New immigrants and undocumented workers are still being asked to cover their own health-care costs despite the Ontario government’s promise that this wouldn’t happen during the COVID-19 pandemic, advocates say.
“This is unfair because these are people who have been working and sustaining the economy,” said Loly Rico, the co-director of FCJ Refugee Centre in Toronto.
“It’s a very high number of people that live in Toronto and need health coverage.”
FCJ Refugee Centre normally operates a health clinic for uninsured people, which saw about 15 patients a week and had a one-month waiting list before it closed because of the pandemic. After Ontario sent a directive telling hospitals to serve all patients, regardless of their insurance coverage, the centre’s health-care staff started sending patients to hospitals.
“... the hospitals have been seeing the clients but they’ve been telling them that they will send a bill.”
“Since the province said that they will cover anyone, no matter what is their status, we had been promoting [that] to our clients,” Rico said. “One of the challenges is the hospitals have been seeing the clients but they’ve been telling them that they will send a bill.”
Rico said one patient went to Humber River Hospital in North York, Ont. with a printed copy of the government’s directive in hand and was still asked for payment upfront.
“They said it doesn’t matter, they have to pay,” Rico said.
Humber River Hospital did not respond to a request for comment.
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“It’s very unfair,” said Rico. “These are people that have been working and they have been sustaining the economy … doing cleaning, helping the hotels, in the restaurants. They have always been working.”
She said some of the clinic’s undcoumented patients don’t have a work permit or are waiting to be approved for permanent residency, but they have been working in Ontario for many years.
Some have lost their jobs because of the pandemic but aren’t eligible for unemployment benefits or social assistance due to their lack of papers.
“They should be eligible to receive health coverage because they are contributing,” Rico said.
“The moment jobs start coming up, these people will lift up their feet and start working. Because that’s how they’ve been surviving for many years.”
The confusion could have long-lasting effects on newcomers to Canada, said Diana DaSilva, a former social worker and the coordinator of Caregivers Action Centre, a group for workers who care for children and seniors, some of whom don’t have status. If people are refused health care or told it will cost hundreds or thousands of dollars, they may avoid going to the doctor in the future, she said.
DaSilva and some other grassroots organizers created a helpline for undocumented people who were having trouble accessing health care during the COVID-19 pandemic.
She heard from one family who took their teenage son to hospital because he was having abdominal pain and was told they had to pay $5,000 up front.
“The family made the decision that they don’t have this money and walked away … leaving the son, who was experiencing abdominal pain, to not get treatment.”
She said that she and her peers were sure that their advice, for undocumented workers to seek care at the hospital, was correct.
“This is not just us being overly optimistic and making up our own rules.”
But the government’s communication around the directive has been muddled.
On Friday, a spokesperson for Health Minister Christine Elliott told HuffPost Canada that the government only intended to cover health care related to COVID-19.
But on Tuesday, a spokesperson for the Ministry of Health said the opposite.
“The ministry is currently funding uninsured persons to receive all hospital care and some community care services, such as assessments with physicians, regardless of the purpose for which they require care,” Christian Hasse told HuffPost by email.
“There will be scenarios where uninsured patients are admitted to hospital for non-COVID emergency reasons and subsequently contract COVID during the course of care. Likewise services being rendered for non-COVID reasons may result in a finding that the patient is also COVID positive. For these reasons the ministry did not feel the funded services could be restricted to COVID care only.”
Arnav Agarwal, an internal medicine resident at two Toronto hospitals who is treating COVID-19 patients, called the unclear communication “disheartening.” Agarwal is also an organizer with OHIP For All, a group of health-care providers who want the province to cover all health care for uninsured people permanently.
“The lack of clear information is among the biggest problems,” he said.
He said there needs to be better communication so that all hospitals are providing the same care without asking for payment.
“We’re in the middle of a pandemic. If anything, we need to make sure that we provide comprehensive care now more than ever.”
He also said that the province should make the policy permanent, arguing that people become sicker and end up needing more care after it has been denied.
“These changes are very important in the pandemic, but the pandemic just highlights gaps in our system that have existed for a long time. These individuals require health-care access chronically,” he said.
“These gaps are more relevant than ever but these gaps are always there.”