Sue Grafe and Nikki Bozinoff have a first-hand look at how last year’s changes to the federal health care program affect refugee health care in Hamilton.
Grafe is a nurse practitioner at REFUGE, a Hamilton refugee clinic, as well as a nursing professor at Mac. Bozinoff is a McMaster medical student and member of Hamiltonians for Migrant and Refugee Health.
Along with Mac economics professor Michel Grignon, they discussed the impact of last year’s refugee health cuts Tuesday at a panel hosted by the Global Citizenship Conference.
Cuts to the Interim Federal Health Program (IFHP) were brought into effect on June 30, 2012, intended to minimize abuse of health privileges. As of then, refugees not assisted by the government have no vision, dental or medical coverage except in emergencies. Refugees from a “designated country of origin” don’t get any coverage.
At the panel, Grafe and Bozinoff said since the cuts were implemented, there has been a great deal of confusion among practitioners about who has coverage and who doesn’t.
“We [at REFUGE] see people regardless of coverage, but the problem becomes, what do you do?” said Grafe.
“There are pregnant clients who don’t get prenatal care because they fall within the gap of having and not having coverage.”
Bozinoff added that there were problems with IFPH even before the cuts were made.
“Even before the cuts, many [refugees] were turned away if they didn’t have a knowledgeable providers,” she said.
Grafe said that prior to the cuts, many Hamilton refugees had been using walk-ins, but because of the confusion, they seem to be using those services less.
She anticipates that refugees from Hungary, Slovakia and the Czech Republic are most affected by the cuts in Hamilton, recognizing that refugees from various countries tend to settle differently across cities.
Grafe also observed some “ironic” inconsistencies in the system with changes to the IFHP.
In some cases, she said, “you can get their medication covered if they qualify for Ontario Works, but you can’t run any blood work.”
In getting coverage through Ontario, she and Bozinoff pointed out, the health care costs are downloaded to the Province.
According to Citizenship and Immigration Canada, the IFHP costs $84 million per year, and the cuts would save $20 million annually to a total of $100 million after five years.
Michel Grignon, director of the Centre for Health Economics and Policy Analysis, approached the issue from a socio-economic perspective.
On whether or not Canada’s international image would be negatively affected by the cuts, Grignon doesn’t think so.
“We’re still doing reasonably well in terms of [the numbers] of refugees who come here—we are still seen as fairly generous.”
Currently, Canada is home to 5 refugees per 1000 people. The US has a ratio of 0.9 per 1000 while Syria has 49 per 1000.
He did express some qualms about the policy moving Canadian healthcare toward a two-tiered system.
“What’s great about universal coverage is that doctors don’t have to worry about who is covered. In the UK nobody will ask you anything, they just treat you,” said Grignon.
Brian Decker
Executive Editor
The Ontario Liberals’ plan to give a 30 per cent discount on tuition may end up costing some students a little bit more.
The Liberals’ election promise, which offered a 30 per cent decrease in the cost of tuition to students from households earning less than $160,000 per year, may be followed by a rise in the overall cost of tuition starting next year.
The current framework that dictates tuition fees expires at the end of the 2011/12 school year.
“Universities can’t really withstand having no new revenue, because they’re going to spend $420 million on this new grant,” said Sam Andrey, Executive Director of the Ontario Undergraduate Student Alliance.
Whether tuition increases at the current rate of five per cent per year is still to be determined.
Andrey said OUSA is advocating for a lower increase rate, but that no increase at all is unlikely.
“We know changing [the tuition increase rate] to something lower is on the table. That’s something we’re going to be advocating for.”
“With the 30 per cent reduction, I think there is a very low appetite on the part of the government to compensate an outright freeze.”
The plan to offer students a tuition discount is set to take place in January, but much of the details of how it will be implemented and distributed is currently pending confirmation.
Residents of Ontario in full-time, first entry programs (excluding law, medicine and graduate programs) will be eligible to apply for a tuition break for the winter semester, but the process of how and where students apply has not yet been determined.
Andrey said for the winter 2012 semester only, approved students will likely receive a cheque equivalent to 30 per cent of tuition, and that a true 30 per cent discount on tuition won’t start until 2012.
“In all likelihood, it will be something like an $800 cheque for most students,” said Alvin Tejdo, OUSA’s Director of Communications, of the 30 per cent discount in January.
Tejdo said many students could potentially be caught unaware of the cheque’s availability. “It’s going to be really important to tell people to apply for it,” he said.
The process by which students’ financial means are approved – determining whether their household earns less than $160,000 – is yet to be established.
The slow implementation of the remaining details is partially due to the change in governing officials. After the Oct. 8 election, Glen Murray became the new Minister of Training, Colleges and Universities, replacing John Milloy. There are also new education critics to be appointed in the opposition.
Andrey said other changes coming to Ontario campuses in the coming year include increasing the availability of mental health and the construction of three new campuses in the Greater Toronto Area, with the site still to be determined.
