Health Inequity and “Restoring Fairness” Through the Canadian Refugee Health Policy Reforms: A Literature Review
- 1.1k Downloads
Refugees and refugee claimants experience increased health needs upon arrival in Canada. The Federal Government funded the Interim Federal Health Program (IFHP) since 1957, ensuring comprehensive healthcare insurance for all refugees and refugee claimants seeking protection in Canada. Over the past 4 years, the Canadian government implemented restrictions to essential healthcare services through retrenchments to the IFHP. This paper will review the IFHP, in conjunction with other immigration policies, to explore the issues associated with providing inequitable access to healthcare for refugee populations. It will examine changes made to the IFHP in 2012 and in response to the federal court decision in 2014. Findings of the review indicate that the retrenchments to the 2012 IFHP instigated health outcome disparities, social exclusion and increased costs for vulnerable refugee populations. The 2014 reforms reinstated some services; however the policy continued to produce inequitable healthcare access for some refugees and refugee claimants.
KeywordsRefugee health policy Interim Federal Health Program Canada Refugees Refugee claimants
This research did not receive funding.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
As this article does not contain any studies with human participants or animals performed by any of the authors, informed consent is not applicable.
- 1.United Nations High Commissioner of Refugees: World at War, Global Trends Forced Displacement 2014. Geneva, 2015. http://unhcr.org/556725e69.html. Accessed 12 Sept 2015.
- 2.United Nations: As Conflicts Multiply, World Community’s Capacity to Respond to People Uprooted by Violence Being Tested in ‘Unforeseen Ways’, Third Committee Told | Meetings Coverage and Press Releases. 2012. http://www.un.org/press/en/2012/gashc4052.doc.htm. Accessed 12 July 2015.
- 3.United Nations High Commissioner for Refugees:War’s Human Cost Global Trends. Geneva; 2014.Google Scholar
- 4.United Nations High Commissioner of Refugees. Asylum trends in industrialized countries. Oxford: Oxford University Press; 2003.Google Scholar
- 6.United Nations High Commissioner for Refugees: Asylum Levels and Trends in Industrialized Countries, 2014. Geneva: 2014. http://www.unhcr.org/551128679.html. Accessed 12 Sept 2015.
- 7.Canada. Parliament. Library of Parliament:Legislative Summary of Bill C-31: An Act to Amend the Immigration and Refugee Protection Act (Report 41-1-C31-E) 2012. www.lop.parl.ga.ca/content/lop/LegislativeSummaries/41/1/c31-e.pdf. Accessed 12 July 2015.
- 8.Government of Canada, Citizenship and Immigration Canada: Information Sheet for Interim Federal Health Program Beneficiaries. 2012a. http://publications.gc.ca/collections/collection_2013/cic/Ci44-15-2012-eng.pdf. Accessed 12 Sept 2015.
- 9.Seeking Solutions Symposium: Access to health care for the uninsured in Canada. Toronto, 2013.Google Scholar
- 10.Government of Canada, Public Works and Government Services Canada: ARCHIVED—Canada Gazette—Order Respecting the Interim Federal Health Program, 2012. http://www.gazette.gc.ca/rp-pr/p2/2012/2012-04-25/html/si-tr26-eng.html. Accessed 12 July 2015.
- 11.Government of Canada, Citizenship and Immigration Canada: 2014 Annual Report to Parliament on Immigration. 2014. http://www.cic.gc.ca/English/resources/publications/annual-report-2014/index.asp#sec-2-2.Accessed 12 July 2015.
- 12.Canadian Doctors for Refugee Care v. Canada (Attorney General). 2014 FC 651.Google Scholar
- 13.United Nations High Commissioner for Refugees: Convention and Protocol Relating to the Status of Refugees. Geneva; 2010.Google Scholar
- 14.Immigration and Refugee Protection Act [Canada]. S. C. 2001, c.27, 77.Google Scholar
- 15.Casswell DG. Singh v. Minister of employment and immigration. Alta L Rev. 1985;24:356.Google Scholar
- 16.Manjikian L. Refugee narratives in montreal: negotiating everyday social exclusion and inclusion. Montreal: McGill University; 2013. p. 1–333.Google Scholar
- 17.Bhuyan R, Osborne B, Sajedeh Z, Tarshis S. Unprotected, unrecognized: Canadian immigration policy and violence against women, 2008–2013. Toronto: Migrant Mothers Project; 2014.Google Scholar
- 18.Jackson S. ‘Citizenship Theatre’: refugee claimants, security, and performing citizenship at the immigration and refugee board. Hamilton: McMaster University; 2013. p. 1–25.Google Scholar
- 19.World Health Organization: News Release. Worldwide action needed to address hidden crisis of violence against women and girls. 2014. http://www.who.int/mediacentre/news/releases/2014/violence-women-girls/en/. Accessed 12 Sept 2015.
- 20.METRAC, Barbara Schlifer Clinic, & LE AF:Bill C-31 will re-victimize women refugees and their children [Press release]. 2012. http://schliferclinic.com/advocacy-and-social-change/legal-reform/immigration/. Accessed 12 Sept 2015.
- 21.Government of Canada, Citizenship and Immigration Canada:The Refugee System in Canada. 2015http://www.cic.gc.ca/english/refugees/outside/summary-ifhp.asp. Accessed 12 Sept 2015.
- 26.Besier M. The health of immigrants and refugees in Canada. Can J Public Health. 2005;96(2):530–44.Google Scholar
- 28.Miedema B, Hamilton R, Easley J. Climbing the walls. Can Fam Phys. 2008;54(3):335–6.Google Scholar
- 29.Barnes S. The real cost of cutting the interim federal health program. Toronto: Wellesley Institute; 2013. p. 1–19.Google Scholar
- 30.Sheikh H, Rashid M, Berger P, Hulme J. Refugee health providing the best possible care in the face of crippling cuts. Can Fam Phys. 2013;59(6):605–6.Google Scholar
- 31.Minister of Justice: Consolidated federal laws of Canada, Order Respecting the Interim Federal Health Program, 2012. http://laws-lois.justice.gc.ca/eng/regulations/SI-2012-26/page-1.html. Accessed 12 Sept 2015.
- 32.Morrison J: Cuts to supplemental health benefits for refugees: Expanding the understanding of patient-centred care. Canadian Pharmacists Journal/Revue Des Pharmaciens Du Canada 2012; 145(6), 285–286. http://www.swslhd.nsw.gov.au/refugee/pdf/NSW_REFUGEE_STARTTS.pdf. Accessed 12 Sept 2015.
- 33.Raza D, Rashid M, Redwood-Campbell L, Rouleau K, Berger P. A moral duty why Canada’s cuts to refugee health must be reversed. Can Fam Phys. 2012;58(7):728–9.Google Scholar
- 34.General Issues Committee: Report 12-014. Hamilton, ON: City of Hamilton; 2012. http://www2.hamilton.ca/NR/rdonlyres/3C1C94E8-0A93-47DD-98A7-86755B14BA05/0/May16EDRMS_n311232_v1_014__Minutes__May_16_.pdf. Accessed 12 Sept 2015.
- 36.Government of Ontario, MOHLTC: Newsroom: Ontario Temporary Health Program 2013. http://news.ontario.ca/mohltc/en/2013/12/ontario-temporary-health-program.html.
- 37.Benzie, R: Health Minister Eric Hoskins says Ontario is sending Ottawa the bill for the $2 million the province will spend this year on basic medical services for refugees. The Toronto Star 2014, July 23. http://www.thestar.com/news/queenspark/2014/07/23/ontario_will_bill_ottawa_for_refugee_health_costs.html.
- 39.Newbold B. Linking immigrant settlement, health, housing and homelessness in Canada. Canadian Issues/ThèmesCanadiens (Newcomer’s experiences of housing and homelessness in Canada). Montréal: Association for Canadian Studies; 2010. p. 8–15.Google Scholar
- 44.Rossi C, Shrier I, Marshall L, Cnossen S, Schwartzman K, Klein MB, Greenaway C. Seroprevalence of chronic hepatitis B virus infection and prior immunity in immigrants and refaugees: a systematic review and meta-analysis. PLoS One. 2012;7(9):e44611. doi: 10.1371/journal.pone.0044611.CrossRefPubMedPubMedCentralGoogle Scholar
- 48.Redditt VJ, Janakiram P, Graziano D, Rashid M. Health status of newly arrived refugees in Toronto, Ont Part 1: infectious diseases. Can Fam Phys. 2015;61(7):e303–9.Google Scholar
- 49.Government of Canada, Citizenship and Immigration Canada: Canada News Centre-Archived–Reform of the Interim Federal Health Program ensures fairness, protects public health and safety [News Releases]. 2012.http://news.gc.ca/web/article-en.do?nid=670949. Accessed 12 Sept 2015.
- 52.Redditt VJ, Graziano D, Janakiram P, Rashid M. Health status of newly arrived refugees in Toronto, Ont Part 2: chronic diseases. Can Fam Phys. 2015;61(7):e310–5.Google Scholar
- 53.Sanders C: Province steps up for refugees. 2012. http://www.winnipegfreepress.com/local/province-steps-up-for-refugees-169590316.html. Accessed 12 Sept 2015.
- 54.Government of Canada, Citizenship and Immigration Canada: Interim Federal Health Program Policy. 2014. http://www.cic.gc.ca/english/department/laws-policy/ifhp.asp.
- 55.Government of Canada, Citizenship and Immigration Canada: Interim Federal Health Program: Summary of Benefits. 2015. http://www.cic.gc.ca/english/refugees/outside/summary-ifhp.asp. Accessed 12 Sept 2015.
- 56.Goel R: OPINION: Federal reversal of refugee health cuts still leaves many uncovered. 2014. http://healthydebate.ca/opinions/reversal-of-refugee-health-cuts. Accessed 12 Sept 2015.
- 57.Government of Canada, IRCC: Guide 5568: Applicaton for the Interim Federal Health Program Coverage. 2016. http://www.cic.gc.ca/english/information/applications/guides/5568ETOC.asp#5568E2. Accessed 12 June 2016.
- 58.Government of Canada, Citizenship and Immigration Canada: Restoring Fairness to the Interim Federal Health Program [New Releases]. 2016. http://news.gc.ca/web/article-en.do?mthd=tp&crtr.page=1&nid=1034619&crtr.tp1D=1. Accessed 15 Jan 2016.
- 59.Government of Canada, Immigration, Refugee and Citizenship, Canada [IRCC]:# WelcomeRefugees: Canada Resesttles Styrian Refugees. 2016. http://www.cic.gc.ca/english/refugees/welcome/. Accessed 12 June 2016.
- 60.Loescher G. Introduction. In: Loescher G, Monahan L, editors. Refugees and international relations. New York: Oxford University Press; 1989. p. 1–33.Google Scholar
- 61.Ghosh B. Managing migration: towards the missing regime. Chapter 5 in migration without borders: essays on the free movement of people, edited by Antoine Pécoud and Paul de Guchteneire. Paris: UNESCO Publishing; 2007. p. 97–118.Google Scholar