale behind the examinations was to reduce the amount of money that would be spent giving care to an individual. Immigrants who failed to meet the threshold missed the opportunity to come to Canada (Bryant 69). However, not every person needs to have public medical insurance. There are immigrants who can afford to pay for their medical costs and they should be allowed to immigrate. Moreover, there have been changes in the world and technology has advanced. Therefore, some conditions that were difficult to treat in the past are now easily treatable. This calls for a change in the health policy directed at the immigrants.
Gaps in the Policies
Studies have shown that though immigrants are healthy in their initial years; their health status deteriorates with time (Raphael 112). Probably, due to changes in lifestyle, they develop various conditions including diabetes, cancer and obesity among other medical problems. Moreover, the policies in place about pre-immigration medical examination were developed in the past when majority of immigrants were from Europe and Asia. The demographics have significantly changed now (Raphael 116). People from other parts of the world come to Canada. As a matter of fact, there has been a reduction in the number of immigrants from Europe while the number from Africa and other parts of the world has increased (Spitzer 146). The cultural background of immigrants has thus changed. Given that various places have unique diseases, medical examination rules need to be changed. This is because contrary to previous years when economically stable immigrants were in the majority, nowadays most of the immigrants are poor (Raphael 116). They will therefore become a social burden if they fall sick.
Effectiveness of Current Policies
The Immigration and Refugee Protection Act is the policy concerned with the whole process of immigrating and settling in Canada. However, refugees and some limited categories of immigrants have the Interim Federal Health Program (IFHP) that addresses some aspects of their stay in Canada (Hankivsky 76). The fact that refugees do not automatically qualify for medical cover complicates their health issues. The IFHP was therefore a good step towards achieving equity in the health sector (Spitzer 156). However, the cuts on IFHP have increased problems that refugees face in their quest for health care services. Recognizing that access to medical care without insurance whether public or private is difficult; there should be a policy that aims at taking care of the uninsured. This could go a long way in reducing the inequalities in health care that have existed between natives and non-natives
The IFHP policy comes at a time when many groups have raised their voice about the issue of refugees’ access to health care services. To begin with, when a person falls sick, whether the person is a native or an immigrant, the society as a whole is affected. Sick people cannot be economically productive. Moreover, the failure to have access to medical care makes the sick a burden to others since they have to come up with ways of treating the patient. Most importantly, it is contrary to human rights to restrict access to better health care for a group of individuals.
The Interim Federal Program Policy also proposes payment of costs and expanded health care coverage for people issued with a temporary resident permit. Besides enabling refugees to get quality health care, this ensures that they can afford medical care (Hankivsky 98). Additionally, the IFHP is expected to alleviate the problem of refugees waiting for long periods before accessing health facilities. For the case of legal immigrants, policies are in place to ensure that they acquire medical cover as fast as possible. However, there are certain services which are vital but are not covered. They include vision care, prescription of drugs and routine dental check up. Similarly, it is important to note that immigrants are prone to various psychological problems (Spitzer 148). This is due to the fact that they are changing societies and might take time to adapt. Mental health services are therefore crucial for them yet they are not fully covered.
Emerging Issues
Immigration trends in the world are changing with time. People from the developing world are becoming increasingly aware of the opportunities available in the developed world. Consequently, the majority of immigrants to Canada are now coming from third world countries (Bryant 58). Unfortunately, the economic status of these people is not so good. As a result, when they settle in Canada, they encounter challenges that will lead to low standards of living (Fierlbeck 267).
On the same note, many of the people coming to Canada do not have good English language skills. As a result, language barrier inhibit their access to health care. Mechanisms should put in place to ensure that language barriers do not affect access to medical care. Arguably, the immigrants who came to Canada as young energetic people in the 1970 or before are now joining the old age group. These people have increased health care needs compared to the young immigrants. Some of them, especially the illegal immigrants and some categories of refugees, may have opted for private health insurance after discovering that they could not qualify for federal medical coverage (Bryant 223). Unfortunately, there are those who chose not to insure themselves. These people will need medical care given the fact that now they are in a high risk group for health problems.
There is also the issue of doctors’ ethical code of conduct. Doctors are supposed to provide medical care to every person without discrimination. However, all health facilities whether private or public need confirmation that the cost of treatment will be paid despite the fact that public hospitals are required by law to attend to emergence cases. The two aspects of health bring into view conflicting ideas. Cases have been reported where uninsured patients have been unable to pay for medical fee after being billed (Bryant 94). Will a doctor send a way a patient who needs medical attention just because the patient is not covered or will he or she demand for upfront payment before commencing treatment?
Sometimes there is the question of whether the amount spent on immigrants’ health care can be recovered from the taxes collected from them (Hankivisky 298). The crux of the matter is whether the immigrants, especially illegal immigrants, pay taxes in the first place. If the government does not put mechanisms in place to ensure that immigrants get employment, then they will not be able to pay taxes and providing health care for them will be uneconomical.
Conclusion
Immigrants are a reality of life that no country can eliminate. People will still travel in search of better living standards. However, it should be noted that immigrants are also human beings and their health should be given the same consideration as that of natives. Canada has tried to provide immigrants with better health care but still more needs to be done. Times have changed and policies that were effective in the 1960s will not be effective today. Similarly, trends in immigration and the needs of immigrants have changed. Therefore, immigrants need a health policy that will address their issues.
Works Cited
Bryant, Toba. An Introduction to Health Policy. Toronto: Canadian Scholars’ Press, 2009. Print.
Fierlbeck, Katherine. Health Care in Canada: A Citizen’s Guide to Policy and Politics. Toronto: University of Toronto Press, 2011. Print.
Hankivsky, Olena. Health Inequalities in Canada: Intersectional Frameworks and Practices. Vancouver: UBC Press, 2011. Print.
Raphael, Dennis. Health Promotion and Quality of Life in Canada: Essential Readings. Toronto: Canadian Scholars’ Press, 2010. Print.
Spitzer, Denise L. Engendering Migrant Health: Canadian Perspectives. Toronto: University of Toronto Press, 2011. Print.