Health Care of Refugees in Canada - Term Paper Example

Health Care of Refugees in Canada Health Care of Refugees in Canada Introduction The emergence of globalization enhanced cross border trade which in turn intensified the need for labors. In order to meet the growing labor needs, nations liberalized their immigration policies. Evidently, this situation contributed to a rise in the number of undocumented immigrants. Industrialists and manufactures in Western countries like US and Canada were happy to welcome illegal workers who were ready to work at cheaper wages. According to recent data published, immigrants account for nearly one fifth of the Canadian population and this number still continues to grow. Undoubtedly, this chaotic situation leads to numerous social as well as health consequences in the country. Studies indicate that the number of people having precarious status and limited access to health is increasing in Canada. It is identified that refugees do not have proper access to health care and they struggle to pay for health care services in the country. Health care is a fundamental human right and hence it is the ethical obligation of medical practitioners to offer health care services to people regardless of one’s age, sex, or nationality. This paper will particularly discuss whether or not the refugees in Canada should have free access to the country’s health care system. Background There is no accurate data on the number of undocumented workers in Canada. According to Rousseau, Kuile, Munoz, Nadeau, Ouimet, Kirmayer et al (2008), nearly 100,000-300,000 illegal immigrants are residing in the country. Although there are no data on the health consequences of Canadian refugee population, evidences from United States and some European countries suggest that lack of health insurance and lower quality of medical care increase the health risk of refugee population. Clinicians working with migrant and refugee populations opine that undocumented and uninsured families have poor access to Canadian health care (Rousseau et al, 2008). They point that Canadian health care institutions pay prime attention to the potential financial burden that may stem from providing care to the refugee population while neglecting the fact that this unethical practice would threaten life and violate the fundamental rights of individuals (Rousseau et al, 2008). It seems that physicians who provide care to refugee families generally perform those tasks discretely. As a result, refugees in the country do not obtain the same level of care which is offered to Canadian citizens. Since uninsured refugees are compelled to pay for services received, help-seeking mentality is discouraged among this already vulnerable population. Clinicians claim that this lack of help seeking mentality among refugees can be directly linked to high levels of morbidity. Delayed care seeking also leads to issues like poor follow up for chronic diseases like diabetes, and growing prevalence of HIV and increased levels of mental illnesses. “In the case of children and youth, problems included delayed surgical interventions, prolonged absence of adequate care for acute mental health conditions (post-traumatic stress disorder and depression), and unavailability of rehabilitation services for children with autism and other developmental problems” (Rousseau et al, 2008). Currently, there are only a few organizations in Canada fighting for the health care needs of the refugee population in the country. Therefore, health organizations do not give particular attention to delivering health services to refugees on time and effectively. In the words of Muggah, Dahrouge, and Hogg (2012), language difficulties and cultural as well as societal influences become a barrier for refugees in Canada to access quality health services. As per reports, the Federal government has decided to limit refugees’ health coverage to services that are “of an urgent or essential nature” (Wayne, 2012). The government has also planned to provide the refugee population with medications and vaccines only if there is a need for preventing or treating a disease that will become a threat to public health. Although these newly formed policies might improve the health status of the refugee population, their health needs are still under-met. Economic Perspective Canada’s publicly funded health care system provides the country’s citizens with cost effective health care services including emergency health services. The governmental involvement in the Canadian health care system must be particularly emphasized. Nearly 70 percent of the country’s health care expenses is met by various levels of the Canadian government (Jurjus, 2008). Hence, the government spends a notable percent of its revenues on the country’s health care sector. Income taxes are primarily used to fund health costs. From an economic perspective, the Canadian government and its health institutions would incur huge additional expenses if it plans to offer free health care access to refugees in the country. Hence the Canadian health institutions are reluctant to provide refugee population with free health care services. According to the Statistics of Canada and the Canadian Institute for Health Information (CIHI), the government health spending increased at an average annual rate of 7.5 percent during the period 2001-10 (as cited in Skinner, 2009). In the context of growing health care costs in the country, the government can defend its position to restrict free health care services to the refugee population. Moreover, this population does not pay income taxes or contributes negligibly to the GDP growth of the country. Hence, providing free health care access to the refugee population can be a growth impediment to the Canadian economy. In the current health environment, refugees in Canada are less likely to obtain quality health care because they do not have sufficient financial strength to buy improved health products and services. As Caulford and Vali (2006) state, refugees represent a vulnerable population and they are highly exposed to epidemic and infectious diseases. If the government does not intervene timely, such diseases may spread to other people. Undoubtedly, this situation would double the health costs of the government. However, the government can regulate such huge health costs by offering free health care access to the refugee population. Through this practice, the government and other health authorities concerned can effectively promote disease prevention and intervention. By providing refugees with well designed health care and rehabilitation facilities, the federal government can improve the strength of its human capital. In short, even though providing free health care access to refugees would increase the financial burden of the government in the short run, the long term economic benefits of this practice can outweigh its short term financial losses. Medical Perspective While treating patients, it is particularly important for physicians to comply with medical ethics and professional ethics. The four fundamental principles of medical ethics include respect for autonomy, beneficence, non-maleficence, and justice. The fourth principle – justice – clearly states that patients with similar health conditions must have access to the equal quality of care. It also reflects that medical practitioners must fairly allocate scarce medical resources to their clients. When the Canadian health care system refuses basic health care to refugees and treats other people favorably, it discriminates a group of people based on their immigration status. In addition, such a health care practice also involves discriminative allocation of medical resources. Hence referring to the principle of justice, denying health care to refugees is against the medical ethics. The American Medical Association (n. d.) particularly directs physicians to support access to health care for all people. It also says that physicians should respect various rights of patients. Equality is not met when basic health care is denied to a particular group. In addition, health organizations violate fundamental patient rights when health care services are refused to refugees. Therefore, denying health care services to any category of people would represent unethical medical practice. Similarly, preventing a particular group from accessing health services is against the professional ethics of physicians. Providing quality care to everyone and promoting patient safety are important to physicians’ professional ethics. When health care is denied to refugees, it would adversely affect patient safety. To illustrate, when individuals with diabetes do not get the opportunity for regular checkups, the situation may result in patient’s diabetic coma. As discussed already, it is identified that physicians perform refugees’ health care in a careless way. Probably, this practice may lead to medical errors and other future health complications. Sometimes, physicians may fail to diagnose the actual disease when they carelessly examine patients. All these issues will negatively impact patient safety. Perspective of Rights Today governments, organizations, and other interest groups take extensive efforts to offer quality health care services to people on a continuous basis. The Universal Declaration of Human Rights states that “everyone has the right to a standard of living adequate for…health and well-being, including… medical care and necessary social services” (as cited in Lai et. al, 2013). Canada is a signatory to it. Canada cannot be justified from a human rights perspective if it refuses quality health care to refugees. According to Lai et. Al (2013), it is frustrating to see that while Canadians donate millions of dollars to improve the living conditions of refugees abroad, refugees in Canada are currently being denied basic health care services such as childhood vaccinations, prenatal care, and treatment of chronic health conditions. Human rights advocates in Canada argue that denying basic health services to refugees in the country is a humanitarian issue. They indicate that basic health care can minimize human suffering to a great extent and it could be implemented cost-effectively. Regular checkups and improved medication is a better way to fight chronic diseases such as diabetes, hypertension, heart diseases, and mental health problems. Through such medical practices, victims of chronic illnesses can remain productive and retain their dignity. Evidently, absence of a basic health care would worsen chronic diseases and eventually patients may end up in emergency departments with life threatening health conditions like diabetic comas or strokes. It is a terrible issue that the Interim Federal Health Program does not have any package for providing coverage for these life threatening emergencies. From an ethical perspective, seriously ill patients should not be denied care under any circumstances. Hence, the health care costs for refugees in Canada have to be met by health institutions and provincial budgets. Refusing health care services to the refugee population will not only increase their risk of irreversible harm and greater suffering but also add to the expenses of providing care at this point. Human rights activists opine that people should be given care based on their medical needs other than their immigration status. The Canadian health care system gives particular focus to the universality of the health coverage (The 1984 Canada Health Act). The same principle must be applied to the refugee population in the country. Therefore, it is vital to make necessary changes to the Interim Federal Health Program to extend the health coverage to refugees in Canada. Conclusion From the above discussion, it is clear that refugees in Canada do not obtain free access to the country’s health care while Canadian people are given most of the health services for free of cost. Recently, the Canadian federal government has restricted health services to refugees in the country. From an economic, medical, or human rights perspective, this policy cannot be justified. Although providing health services to refugees may add to the short term financial burden of the federal government, this practice may assist the country to promote disease prevention and intervention effectively and thereby save health costs in the long run. When the country refuses health services to refugees, it is against the core principles of medical ethics. Discrimination in health care delivery clearly reflects unethical medical practice. This practice also hurts the professional ethics of physicians. In addition, physicians are professionally obliged to respect patient rights. According to the Universal Declaration of Human Rights, to which Canada is a signatory, health care is recognized as one of the fundamental human rights. Denying health services to refugees may cause them to end up in emergency departments. Human rights advocates argue that patients must be treated on the basis of their medical needs and not on immigration status. References American Medical Association. Principles of Medical Ethics. Retrieved from http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/principles-medical-ethics.page Caulford, P & Vali, Y. (2006). Providing health care to medically uninsured immigrants and refugees. Analysis. CMAJ, April 25. 174(9): 1253-54. The 1984 Canada Health Act. U Ottawa. Retrieved from http://www.med.uottawa.ca/sim/data/Canada_Health_Act.htm Jurjus, A. (2008). Health care in Canada: An overview. Human & Health. Nov 4: 10-14. Retrieved from http://www.syndicateofhospitals.org.lb/magazine/jul2008/Latin%2010-13%20Health%20System.pdf Lai, W. et. Al. (2013). Refugees in Canada have poorer access to health care than in refugee camps. Thestar.com, Jan 20. Retrieved from http://www.thestar.com/opinion/editorialopinion/2013/01/20/refugees_in_canada_have_poorer_access_to_health_care_than_in_refugee_camps.html Muggah, E., Dahrouge, S & Hogg, W. (2012). Access to primary health care for immigrants: results of a patient survey conducted in 137 primary care practices in Ontario, Canada. BMC Family Practice. 13: 128. Rousseau, C., Kuile, S & Munoz, M et al. (2008). Health Care Access for Refugees and Immigrants with Precarious Status: Public Health and Human Right Challenges. Canadian Journal of Public Health, July- August. 99 (4): 290-292. Skinner, B. (2009). Brett Skinner: Don’t blame prescription drugs for increased healthcare costs. National post, Oct 12. Retrieved from http://fullcomment.nationalpost.com/2012/10/09/brett-skinner-dont-blame-prescription-drugs-for-increased-healthcare-costs/ Wayne, K. (2012). Limits on health care for refugees. Canadian Medical Association, Jan 12. 184. 9. Read More