Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-29T16:40:06.895Z Has data issue: false hasContentIssue false
  • English
  • Français

The 2012 Cuts to Refugee Health Coverage in Canada: The Anatomy of a Social Policy Failure

Published online by Cambridge University Press:  22 February 2016

Paul Sheridan  and
Ketan Shankardass
Paul Sheridan*
Affiliation:
Winnipeg, Manitoba
Ketan Shankardass*
Affiliation:
Wilfrid Laurier University
*
433 Lyndale Dr., Winnipeg MB, R2H 1M8, Email: [email protected]
Department of Health Sciences, Wilfrid Laurier University, 75 University Ave W, Waterloo ON, N2L 3C5, Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

In 2012, Canada's federal government announced cuts to refugee health coverage. Evidence suggesting that the cuts represent a social policy failure has since been accumulating, including the 2014 Federal Court ruling ordering their reversal. This explanatory case study uncovers the problem definition process that led policy development by applying coding methods to governmental publications, transcripts of parliamentary proceedings and internal governmental correspondence obtained under the Access to Information Act. The systematic analysis identifies avoidable gaps that occurred and proposes an avenue for strengthening future federal social policy processes so as to avoid negative outcomes such as those that resulted here.

Résumé

En 2012, le gouvernement fédéral canadien annonça des coupures dans la couverture des soins de santé pour les réfugiés. Des preuves qui laissent croire que ces coupures représentent une politique sociale ratée s'accumulent depuis, y compris sa défaite devant la Cour fédérale en 2014. Cette étude de cas explicative révèle le processus de définition de problème qui a guidé le développement de la politique en appliquant des méthodes de codage aux publications gouvernementales, aux procès-verbaux de délibérations parlementaires, et à la correspondance gouvernementale interne obtenue en vertu de la Loi sur l'accès à l'information. L'analyse systématique identifie des lacunes évitables qui se sont produites et propose des moyens de renforcer les processus de politique sociale futurs afin d'éviter des résultats négatifs tels ceux ayant abouti dans ce cas.

Type
Research Article
Information
Canadian Journal of Political Science/Revue canadienne de science politique , Volume 48 , Issue 4 , December 2015 , pp. 905 - 931
Copyright
Copyright © Canadian Political Science Association (l'Association canadienne de science politique) and/et la Société québécoise de science politique 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alboim, Naomi and Cohl, Karen. 2012. Shaping the future: Canada's rapidly changing immigration policies. Maytree Foundation. http://maytree.com/wp-content/uploads/2012/10/shaping-the-future.pdf (January 16, 2015).Google Scholar
Barnes, Steve. 2012. The Real Cost of Cutting Refugee Health Benefits: A Health Equity Impact Assessment. Wellesley Institute. http://www.wellesleyinstitute.com/wp-content/uploads/2012/05/The-Real-Cost-of-Cutting-Refugee-Health-Benefits.pdf (January 16, 2015).Google Scholar
Barnes, Steve. 2013. The Real Cost of Cutting The Interim Federal Health Program. Wellesley Institute. http://www.wellesleyinstitute.com/wp-content/uploads/2013/10/Actual-Health-Impacts-of-IFHP.pdf (January 16, 2015).Google Scholar
Burstein, Paul and Bricher, Marie. 1997. “Problem Definition and Public Policy: Congressional Committees Confront Work, Family and Gender, 1945–1990*.” Social Forces 76 (1): 135–69. doi:10.1093/sf/76.1.135.Google Scholar
Canadian Council for Refugees. 2012. “Government information on refugee healthcare changes is misleading, may be fatal.” http://ccrweb.ca/en/bulletin/12/05/03 (January 16, 2015).Google Scholar
Canadian Doctors for Refugee Care. 2014. “The Issue.” http://www.doctorsforrefugeecare.ca/the-issue.html (January 16, 2015).Google Scholar
Canadian Doctors for Refugee Care, the Canadian Association of Refugee Lawyers, Daniel Garcia Rodriques, Hanif Ayubi and Justice for Children and Youth v. Attorney General of Canada and Minister of Citizenship and Immigration , 2014 FC 651. July 4, 2014. http://cas-ncr-nter03.cas-satj.gc.ca/rss/T-356-13%20Cdn%20Doctors%20v%20AGC%20Judgment%20and%20Reasons.pdf (January 16, 2015).Google Scholar
Canadian Press. 2015. “Refugee health advocates return to court, pushing feds to comply.” CBC News, 27 January. http://www.cbc.ca/m/touch/canada/story/1.2933071 (July 27, 2015).Google Scholar
CBC News . 2012. “Refugee health wrong priority for provinces, Kenney says.” CBC News, 29 June. http://www.cbc.ca/news/politics/refugee-health-wrong-priority-for-provinces-kenney-says-1.1193757 (July 27, 2015).Google Scholar
Chaput, Maria. 2012. Canada. Parliament. Senate. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/Content/Sen/Chamber/411/Debates/pdf/097db_2012-06-26-e.pdf (January 16, 2015).Google Scholar
Chisu, Corneliu. 2012. Canada. Parliament. House of Commons. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/House/411/Debates/097/HAN097-E.PDF (January 16, 2015).Google Scholar
Citizenship and Immigration Canada. nd-a. “Backgrounder—Overview of Changes to the Interim Federal Health Program.” Obtained under the Access to Information Act from Citizenship and Immigration Canada. File A-2012-24057: 90–91.Google Scholar
Citizenship and Immigration Canada. nd-b. “Backgrounder—Summary of Changes to the Interim Federal Health Program.” Obtained under the Access to Information Act from Citizenship and Immigration Canada. File A-2012-24057: 76–82.Google Scholar
Citizenship and Immigration Canada. 2012. “Media Lines / Qs and As—Reform of the Interm Federal Health Program.” Obtained under the Access to Information Act from Citizenship and Immigration Canada. File A-2012-24057: 38–57.Google Scholar
Cordy, Jane. 2012a. Canada. Parliament. Senate. Standing Committee on Social Affairs, Science and Technology. Evidence. 41st Parliament, 1st session. http://www.parl.gc.ca/content/sen/committee/411/SOCI/pdf/20issue.pdf (January 16, 2015).Google Scholar
Cordy, Jane. 2012b. Canada. Parliament. Senate. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/Content/Sen/Chamber/411/Debates/pdf/097db_2012-06-26-e.pdf (January 16, 2015).Google Scholar
Croucher, Sheila L. 1997. “Constructing the image of ethnic harmony in Toronto, Canada: The politics of problem definition and nondefinition.” Urban Affairs Review 32 (3): 319–47. doi:10.1177/107808749703200302.Google Scholar
Csanyi-Robah, Gina. 2012. Canada. Parliament. Senate. Standing Committee on Social Affairs, Science and Technology. Evidence. 41st Parliament, 1st session. http://www.parl.gc.ca/content/sen/committee/411/SOCI/pdf/20issue.pdf (January 16, 2015).Google Scholar
CTV News . 2015. “‘Day of Action': Doctors, activists protest refugee health care cuts.” CTV News, 15 June. http://www.ctvnews.ca/canada/day-of-action-doctors-activists-protest-refugee-health-care-cuts-1.2423023 (July 27, 2015).Google Scholar
Davies, Libby. 2012. Canada. Parliament. House of Commons. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/House/411/Debates/138/HAN138-E.PDF (January 16, 2015).Google Scholar
DeLeon, Peter. 1994. “Reinventing the Policy Sciences: Three Steps Back to the Future.” Policy Sciences 27: 77–95. doi:10.1007/BF00999600.CrossRefGoogle Scholar
Dery, David. 1984. Problem definition in policy analysis. Lawrence KS: University Press of Kansas.Google Scholar
Dewar, Paul. 2012. Canada. Parliament. House of Commons. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/House/411/Debates/122/HAN122-E.PDF (January 16, 2015).Google Scholar
Dykstra, Rick. 2012a. Canada. Parliament. House of Commons. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/House/411/Debates/122/HAN122-E.PDF (January 16, 2015).Google Scholar
Dykstra, Rick. 2012b. Canada. Parliament. House of Commons. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/House/411/Debates/177/HAN177-E.PDF (January 16, 2015).Google Scholar
Eggleton, Art. 2012. Canada. Parliament. Senate. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/Content/Sen/Chamber/411/Debates/pdf/097db_2012-06-26-e.pdf (January 16, 2015).Google Scholar
Evans, Andrea, Caudarella, Alexander, Ratnapalan, Savithiri and Chan, Kevin. 2014. “The Cost and Impact of the Interim Federal Health Program Cuts on Child Refugees in Canada.” PLoS ONE 9 (5): e96902. doi:10.1371/journal.pone.0096902.Google Scholar
Fildebrandt, Derek. 2012. Canada. Parliament. House of Commons. Standing Committee on Citizenship and Immigration. Evidence. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/Committee/411/CIMM/Evidence/EV5538018/CIMMEV34-E.PDF (January 16, 2015).Google Scholar
Goodale, Ralph. 2012. Canada. Parliament. House of Commons. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/House/411/Debates/185/HAN185-E.PDF (January 16, 2015).Google Scholar
Grondin, Danielle. 2011. Canada. Parliament. House of Commons. Standing Committee on Citizenship and Immigration. Evidence. 40th Parliament, 3rd session. http://www.parl.gc.ca/content/hoc/Committee/403/CIMM/Evidence/EV4924881/CIMMEV40-E.PDF (January 16, 2015).Google Scholar
Hanberger, Anders. 2001. “What is the Policy Problem? Methodological Challenges in Policy Evaluation.” Evaluation 7 (1): 45–62. doi:10.1177/13563890122209513.CrossRefGoogle Scholar
Houston, David J. and Richardson, Lilliard E. Jr. 2000. “The Politics of Air Bag Safety: A Competition among Problem Definitions.” Policy Studies Journal 28 (3): 485–501. http://search.proquest.com/ (November 5, 2014).CrossRefGoogle Scholar
Immigration and Refugee Protection Act. 2012. “Order Respecting the Interim Federal Health Program, 2012.” Canada Gazette Part II 146 (9), April 25. http://www.gazette.gc.ca/rp-pr/p2/2012/2012-04-25/html/si-tr26-eng.html (January 16, 2015).Google Scholar
Jones, J. 2012. Personal communication to Peter Norton. Obtained with omissions under the Access to Information Act from Citizenship and Immigration Canada. File A-2012-24057: 190–91.Google Scholar
Kenney, Jason. 2012a. Canada. Parliament. House of Commons. Standing Committee on Citizenship and Immigration. Evidence. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/Committee/411/CIMM/Evidence/EV5629241/CIMMEV46-E.PDF (January 16, 2015).Google Scholar
Kenney, Jason. 2012b. Canada. Parliament. Senate. Standing Committee on Social Affairs, Science and Technology. Evidence. 41st Parliament, 1st session. http://www.parl.gc.ca/content/sen/committee/411/SOCI/pdf/20issue.pdf (January 16, 2015).Google Scholar
Kenney, Jason. 2012c. Canada. Parliament. House of Commons. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/House/411/Debates/142/HAN142-E.PDF (January 16, 2015).Google Scholar
Kenney, Jason. 2012d. Canada. Parliament. House of Commons. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/House/411/Debates/185/HAN185-E.PDF (January 16, 2015).Google Scholar
Kenney, Jason. 2012e. Canada. Parliament. House of Commons. Standing Committee on Citizenship and Immigration. Evidence. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/Committee/411/CIMM/Evidence/EV5895073/CIMMEV64-E.PDF (January 16, 2015).Google Scholar
Keung, Nicholas. 2015. “Court rules denial of appeals for ‘safe country’ refugees unconstitutional.” Toronto Star, 23 July. http://www.thestar.com/news/immigration/2015/07/23/court-strikes-down-ottawas-safe-country-list-for-refugees.html (July 27, 2015).Google Scholar
Kingdon, John W. 2002. Agendas, Alternatives and Public Policy. 2nd ed. Boston MA: Little, Brown.Google Scholar
Kloos, Bret, Hill, Jean L., Dalton, James H., Elias, Maurice J., Wandersman, Abraham and Thomas, Elizabeth. 2011. Community Psychology: Linking Individuals and Communities. 3rd ed. Belmont CA: Cengage Learning.Google Scholar
Künsken, D. 2011. Personal communication to Della Faulkner. Obtained with omissions under the Access to Information Act from Citizenship and Immigration Canada. File A-2012-24051: 31–32.Google Scholar
Lamoureux, Kevin. 2012. Canada. Parliament. House of Commons. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/House/411/Debates/154/HAN154-E.PDF (January 16, 2015).Google Scholar
Langlais, Hugues. 2012. Canada. Parliament. Senate. Standing Committee on Social Affairs, Science and Technology. Evidence. 41st Parliament, 1st session. http://www.parl.gc.ca/content/sen/committee/411/SOCI/pdf/20issue.pdf (January 16, 2015).Google Scholar
Lasswell, Harold D. 1956. The Decision Process: Seven Categories of Functional Analysis. College Park, MD: Bureau of Governmental Research, College of Business and Public Administration, University of Maryland.Google Scholar
Leung, Chungsen. 2012. Canada. Parliament. House of Commons. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/House/411/Debates/193/HAN193-E.PDF (January 16, 2015).Google Scholar
Linton, Lillian, Phelps, Fred, Sutherland, Robert, Haggie, John, Mildon, Barbara, Poston, Jeff, Buchman, Sandy and Padmos, Andrew. 2012. “Letter to Citizenship and Immigration Minister Jason Kenney.” http://www.cfpc.ca/uploadedFiles/Publications/News_Releases/News_Items/kenney%20vers3%20-%20may2012.pdf (January 16, 2015).Google Scholar
Médecins du Monde Canada. 2014. “Journée pancanadienne de mobilisation.” http://www.medecinsdumonde.ca/index.php/journee-pancanadienne-de-mobilisation/ (January 16, 2015).Google Scholar
Morrissey, Chris. 2012. Canada. Parliament. Senate. Standing Committee on Social Affairs, Science and Technology. Evidence. 41st Parliament, 1st session. http://www.parl.gc.ca/content/sen/committee/411/SOCI/pdf/20issue.pdf (January 16, 2015).Google Scholar
Murray, Sally B. and Skull, Sue A.. 2005. Hurdles to health: Immigrant and refugee health care in Australia. Australian Health Review 29 (1): 25–29. doi:10.1071/AH050025.CrossRefGoogle ScholarPubMed
National Post . 2012. “Cuts to refugee health insurance dangerous, inhumane, doctors say.” National Post, 7 May. http://news.nationalpost.com/news/canada/cuts-to-refugee-health-insurance-dangerous-inhumane-doctors-say (July 27, 2015).Google Scholar
Nerenberg, Karl. 2012. “Why immigration ‘reform' is so central to the Conservatives' agenda.” Rabble.ca, December 5. http://rabble.ca/blogs/bloggers/karl-nerenberg/2012/12/why-immigration-reform-central-harper-governments-agenda (January 16, 2015).Google Scholar
Norredam, Marie, Mygind, Anna and Krasnik, Allan. 2005. Access to health care for asylum seekers in the European Union: A comparative study of country policies. European Journal of Public Health 16 (3): 285–89. doi:10.1093/eurpub/cki191.CrossRefGoogle ScholarPubMed
Office of the United Nations High Commissioner for Refugees. 2010. “Introductory Note.” In Convention and protocol relating to the status of refugees. http://www.unhcr.org/3b66c2aa10.html (January 16, 2015).Google Scholar
Ontario Ministry of Health and Long-Term Care. 2013. “Reinstating Access to Health Care for Refugee Claimants: Ontario Filling Federal Funding Gap with Temporary Health Program.” December 9. http://news.ontario.ca/mohltc/en/2013/12/reinstating-access-to-health-care-for-refugee-claimants.html (January 16, 2015).Google Scholar
Paperny, Anna Mehler. 2015. “Refugee health cuts: Even those who qualify get turned away.” Global News, July 9. http://globalnews.ca/news/2082760/refugee-health-cuts-even-those-who-qualify-get-turned-away/ (July 27, 2015).Google Scholar
Parliament of Canada. 2013. Parliamentary publications: Debates (Hansard). http://www.parl.gc.ca/About/House/compendium/web-content/c_d_debateshansard-e.htm (July 24, 2015).Google Scholar
Phelps, Fred. 2012. Canada. Parliament. House of Commons. Standing Committee on Finance. Evidence. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/Committee/411/FINA/Evidence/EV5785028/FINAEV82-E.PDF (January 16, 2015).Google Scholar
Portz, John. 1996. “Problem Definitions and Policy Agendas: Shaping the Educational Agenda in Boston.” Policy Studies Journal 24 (3): 371–86. doi:10.1111/j.1541-0072.1996.tb01635.x.Google Scholar
Pralle, Sarah B. 2009. “Agenda-setting and climate change.” Environmental Politics 18 (5): 781–99. doi:10.1080/09644010903157115.Google Scholar
Pressé, D. 2012a. Personal communication to Sonia LeBris and Sonja McKay. Obtained with omissions under the Access to Information Act from Citizenship and Immigration Canada. May 11, 13:17. File A-2012-24051: 7–10.Google Scholar
Pressé, D. 2012b. Personal communication to Salam Hawa and Shelley Duffin. Obtained with omissions under the Access to Information Act from Citizenship and Immigration Canada. May 21, 16:34. File A-2012-24051: 40–42.Google Scholar
Prilleltensky, Isaac. 2012. “Wellness as fairness.” American Journal of Community Psychology 49: 1–21. doi:10.1007/s10464-011-9448-8.CrossRefGoogle ScholarPubMed
Privy Council Office. 2009. Guide to Making Federal Acts and Regulations: Part 3—Making Regulations. http://www.pco-bcp.gc.ca/index.asp?lang=eng&page=information&sub=publications&doc=legislation/part3-eng.htm (January 16, 2015).Google Scholar
Rashid, Meb. 2012. Canada. Parliament. House of Commons. Standing Committee on Citizenship and Immigration. Evidence. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/Committee/411/CIMM/Evidence/EV5543489/CIMMEV35-E.PDF (January 16, 2015).Google Scholar
Rochefort, David A. and Cobb, Roger W.. 1993. “Problem Definition, Agenda Access and Policy Choice.” Policy Studies Journal 21 (1): 56–71. doi: 10.1111/j.1541-0072.1993.tb01453.x.CrossRefGoogle Scholar
Root, Jesse, Gates-Gasse, Erika, Shields, John and Bauder, Harald. 2014. Discounting immigrant families: Neoliberalism and the framing of Canadian immigration policy change–A literature review. RCIS working paper series. no. 2014/7. Ryerson Centre for Immigration and Settlement. Ryerson University. http://www.ryerson.ca/content/dam/rcis/RCIS-WP-Root-No2014-7.pdf (August 4, 2015).Google Scholar
Saldaña, Johnny. 2012. The Coding Manual for Qualitative Researchers. 2nd ed. Thousand Oaks CA: SAGE.Google Scholar
Scott, Lise. 2010. Canada. Parliament. House of Commons. Standing Committee on Health. Evidence. 40th Parliament, 3rd session. http://www.parl.gc.ca/content/hoc/Committee/403/HESA/Evidence/EV4515830/HESAEV16-E.PDF (January 16, 2015).Google Scholar
Sims, Jenny Jogindera 2012a. Canada. Parliament. House of Commons. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/House/411/Debates/126/HAN126-E.PDF (January 16, 2015).Google Scholar
Sims, Jenny Jogindera 2012b. Canada. Parliament. House of Commons. Official Report. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/House/411/Debates/142/HAN142-E.PDF (January 16, 2015).Google Scholar
Statutory Instruments Act, Revised Statutes of Canada. 1985, c. S-22. http://laws-lois.justice.gc.ca/eng/acts/S-22/FullText.html (January 16, 2015).Google Scholar
Stone, Deborah A. 1988. Causal Stories and the Formation of Policy Agendas. Political Science Quarterly 104 (2): 281–300. http://www.jstor.org/stable/2151585 (January 16, 2015).Google Scholar
Tekle, Johannes and Janczur, Axelle. 2012. “Letter Opposing cuts to IFH.” http://accessalliance.ca/sites/accessalliance/files/Access%20Alliance%20MHCS%20Letter%20Re%20IFH%20changes%2005%2010%202012.pdf (January 16, 2015).Google Scholar
Treasury Board of Canada Secretariat. 2012. Cabinet Directive on Regulatory Management. http://www.tbs-sct.gc.ca/rtrap-parfa/cdrm-dcgr/cdrm-dcgr01-eng.asp (January 16, 2015).Google Scholar
Treasury Board of Canada Secretariat. 2014a. Assessing, Selecting and Implementing Instruments for Government Action. http://www.tbs-sct.gc.ca/rtrap-parfa/asses-eval/asses-eval01-eng.asp (January 16, 2015).Google Scholar
Treasury Board of Canada Secretariat. 2014b. Guide to the Federal Regulatory Development Process. http://www.tbs-sct.gc.ca/rtrap-parfa/gfrpg-gperf/gfrpg-gperfpr-eng.asp (January 16, 2015).Google Scholar
Treasury Board of Canada Secretariat, 2015. The 2013–14 Scorecard Report: Implementing the Red Tape Reduction Action Plan. http://www.tbs-sct.gc.ca/rtrap-parfa/report-rapport/2013-14/asr-fea-eng.pdf (August 4, 2015).Google Scholar
Tyndall, Mark. 2012. Canada. Parliament. House of Commons. Standing Committee on Citizenship and Immigration. Evidence. 41st Parliament, 1st session. http://www.parl.gc.ca/content/hoc/Committee/411/CIMM/Evidence/EV5738793/CIMMEV52-E.PDF (January 16, 2015).Google Scholar
Undisclosed author. 2012a. Personal communication to Bill Brown. Obtained with omissions under the Access to Information Act from Citizenship and Immigration Canada. File A-2012-24057: 138–40.Google Scholar
Undisclosed author. 2012b. Personal communication to Andrée Beland. Obtained with omissions under the Access to Information Act from Citizenship and Immigration Canada. File A-2012-24057: 156–59.Google Scholar
Undisclosed author. 2012c. Personal communication to Rémi Larivière. Obtained with omissions under the Access to Information Act from Citizenship and Immigration Canada. File A-2012-24057: 171.Google Scholar
Warmington, A. 2012. Personal communication to Shelley Duffin. Obtained with omissions under the Access to Information Act from Citizenship and Immigration Canada. File A-2012-24051: 22–27.Google Scholar
Weiss, Janet A. 1989. “The powers of problem definition: The case of government paperwork.” Policy Sciences 22: 97–121. doi:10.1007/BF00141381.Google Scholar
Wildavsky, Aaron B. 1979. Speaking Truth to Power: The Art and Craft of Policy Analysis. Boston MA: Little, Brown.Google Scholar
Yin, Robert K. 2009. Case Study Research: Design and Methods. 4th ed. Thousand Oaks CA: Sage.Google Scholar