"dissenting doctors do canada proud" as harper and kenney follow a familiar pattern

The fightback over the Interim Federal Health Program (health coverage for refugees) is being noticed. So is the typical pattern of propaganda staged by the Harper GovernmentTM when it wants to kill another piece of what makes Canada a decent country.

First, Janet Bagnall in the Montreal Gazette nails the Harper Government playbook. Then Jeremy Klaszus, writing in the Calgary Herald, Harper and Kenney's home turf, writes:
Canadian doctors are fighting for all the refugee health cuts to be rescinded, so all are treated with dignity. Their dissent is an honourable act of welcoming, an example of what Canada can and should be.
Bagnall's excellent column is worth reading in its entirety.
The Harper government is nothing if not predictable in how it goes about dismantling a program or service. It starts by denigrating the program and the program's beneficiaries, and telling Canadians that they've been played for fools by the beneficiaries. Once that message has been drilled home, and the government judges that the moment is right and Canadians' attitudes changed, it proceeds to get rid of the offending program - no matter how impractical, immoral or ultimately costly the exercise might prove to be.

Examples include the gun registry (accompanied by criticism of the police departments that claimed it was useful) and alternative sentencing programs (with much sneering at justice departments, notably Quebec's, that believed having sentencing options was good for society).

The latest case is the government's decision to severely curtail or simply eliminate health benefits for refugees, with some slight backtracking last Friday.

Until June 30, the Interim Federal Health program, which is similar to provincial health-insurance programs, provided basic health coverage to refugee claimants no matter where they came from or under what circumstances. The coverage was available until a claimant became a permanent resident, at which point the province began picking up the tab, or until the claimant abandoned or withdrew his or her claim.

The government proceeded as it always does. First, denigrate the program: Citizenship and Immigration Minister Jason Kenney has tirelessly painted the IFH program as little more than a draw for bogus refugee claimants. Free eyeglasses and a round of antibiotics are, apparently, more than enough reason for people to try to sneak into Canada on their flight from war, famine or violence. Kenney labels failed claimants "illegal immigrants."

Second, tell Canadians they are being played for fools: Kenney has done his best to set Canadian citizens against refugees, saying refugees have until now been given better health care than residents, whereas in fact refugees have been given the same level of care as the lowest-income Canadians.

Third, when Canadians protest, as virtually the entire medical community in the country has, just tough it out: Call them "militants," "activists" and "extremists."

Dr. Philip Berger, chief of family and community medicine at St. Michael's Hospital in Toronto and a founding member of a group called Canadian Doctors for Refugee Care, says that those are words Kenney has used to describe national medical groups including the Canadian Medical Association, the College of Family Physicians of Canada, the Canadian Federation of Nurses Union, the Canadian College of Physicians, the Royal College of Physicians and Surgeons of Canada, the Canadian Psychiatric Association and the Canadian Paediatric Society.

From Kenney's zeal to reform Canada's refugee program no one would guess that refugee-acceptance rates are at their lowest in the history of the Immigration and Refugee Board, at 38 per cent in 2010 and 2011, according to the University of Ottawa's Human Rights Research and Education Centre. In recent years, the centre has found, the acceptance rate has been stable at between 40 and 45 per cent of the roughly 25,000 claims made every year. At that rate, a total of 11,250 people are accepted every year, including 2011.

That figure is dwarfed by the 4.3 million people around the world who were newly displaced in 2011. Last year "saw suffering on an epic scale. For so many lives to have been thrown into turmoil over so short a space of time means enormous personal cost for all who were affected," Antonio Guterres, the United Nations High Commissioner for Refugees, said last month.

Ottawa seems less concerned with the fate of refugees than with how to categorize them. The government has two types: deserving and undeserving.

Deserving refugees, if health-care provision is a guide, are those who are government-sponsored, brought to Canada as permanent refugees through the Resettlement Assistance Program (as well as some victims of people-smuggling). According to Canadian Doctors for Refugee Care, these refugees will have cost-free access to physician visits, diagnostics and laboratory testing through their provincial health coverage, along with prescription drugs, vision care and dental coverage.

Undeserving refugees appear to include those sponsored by church groups or other humanitarian organizations; those who have come from countries designated by the minister as places where refugees should not be coming from; those who have sought asylum in Canada after fleeing their homeland; and those whose claims have been denied. Refugees from countries deemed "safe" by the minister will have no coverage even in the case of emergencies. ("Safe" is a fast-moving target. Amnesty International reported this week that migrants in Greece are being beaten up.)

Refugee claimants from countries Canada recognizes as not safe will be covered for urgent or essential care, including physician visits and laboratory and diagnostic testing, the Doctors for Refugee Care group says. There is no coverage for preventive care. Otherwise, refugees will not be eligible for health care unless their condition involves a risk, narrowly defined, to public health. A contagious illness such as pneumonia is not considered a threat.

Quebec has promised, temporarily, to fill the gap by paying for medical care for all refugees. Doctors have promised to keep track of cases of compromised care. The group Doctors for Refugee Care will collect data as refugee patients run out of medication and become ineligible for care.

"As soon as we get data on harm done to refugees, we will be reporting it," said Berger.
Klaszus brings the fight to Harper and Kenney's doorstep; this excellent column ran in the Calgary Herald. (It was posted in comments on this earlier thread, but many people don't see comments.)
Dissenting Doctors Do Canada Proud

It would have been easy to just keep quiet.

When the federal government announced cuts to refugee health care in April, it seemed like a done deal. Immigration Minister Jason Kenney indicated that starting this month, the government would no longer pay for supplemental health services such as prescription drugs, dentistry and eye care for refugees. This was framed in terms of fairness: most Canadians don't get government coverage for such things, so why should outsiders? That's not right!

"We do not want to ask Canadians to pay for benefits for protected persons and refugee claimants that are more generous than what they are entitled to themselves," Kenney said in a news release at the time. This, he suggested, would save money and protect Canadian taxpayers from being exploited.

Doctors were having none of it. Kenney's announcement triggered an incredible flourish of dissent. A coalition of care provider groups - including the Canadian Medical Association, dentists and social workers - protested the cuts in an open letter, warning Kenney that the changes would hurt some of the most vulnerable people in the country. The consequences could be "catastrophic," they warned. Protests erupted across the country.

To make their point, a couple of doctors even interrupted funding announcements by Conservative cabinet ministers. That takes cojones. These events are usually self-congratulatory affairs at which the minister is showered with adulation. Everyone present is expected to fall in line and give thanks.

So it was encouraging to see Chris Keefer, a doctor, spoil that tired script by confronting Natural Re-sources Minister Joe Oliver at Toronto General Hospital last month. "This is not the legacy of Canada," Keefer said of the cuts, interrupting Oliver. "This is not the kind of country that we want to live in."

Hospital administrators were visibly embarrassed by the disruption, and told Keefer to sit down. He didn't. He was then told that he ruined the announcement.

Tarek Loubani, a doctor in London, Ont., did the same thing to Human Resources Minister Diane Finley. "I'm very sorry minister, I cannot let you continue until the position of your government changes on this issue," said Loubani. "We're talking about people's lives here."

In the face of this dissent, Kenney is doing a contortion act, saying the supplemental coverage will continue for government-sponsored refugees, though not others. That appears to be a switch, though Kenney has described it as a clarification.

It seems more like obfuscation. If the goal is to make coverage equal for all, why is supplemental coverage now being upheld for government-sponsored refugees? That's inconsistent with the rationale Kenney laid out in April. Why should outsiders - government-sponsored or not - get coverage that we Canadians do not? This is supposed to irk us, remember? How quickly Kenney has forsaken the taxpayer!

The dissent will keep on, in part, because so many Canadians are connected with the refugee experience. My grandfather experienced it in Germany when the Red Army forced his family to flee westward from East Prussia in 1944. Even though my grandfather was a Ger-man seeking shelter and food from other Germans, he was always aware that he was viewed as an outsider. "An intruder," as he put it.

Refugees from eastern Germany took work from locals in the west. It was the same old story: Why are these people taking what is ours?

That experience of being ostracized made a deep impression on him. But so did small acts of welcome: a bed to sleep in, a foot bath, a loaf of bread. Later, he and my grandmother would extend similar hospitality by sponsoring a Vietnamese family when Canada opened its arms to the boat people. That great welcoming was easily one of our proudest moments as a nation.

Canadian doctors are fighting for all the refugee health cuts to be rescinded, so all are treated with dignity. Their dissent is an honourable act of welcoming, an example of what Canada can and should be.
Also: Elie Wiesel and the Toronto Board of Rabbis publicly denounce the defunding of refugee health care.

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