The COVID-19 pandemic has shown us that our worlds are interconnected and that our well-being is interdependent.
Countries with the most effective responses to COVID-19 have been those with policies grounded in the basic understanding that to achieve better health for everyone, you must begin with a set of policies that ensure no one is left behind.
This is a lesson Canada has yet to learn.
Recent studies in various regions of the country have found that immigrants, refugees and newcomers are experiencing higher rates of COVID-19 infection and of hospitalization. Provinces such as Ontario and British Columbia took steps early in the pandemic to extend healthcare temporarily to uninsured migrants. They deserve to be applauded. Others such as Nova Scotia and Alberta have remained notably silent.
This has prompted a national coalition of 200 organizations representing healthcare providers, legal experts and impacted communities to write an open letter to all levels of government calling for expanded healthcare, including covering all medically necessary services without artificial distinctions between COVID-19 services and others; that all uninsured communities and the broader public are informed through a public messaging campaign that services are available at no charge regardless of immigration status; and that coverage be made permanent, carrying on beyond the COVID-19 pandemic, as a human right and public health measure.
Efforts at the provincial level to address these gaps are critical and necessary but the patchwork approach is not enough. Even in provinces where expanded healthcare coverage is mandated, inconsistencies in implementation remain. This uneven approach is unacceptable, especially at a time when we need our governments to take coordinated action. It is time for Canada to cohesively extend healthcare to all people and to implement policies that will support us in collectively achieving better health outcomes.
Universal healthcare is one of the values Canadians are proud of. However, the sad reality is that universal healthcare is not, in fact, universal. Individuals without status, rejected refugee claimants, migrant workers and other migrants do not have access to free healthcare in Canada. Instead, they are confronted with the threat of deportation and insurmountable debt to access healthcare. Hundreds of thousands of people across the country face this reality.
In 2014, the World Health Organization released a framework to help countries implement what are known as “Health for All” policies. When implemented, this framework holds policymakers accountable for legislation that impacts health and is grounded in the recognition of health as an inherent human right. It should concern us all that healthcare is inaccessible for so many in Canada.
It’s true that COVID-19 has left no communities untouched. However, it’s not true that all of us are experiencing this pandemic in the same ways. The hardest hit are overwhelmingly among the most marginalized and vulnerable.
It’s time for Canada to acknowledge the harms of limiting access to healthcare for migrants, refugees and other uninsured people. Temporary coverage expansion implemented during the pandemic response must be made permanent and the federal government must work in collaboration with provinces and territories to ensure that policies are grounded in principles that promote the health of all.
These gaps are imprinted in the DNA of our country’s health system and have been for decades. To address these ingrained inequities, we need solutions that can shift our national consciousness to one that truly reflects a collective belief in health care as a human right.
Unexpected as it is, we now have an opportunity to build a healthcare system that works for everyone. What we used to call “normal” isn’t good enough. Canada must seize this moment to build a responsive healthcare system. Migrants, refugees and uninsured people are no less deserving.
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Yes, I agree with your perspective.
What is the next step in your thinking to make this happen. Do you have a strategy in mind that brings together elements of care planning, financing in the face of a limited budget, agreement among politicians, agreement among provinces , a practical plan document that can be used for a constructive public and political debate. Is there a study available of successful universal systems in place in other countries where practical issues have been worked out that we can learn from?
Absolutely, but don’t stop there. It’s time for a complete reset. Let’s design our ‘Canadian’ Medicare system to fit the realities of the 21st century. A national framework of standardized quality, coverage, access, and supported by modern digital networks. Reduce the insane levels of fragmentation & duplication and rationalize the structure, governance, and organization of the delivery system. Rebalance the provision of care through all settings of care from public health, primary care, acute care, community and LTC. It’s time.
“These gaps are imprinted in the DNA of our country’s health system and have been for decades. To address these ingrained inequities, we need solutions that can shift our national consciousness to one that truly reflects a collective belief in health care as a human right.
Unexpected as it is, we now have an opportunity to build a healthcare system that works for everyone. What we used to call “normal” isn’t good enough. Canada must seize this moment to build a responsive healthcare system. Migrants, refugees and uninsured people are no less deserving.”
Thank you! Hit the nail on the head!
Thank you for your amazing work and this awesome article.