The federal government today released its list of Designated Countries of Origin The dangerous health impact will be that refugee claimants from these countries considered ‘safe’ will be denied almost all healthcare. This will make a harshly inequitable health situation even worse.
This list policy is fundamentally flawed and dishonest. The evidence is enormous and well-known that vulnerable communities within the ‘safest’ of these countries face persecution, violence and discrimination. Women may be fleeing family violence. Lesbian, gay and transgendered people face systemic discrimination in the ‘safest’ countries. Among the most dramatic and well known examples is the terrible treatment and conditions of Roma communities in the ‘safe’ country of Hungary.
Refugees in this category will be denied all care except for treating conditions deemed to dangerous to public health. Aside from the social nastiness of singling out particularly vulnerable people, it is flawed health policy. The cough that could indicate TB will not be identified if people are denied access to primary care.
As these changes to the Interim Federal Benefits for refugees were first announced we did a Health Equity Impact Assessment, concluding that the real cost of cutting refugee health benefits would be virtually no access to preventative care, delayed treatment for serious conditions and more adverse outcomes for those denied care. Unfortunately, emerging evidence being collected by refuge health indicates that this is exactly what has been happening. This latest development will make this terrible — and totally avoidable — crisis even worse.
There will also be significant system costs as, for example, when women who have had no prenatal care are hospitalized for difficult births or their children face poorer outcomes, or when people show up at Emergency Departments for conditions that could have been prevented through proper primary care. Many provinces have pointed out that they will be bearing these predictable cost increases, and LHINs, the Ministry of Health and Long-Term Care and providers here in Ontario have been analyzing how to deal with this unnecessary crisis.
This list enshrines inequitable treatment, creating a two-tiered health system. But it creates two particularly inequitable tiers: restricting access for almost all refugees to adequate healthcare, and effectively denying virtually any access at all to the most vulnerable.