Ottawa’s treatment of refugees is shocking – André Picard

Hard to disagree with Picard’s assessment:

The IFHP cuts outraged physicians who provide care to immigrants and refugees and non-governmental organizations who sponsor them because they were mean-spirited, bureaucratic and ethically challenging.

They also “saved” very little money; IFHP costs fell to about $65-million. But those savings were illusory because refugees did to not stop having babies, getting sick and suffering from chronic conditions like diabetes, regardless of their country of origin. They just ended up emergency rooms, where no one is turned away and, having no insurance, they were billed, bills they could not pay. Essentially, the costs were shifted from Ottawa to cash-strapped hospitals; in response, a number of provinces offered health coverage to refugee claimants but grudgingly, because it’s Ottawa’s jurisdiction and responsibility, constitutionally.

There was also a lawsuit and, in a landmark ruling this past July, Madam Justice Anne Mactavish ruled, to no one’s surprise, that the cuts were unconstitutional. What was surprising was the court deeming the cuts to be “cruel and unusual punishment” because they were aimed at the most poor and oppressed among us, targeted at “innocent and vulnerable children in a manner that shocks the conscience and outrages our standards of decency.” Judge Mactavish gave the government four months to fully restore the program.

The government’s response to being chastised in this manner was to dig in its heels. Immigration Minister Chris Alexander, once a respected diplomat, hinted the order would be defied. The government went to court and asked for the Nov. 4 deadline to be extended, which a judge rejected out-of-hand.

Then, at the last minute, on the court-imposed deadline, Mr. Alexander announced that the ruling would be appealed and, in the meantime, the program would be restored, but only partially and temporarily.

This is as shocking – if not more so – than the original cuts.

The IFHP should have been fully restored to its pre-2012 form. Period. No ifs, ands or buts.

Since when is a government allowed to partially respect a court order? How is this not contempt of court? The government has every right to appeal a court ruling but it should treat the institution with respect, not crass cynicism.

Ottawa’s treatment of refugees is shocking – The Globe and Mail.

Refugee health care temporarily restored in most categories

Government partial compliance with the refugee claimant health care coverage:

“We are doing this because the court has ordered us to do it. We respect that decision while not agreeing with it,” Immigration Minister Chris Alexander said following question period on Tuesday.

The government had until the end of today to review a 2012 policy the Federal Court deemed unconstitutional, “cruel and unusual” last July.

The government had asked for a stay until an appeal is heard, but that request was rejected on Friday. A date for the appeal has not been set.

“Under the temporary measures, most beneficiaries are eligible to receive coverage for hospital, medical and laboratory services, including pre- and post-natal care as well as laboratory and diagnostic services,” the government said in a notice posted on the website of the Department of Citizenship and Immigration over an hour after the minister spoke.

Children under 19 years of age will receive full coverage, while pregnant women will be covered for all but supplemental health benefits.

Supplemental benefits include “limited dental and vision care, prosthetics and devices to assist mobility, home care and long-term care, psychological counselling provided by a registered clinical psychologist, and post-arrival health assessments.”

However, refugee claimants in seven of the 12 categories included in the governments chart will not be covered for drugs or supplemental health coverage.

….The Canadian Association of Refugee Lawyers, one of the groups that took the government to court over the changes the Conservatives brought in back in 2012, says the temporary plan does not comply with the Federal Court ruling.

“The government is still being punitive, they’re being selective and the court told them to reinstate all benefits,” said Peter Showler, co-chair of the refugee lawyers’ group and a former chair of the Immigration and Refugee Board of Canada. He is also an expert in refugee law at the University of Ottawa.

Showler was critical of the government’s decision to deprive certain refugee claimants of coverage for prescription medications.

“They are not in compliance with the decision based on the information that the government put out on its website today.”

Refugee health care temporarily restored in most categories – Politics – CBC News.

And the link to the table outlining what is covered and what is not:

Text of the government’s temporary plan for refugee health care

Refugee health cuts: Ottawa has until Nov. 4 to put in place new policy

A pretty resounding defeat (again) for the Government for a particularly mean-spirited policy change, one whose policy rationale sharply diminished given the dramatic reduction in the number of refugee claimants following refugee reform:

A spokesman for Immigration Minister Chris Alexander was critical of the decision.

“Our government disagrees with the courts flawed decision and will continue to do whats necessary to protect the interests of Canadian taxpayers and genuine refugees,” Kevin Menard said in an email.

Lawyers for the refugee claimants who brought the case had argued the stay was unnecessary as the government could just revert to the pre-2012 system referred to in Fridays decision as the 1957 program, which granted coverage to everyone.

The Conservatives had implemented a new refugee health-care program in 2012 which drastically cut coverage and meted it out depending on the nature of the refugee claim itself.

They argued that since the old program is no longer operational, the four months given by the Federal Court to create a new one wasnt enough time.

In his decision, Webb said allowing the stay would have meant saddling affected refugees with reduced health-care coverage for an undetermined period while the case continued to churn through the courts.

“It seems to me that the effect of denying the stay which would mean that the changes to the 1957 program … would not be made would be to defer these changes until the final resolution of the appeal, if the appellants are successful,” he wrote.

“The harm that would be caused by reverting to the 1957 program … is outweighed, in this case, by the harm that would be suffered by those who would have reduced health coverage under the 2012 program if the stay is granted and the respondents are ultimately successful.”

We will see if the Government chooses to respond by creating “confusion” or just gets on with implementing the change.

Refugee health cuts: Ottawa has until Nov. 4 to put in place new policy – Politics – CBC News.

Refugee health cuts: Not cruel but unusual – Colby Cosh

Colby Cosh takes a self-critical look at journalists and commentators on how they influenced the refugee claimant healthcare decision:

This is pleasing to the ego, yet I am not as confident as Justice Mactavish that the Conservative cuts to the old refugee health arrangements are shocking to Canadians. One obvious problem with using pundits as an index of conscience is that people who are angry about something will write about it, and people who aren’t, won’t.

The old IFHP provided not only the health care ordinarily given free to citizens by the provinces, but also extra entitlements working Canadians typically devote part of their paycheques to, including drug coverage, vision care, dentistry and contraception. Refugee claimants typically became eligible for IFHP immediately upon setting foot in the country—and remained eligible until they were removed from Canada, even if their refugee claims failed. ….

These [diabetic Afghan, Colombian eye surgery] are hard cases that could have been rectified by means of modest tweaks. Justice Mactavish instead threw out the whole 2012 IFHP revision, citing a further panoply of ill-documented or downright hypothetical cases in which the effects of the revised IFHP might also be “cruel and unusual.”

This procedure has met with near-universal approval from journalists. We, after all, sort of helped write the ruling. But what if the Conservatives run against it in 2015, challenging the media’s reading of the nation’s “general conscience”. . . and they win? Should we really be so sure we speak for you?

Valid points, but part of the role of journalists is to draw issues to our attention, and the decision likely relied more on the testimony of doctors and healthcare experts than journalists. And the Government, as in so many cases, by aiming for simple and simplistic solutions, along with its apparent lack of evidence (not to mention rhetoric), did not help itself. Refugee health cuts: Not cruel but unusual.

Cruel to take health care away from refugee claimants – Globe and Star Editorials

Harper Flesh WoundNot much support for the Government on the refugee claimant healthcare cuts, starting with the Globe’s editorial:

The problems with the federal cuts to refugee health care begin with the rationale used by government to introduce them in the first place: cost, deterring false refugee claims and equity – the idea that refugees are receiving better health care than Canadians. The court found the government wrong on all counts.

Citizenship and Immigration Minister Chris Alexander defended the cuts by saying they would save taxpayers $100-million over five years. The calculation was always suspect. It never factored in hidden costs, such as those incurred by neglecting certain health conditions as a result of no coverage. Mr. Alexander consistently argued that any refugee with a serious illness could still turn to hospital emergency rooms, as if that came at no cost. The government also argued the cuts would reduce the number of bogus refugees coming to Canada simply to access the country’s health care. Ottawa’s decision to penalize potential offenders by depriving every claimant in that category of health care is a kind of collective punishment. A court of law presumes innocence until guilt is proven. When it comes to refugee claimants, Ottawa should at least extend the same benefit of the doubt.

The Federal Court ruling reverses the government’s dumb cuts to refugee health care. There’s a legitimate concern about bogus refugee claimants abusing the system. This health care policy, a weapon that has now come back to wound its creator, was never the right way to deal with the problem.

Cruel to take health care away from refugee claimants – The Globe and Mail.

Predictably, from the Star:

While the Canadian Medical Association cheered the ruling as “a victory for reasonable compassion and a big step for natural justice,” Citizenship and Immigration Minister Chris Alexander intends to appeal. A less obtuse government would have been shamed into retreat, given the string of humiliating court defeats the Conservatives have suffered over Harper’s clumsy attempt to shoehorn an unqualified judge onto the Supreme Court, his hugely flawed law-and-order agenda and his unlawful bid to change the Senate. But this government is shameless. Alexander has even attacked Ontario for trying to plug the gap, accusing officials of coddling “bogus claimants” and “fraudsters.”

Federal Court rightly strikes down Harper’s refugee health-care cuts: Editorial

And prior to the Federal Court ruling, from the Calgary Herald (not just the suspect Toronto media):

A national day of action was held Monday by health-care professionals, people one doesn’t usually associate with protests and public forms of advocacy. The federal government should live up to its obligations and reinstate medical coverage for all refugees — not just those with the greatest chance of having a legitimate claim. If it wants to protect taxpayers, the government can do so by handling refugees claims in a timely fashion and sending those who are found lacking back home as quickly as possible. But under no circumstances should refugees — many of them already victims of abuse — be made to needlessly suffer.

Editorial: Reinstate refugees’ medical coverage

And Jon Kay in the National Post:

The moral relativist tries to blur the line between us and them. The punitive moral absolutist, on the other hand, paints the line stark and thick, and turns politics into a game of inflicting symbolic cruelties on the people on the wrong side of it. Thus, Tory criminal-justice policy consists of finding new and gratuitous ways to make life harsher for convicts — including taking away their rights to receive visitors, and eliminating widely lauded prison-work programs. Canada is one of the safest countries in the world, and has been getting safer for decades. But prisoners — like diabetic migrants — have no politically influential constituency, so tightening the screws on them scores well at poll-driven Tory brainstorming sessions.

When it comes to performing the same stunt on migrants, the irony is that the current Immigration Minister, former ambassador to Afghanistan and UN official Chris Alexander, has done more than just about any other Canadian to help the population of one of the most destitute nations on earth. Yet now that he is back on Canadian soil, he has been tasked with a policy aimed at denying health benefits to vulnerable people who have come to our shores.

Canada’s valuable post-9/11 work in Afghanistan — building schools for girls, and creating a democracy — was a powerful rebuke to the moral relativist idea that no system of values is better than any other. But as last week’s Federal Court ruling demonstrates, not every issue should be treated with the same aggressive us-vs.-them spirit.

Jonathan Kay: The refugee health-care decision lays bare Harper’s creed — punitive moral absolutism

Blatchford: Government policy on refugee health care exposed as heartless and shameful – and other Commentary

Some of the first commentary in the mainstream media on the refugee claimant health ruling, starting with Christie Blatchford of the National Post and her savage teardown of the Government:

But, in fact, Judge Mactavish found, if any of that is true, the government can’t demonstrate it and hasn’t done so.

The government’s own witnesses admitted the changes to the program were based on various “perceptions” and “beliefs.” From a “cost containment” perspective, the government offered no evidence that the changes “will in fact result in any real savings to Canadian taxpayers.” And Ottawa conceded “it has not carried out any research in order to determine whether denying health care as a means of deterrence has any empirical validity or chance of success.”

And there you have it: The government brought in a cruel and inhumane program aimed squarely at the most vulnerable people in the country, sold it in the basest way imaginable by appealing to the least generous impulses in us all and hasn’t proved it will save one red cent of the $91-million cost of the program (as of 2009-10).

(The judge drily noted that if the government really wants to save money, perhaps it could speed up the bloody process by appointing more members to the Immigration and Refugee Board.)

With the changes, she said, “the executive branch of the Canadian government intentionally set out to make the lives of these disadvantaged individuals even more difficult. It has done this in an effort to force those who have sought the protection of this country to leave Canada more quickly, and to deter others from coming here to seek protection.”

Judge Mactavish agreed with Dr. Paul Caulford, a family doctor and co-founder of a clinic for those without insurance, who said that sooner or later, “a refugee claimant will eventually die as a result of inadequate access to health care.”

Well, maybe that would deter people.

Christie Blatchford: Government policy on refugee health care exposed as heartless and shameful

And Kate Heartfield in the Citizen:

A policy that “shocks the conscience and outrages our standards of decency” is not defensible, politically and morally, even if it is legal. It is hard to argue against the court’s opinion that the government “has intentionally set out to make the lives of these disadvantaged individuals even more difficult than they already are in an effort to force those who have sought the protection of this country to leave Canada more quickly, and to deter others from coming here.”

This judgment might not be the final word on the constitutionality of refugee health care, but it’s a damning critique not only of a particular policy, but also of the way our government makes policy in general.

Refugee rules are bad policy, legal or not | Ottawa Citizen.

In Macleans, Aaron Wherry asks the obvious:

Whatever the courts decide, there is probably here a good basis for a real debate about what the government has done with the Interim Federal Health Program. That we should hope to limit abuse of the immigration and health care systems seems like a reasonable goal. The question here is how—and particularly whether the changes to the IFHP are a good way to go about doing that.

That we should have this sort of analysis now is surely useful, even if it might be odd that we should have to get it from a judge. If only we had some kind of public forum for the consideration and debate of such stuff. Perhaps if we did, we could delegate a committee to pick up this ruling, independently study it at length and propose a comprehensive response. That at least seems like the sort of thing we might elect people to do.

Do the cuts to refugee health care amount to good policy?