As we have previously blogged, the federal government recently cut health benefits for many refugees. In The Real Cost of Cutting Refugee Health Benefits, the Wellesley Institute argued that these cuts would have an unfair and inequitable impact on some of the most vulnerable people in Canada.
It is totally predictable that the costs for providing health care to refugees will be passed to the Provinces and Territories and care will be more expensive than it would be as preventable conditions deteriorate as is provided in urgent or emergency circumstances.
To address this, the Wellesley Institute, a member of the Hospital Collaborative on Marginalized and Vulnerable Populations, and other physicians providing care to refugees recently met to provide input to senior LHIN and Ministry of Health and Long Term Care officials about the impacts of cuts to refugee health benefits and options to mitigate the avoidable negative health outcomes at a local and provincial level. We concluded that actions should take place at the health care provider, LHIN, and provincial level.
Health care providers should:
- Continue to develop contingency plans, monitor the demand for services by refugees, and document the impact of the cuts on individual patients and on provider costs and services.
- Endorse the documentation of impacts and adapt the documentation tool developed by providers for use by health care organizations.
- Enable or require health care providers to document cases and track additional costs incurred in serving refugee patients.
The Ontario Ministry of Health and Long Term Care should:
- Systematically collect data on additional costs to the Province caused by reductions to the IFHP.
- Encourage or require LHINs to document adverse health impacts using the common tool.
- Commit, as Quebec has done, to ensure that refugees no longer supported by IFHP are not denied care:
- Allowing preventable and avoidable conditions to progress will increase emergency costs down the line for the provincial health system.
- The main mechanism should be through primary care, and one option would be to pool funds for community health centres to provide care for uninsured patients. Specialized Family Health Teams could also be funded to provide services to refugees.
- Consider the wider context of cuts to refugee health benefits and care for other uninsured populations:
- The impending designation of ‘safe’ countries of origin by Minister Kenney may result in even more refugees being denied basic health benefits. The Province should advocate with the federal government to ensure that this categorization is not damaging.
- In terms of the wider issue of immigrant health, the Province could reconsider the three month wait for OHIP for newcomers to Ontario and returning Canadians. There could be a risk of not acting on an inequitable restriction within their control, while advocating with the federal government around restrictions for refugees.
These actions are essential to ensuring the good health of all refugees. However, the need for local and provincial authorities to react to the lack of basic health care for refugees is due to the federal government’s decision to cut the Interim Federal Health Program. The Wellesley Institute has joined with a multitude of professional associations and health care providers across the country in calling for the federal government to immediately reinstate refugee health benefits.