May 20, 2015
Interim Federal Health Care Reforms (2012): A Consideration of Some Policy Rationales
The decision of Canadian Doctors for Refugee Care v. Attorney General of Canada and Minister of Citizenship and Immigration (2014) FC 651 (Canadian Doctors), in which Justice Mactavish found the 2012 changes to the Interim Federal Health Program unconstitutional and in violation of sections 7 and 15 of the Charter, is currently under appeal. An earlier entry provided details regarding that judgement.
This entry will explore two of the federal government’s rationales for the reforms, which focus on the need to (1) limit “health tourism” and (2) limit costs.
Limiting “Health Tourism”
There is only limited evidence on the connection between the provision of healthcare for asylum seekers and their decision to migrate to a certain country. However, in the UK, evidence demonstrates that the availability of treatment for HIV does not significantly influence an asylum seeker’s decision to migrate to the UK. Further, even if a few individuals migrate with the intent of taking advantage of the healthcare system, it might be unreasonable to deny many other vulnerable individuals health care on this basis.
Reduction of Costs
A second government rationale for the reforms is that they are intended to save costs for the Canadian government. Before the 2012 reforms, there was indeed a rise in the number of people who were eligible for healthcare. For instance, 23 thousand more were eligible for IFHP coverage in 2009 than in 2002. However, we have more than 35 million Canadians in Canada – and the number of potential beneficiaries should be considered within this context. Additionally, we have a nearly balanced budget of $27.2 billion dollars and natural resources only imagined by other countries.
Furthermore, federal cost savings would be downloaded onto the provinces, especially as many have already signaled that they would provide healthcare in the absence of federal coverage. Finally, the reforms continue to provide emergency care for many, creating the possibility that individuals will wait until their conditions reach a critical stage to seek medical attention – this has negative implications for both the suffering of refugee claimants, as well as higher costs for treating more complicated cases.
As we watch closely how the Federal Court of Appeal decision unfolds, it is important to also critically engage with the policy rationales underlying the reforms.
If you have any Canadian immigration and refugee related questions, contact us for a consultation.