Refugee health care protest on Parliament Hill, June 17. Photo: Adrienne Vicente

by Qasim Kareemi

The Harper government has continued to limit refugee access to healthcare despite a federal court order demanding it reinstate pre-2012 levels of Interim Federal Health Plan (IFHP) coverage for refugees by Nov. 4.

The deadline was set by a July federal court decision to strike down the government’s recent cutbacks to refugee health care, brought forward by Canadian Doctors for Refugee Care (CDRC), the Canadian Association of Refugee Lawyers, non-profit Justice for Children and Youth, as well as refugees Hanif Ayubi and Daniel Garcia Rodriguez.

Presiding Justice Anne Mactavish found that the cutbacks made to refugee healthcare by the Harper government in June 2012 were in violation of the Canadian Charter of Rights and Freedoms and deemed them “cruel and unusual” to refugees.

In response, Immigration Minister Chris Alexander requested a stay on the decision. If granted, a stay effectively delays the requirement to enforce a court decision until the appeal process has been exhausted.

The federal court denied Alexander’s request, meaning that, as of Nov. 5, the federal government is required to return to the more adequate coverage offered before the 2012 cutbacks.

The government has now partially reinstated the pre-2012 coverage, but Alexander, in a post-question period interview on Nov. 4, has insisted that they will still seek to appeal the decision.

The major cutbacks to refugee healthcare resulted from the government’s implementation of a tiered system and changes to the categorization of refugee status in 2012. Health care was made less accessible due to the government’s restructuring of Designated Country of Origin (DCO) refugee status based on an expansion of what constituted “safe” countries. In short, individuals who may have been persecuted in their home countries could be labelled unworthy of care under the IFHP based on the immigration minister’s ranking of the overall stability of the country from which they fled.

As the CDRC has pointed out on their website, this system essentially ignores individualized persecution, ranks the status of a refugee, and delivers limited health care based on that refugee’s status.

The Toronto Star reported that Alexander has claimed that the 2012 policy saved the federal government millions of dollars, and noted that the cost of the reinstatement of the pre-2012 system to Canadian taxpayers stands at approximately $4 million.

The CDRC, however, has argued that the federal government’s reduced IFHP results in cheaply preventable health problems which may become more costly at a later time. In some cases this occurs when a refugee’s health deteriorates to a point where an ongoing lack of treatment could result in severe sickness or death, forcing health care workers to respond. In other cases this occurs when a refugee is granted citizenship and treatment becomes more costly due to prior neglect. This especially affects refugee claimants who came to Canada before claiming refugee status, as they were primarily cared for under the IFHP prior to the 2012 cuts.

The decision to disregard the court ruling and continue to restrict refugee access under the IFHP suggests that the federal government is effectively breaking the rule of law. As a majority government, the Harper government can introduce reform legislation in order to circumvent the court ruling. At the time of writing, however, no such legislation is on the table. This means that the Harper government has forgone the legislative process and their accountability to the courts in order to maintain an effectively illegal policy that continues to marginalize refugees.

This article first appeared in the Leveller, Vol. 7, No. 3 (Nov/Dec 2014).