The Commons: Should the federal government pay for a refugee claimant’s cancer treatment?

By Aaron Wherry - Monday, November 26, 2012 at 5:30 PM - 0 Comments

The Scene. Ralph Goodale stood with right hand in pocket, a piece of paper in his left hand, to read the indictment against his former assistant.

“Mr. Speaker, the government’s decision to deny health care services to certain refugee claimants faces very stiff opposition. Doctors, nurses and every significant health care organization in Canada says the decision is wrong. Media editorials say the immigration minister has dropped the ball. Most especially, provincial governments are universally critical, Ontario, Quebec, Manitoba. Saskatchewan’s premier describes federal refugee cuts as ‘unCanadian,’ ” the deputy Liberal leader reported to the House.

This much seemed inspired by the case of a man from Pakistan who arrived in Saskatchewan and was subsequently diagnosed with cancer. The man received chemotherapy, but, apparently as a result of the Harper government’s changes to the refugee health care program, the man’s anti-nausea medication was not covered. The Saskatchewan government has said it will cover the costs, but the Premier is unimpressed. This just a month after Conservative MP Kelly Block was criticized for celebrating the new policy.

“Before this gets worse and people die,” Mr. Goodale asked, “will the government correct itself and reinstate sensible health coverage for refugee claimants?”

Jason Kenney was perfectly passive aggressive in response.

“Mr. Speaker, we continue to provide health coverage to refugee claimants,” he assured. “We provide the same package of basic hospital and physician services that are typically available to Canadians. Not every province funds all of the same services precisely the same way. However, if provinces want to provide additional insurance for certain services to asylum claimants, they are more than free to do so.”

The issue seems rather more contentious than Mr. Kenney’s reading here might otherwise suggest.

“I would remind the member that, for example, we have no federal insurance at all for people who are here illegally, for temporary visitors, for newly arrived permanent residents, or for Canadian citizens who are re-establishing themselves,” the Immigration Minister went on. “They get no federal, or for that matter, provincial coverage. However, provinces are always free to provide insurance to people where they think it is appropriate.”

Mr. Goodale was unconvinced, his right hand emerging from his pocket to jab at the air in front of him for emphasis. Continue…

‘This is the kind of country we are. You cover it.’

By Aaron Wherry - Friday, November 23, 2012 at 10:00 AM - 0 Comments

Saskatchewan Premier Brad Wall rips the Harper government over its refusal to fund the treatment of a cancer-stricken refugee.

“It’s unbelievable that some of the decisions that have been taken federally are having this impact on people who are clearly the most vulnerable, refugees who are obviously fleeing something quite terrible — that’s why they’re refugees,” Wall said Thursday.  “On the face of it, you just consider the case of this particular gentleman or others who, for example, as it was pointed out … might need prenatal care, this is just common sense. You just do this. This is the kind of country we are. You cover it.”

Previous coverage of the cuts to refugee health care is compiled here.

Ralph Goodale asked the Immigration Minister about this yesterday. Continue…

Paul Wells explains why Canada’s policy on Roma refugees hits a flat note

By Paul Wells - Sunday, October 28, 2012 at 7:50 AM - 0 Comments

PHOTOGRAPHS BY Colin O’Connor

More than a thousand spectators packed Koerner Hall, the opulent concert theatre on Bloor Street in Toronto, for Robi Botos’ birthday concert earlier this month. Botos was turning 34. When he came onstage the audience broke into a raggedy chorus of Happy Birthday. Botos wheeled around on his heel and bent over the piano keyboard so he could accompany the last line of the song with a bluesy phrase. “What key was that in, Robi?” somebody shouted from the back of the hall. “D flat,” he said. Perfect pitch.

There followed three hours of extraordinary jazz. Botos was born in 1978 in Nyiregyhaza, Hungary. Since he moved to Toronto 14 years ago he has become one of the city’s most prominent musicians. His guests for the concert’s second half included the great saxophonist Branford Marsalis and the drummer Jeff “Tain” Watts, two of the most demanding musicians in the world. Before the first tune was half done, Watts was leaning forward over his drum kit, his eyes locked on Botos’, a wide and satisfied smile on his face. I can do business with this guy, the smile said. The music sounded like a freight train.

But there was a special spirit about the concert’s first half, when Botos played with members of his family: his father Lajos Botos Sr. on drums, brother Lajos Jr. on bass and first cousin Jozsef on guitar. Here the music was more casual, often based on folk themes. Robi Botos, who befriended Oscar Peterson before Peterson died, often played in ways that specifically recalled Peterson: the way he tapped his foot, the way he dropped his right hand onto the keyboard from high altitude to kick off long phrases. I’ve been hearing about him for years, but this concert gave me a chance to confirm for myself that Robi Botos is a tremendous jazz pianist. Continue…

Disagreeing with Kelly Block

By Aaron Wherry - Monday, October 22, 2012 at 10:26 AM - 0 Comments

Kelly Block’s refugee health care flyer draws a protest outside her constituency office.

More than 250 people gathered outside the constituency office of Conservative MP Kelly Block on Saturday to protest what they call the “racist” and “divisive” message of a mail-out sent two weeks ago by the MP that applauds a recent decision by the federal government to end free dental and vision care and prescriptions for certain refugees.

Some placards at the rally went as far as calling the mail-out “xenophobic.” Others say Block’s message is politically motivated and misinformed. ”They are intentionally sowing division for their own political gain,” Dr. Mahli Brindamour told the crowd. “This offensive flyer fosters intolerance by pitting Canadians against each other and against some of the world’s most vulnerable populations.”

Last week, the NDP’s Jinny Sims pointed to a similar flyer sent out by Conservative MP Scott Reid.

‘It wasn’t meant to be divisive’

By Aaron Wherry - Tuesday, October 16, 2012 at 12:53 PM - 0 Comments

Conservative MP Kelly Block is receiving some criticism for a flyer she sent to constituents that was headlined, “Ending Unfair Benefits for Refugee Claimants.”

Block said she’s always eager to receive feedback, and will consider wording future mail-outs on the issue differently. “I really do appreciate hearing from constituents,” she said. She said the subject matter was her own initiative rather than the Conservative Party’s. She said it was an attempt to educate her constituents. “It is never my intention to offend … It wasn’t meant to be divisive,” Block said.

Block said the amount of tax dollars spent on refugee claimants’ health care needs was only two per cent of the total for all refugees, such as those sponsored by churches. She said she opposed granting services to refugee claimants, many of whom were eventually rejected. Block said she was simply stating the facts of the new government policy rather than giving her opinion.

An NDP MLA and the Star-Phoenix editorial board are unimpressed.

Previous coverage of this issue is compiled here and here.

‘As a medical doctor yourself’

By Aaron Wherry - Friday, August 3, 2012 at 11:43 AM - 0 Comments

Liberal MPs Hedy Fry and Carolyn Bennett—both doctors—challenge Conservative MP Kellie Leitch to join other doctors in opposing the Harper government’s cuts to health care for refugees.

As the only medical doctor in the Conservative Caucus it is incumbent upon you to examine the evidence and not be blinded by ideology. Indeed, as a medical doctor yourself, you have a special responsibility to your fellow human beings to protect health, provide sympathetic care, to prevent disease.

It is time you respected this duty. It is time you listened to the medical profession and the provinces and protect the most vulnerable in our society. It is time that you stand up for refugees and tell your caucus, the cabinet and the Prime Minister to reverse this reprehensible injustice.

Dr. Leitch responds via the CBC.

In a statement to CBC News, Leitch said the changes are “fair and necessary.” … Leitch, who represents the Ontario riding of Simcoe-Grey, referred to the open letter by the Liberals as an example of their “increasing desperation.”

Dr. Leitch was previously challenged to oppose her government’s policy on asbestos exports.

‘Very fair and balanced changes’

By Aaron Wherry - Wednesday, August 1, 2012 at 9:45 AM - 0 Comments

After the Liberals demanded to see evidence, Jason Kenney points to numbers to defend cuts to health care for refugees.

Between Jan. 17 and Dec. 31, 2011, 8,819 Mexicans racked up nearly $7 million in health care costs under the Interim Federal Health Program. Some 6,749 Hungarians charged more than $4.4 million, while 4,583 Columbians racked up more than $2.6 million in costs. Meanwhile, 3,790 Americans received more than $1.4 million in free health care. Jamaican claimants round out the top five with 809 health care users receiving more than $808,000 worth of health services … 

According to Immigration and Refugee Board figures, last year 83 per cent of Mexican refugee applications were rejected, abandoned or withdrawn. The same could be said for 91 per cent of Hungarian claims, 98 per cent of American claims, 63 per cent of Columbian claims and 62 per cent of Jamaican claims.

Previous coverage of this issue and the protests around it here, here, here, here, here, here, here, here,here, here, here, here and here.

‘We would like to see the evidence’

By Aaron Wherry - Tuesday, July 31, 2012 at 3:31 PM - 0 Comments

Parliament doesn’t reconvene for another six weeks, but the Liberals are serving notice that they’d like the immigration committee to study cuts to health care for refugees.

Lamoureux said his party wants Kenney to produce evidence to support the policy decision and show that it was based on consultations or studies of some kind. ”There was a great deal of suspicion that this was a decision that was made on the whim, that there was no real consultation, there was no real studies. We haven’t seen that and we would like to see the evidence,” he said at a news conference in Ottawa. ”Good government policy is made when you have evidence-based policy decisions and we haven’t seen any evidence and we’re calling for the minister to provide that,” the critic said.

Yesterday, Marc Garneau posted a lengthy denunciation of Conservative immigration policy.

The doctors who protested in Hamilton earlier this month explain themselves here.

‘Someone will die from this’

By Aaron Wherry - Friday, July 20, 2012 at 9:57 AM - 0 Comments

Doctors confronted Health Minister Leona Aglukkaq in Hamilton yesterday.

O’Shea asked why the federal government hasn’t met with the Canadian Doctors for Refugee Health Care, a national collective that formed this year in response to cuts to refugee benefits.

Kraeker later stood to tell a story about a local seven-year-old refugee seen in Hamilton’s refugee health clinic, where both Kraeker and O’Shea see patients. The boy had an epileptic seizure because he couldn’t get his medication, which would have cost less than a dollar a day, Kraeker said. He was rushed to the emergency room. “I don’t think it’s a stretch to say someone will die from this,” O’Shea said.

The Spectator has more on the exchange between the doctors and Ms. Aglukkaq here.

Joanna Smith talked to some of the doctors involved in these protests here. Jason Kenney was also questioned by a doctor earlier this week in Leduc, Albeta.

Previous coverage of this issue and the protests around it here, here, here, here, here, here, here, here,here, here, here, here and here.

‘There is a social equity issue there’

By Aaron Wherry - Tuesday, July 17, 2012 at 12:26 PM - 0 Comments

Jason Kenney talks to the Edmonton Journal about cuts to health care coverage for refugees.

The government said the scaling back of services offered through the Interim Federal Health Program is aimed at levelling the playing field by limiting refugee claimants to the same health-care benefits package that the average Canadian is able to access for free from each province or territory. ”I think there is a social equity issue there,” Kenney told the Journal’s editorial board on Monday, adding that cutting off access to extended prescription, dental and vision benefits for the targeted refugees will save $19 million per year. The program cost Canadians $84 million last year and Kenney said it was due to become a $100-million expense soon.

Critics argue that each Canadian would only have to shell out 59 additional cents per year to maintain the benefits, but they miss the point. Kenney said the cuts are aimed at people whose asylum claims have been denied on appeal but have yet to leave the country. ”If you’ve lost your asylum claim, don’t expect to stay four or five years getting extended benefits.” However, the cuts will also affect refugees who have been sponsored by religious groups and are in Canada legally. Kenney said it is reasonable to expect the religious groups that are already paying for refugees’ housing and food would also cover the $170 annual cost of extended benefits for the people they bring to Canada.

‘Bogus refugee claimants receiving gold-plated health care benefits’

By Aaron Wherry - Monday, July 16, 2012 at 4:15 PM - 0 Comments

I asked Jason Kenney’s office if there was any response to my interview with Dr. Philip Berger. Mr. Kenney’s spokeswoman sent along the following statement.

Canadians have been clear that they do not want illegal immigrants and bogus refugee claimants receiving gold-plated health care benefits that are better than those Canadian taxpayers receive. Our Government has listened and acted. We have taken steps to ensure that protected persons and asylum seekers from non-safe countries receive health care coverage that is on the same level as Canadian taxpayers receive through their provincial health coverage, no better. Bogus claimants from safe countries, and failed asylum seekers, will not receive access to health care coverage unless it is to protect public health and safety. Shamefully, the NDP and Liberals support bogus and rejected asylum seekers receiving gold-plated health care benefits. We disagree. Those who have been through our fair system and rejected should respect Canada’s laws and leave the country.

Previous coverage of this issue and the protests around it here, here, here, here, here, here, here, here, here, here and here.

BBQ interrupted

By Aaron Wherry - Monday, July 16, 2012 at 9:00 AM - 0 Comments

Jason Kenney was shouted at this weekend by a teenager who wanted to inquire about the Harper government’s cuts to health care for refugees. Mr. Kenney tweeted about the incident here and here. Bashir Mohamed now wants to debate the Immigration Minister.

The Edmonton teen who said he was dragged out of a Conservative party event Saturday and then arrested has a challenge for federal Immigration Minister Jason Kenney. “I want to debate him one-on-one; a 10-minute debate about the issue,” Bashir Mohamed, 17, said Sunday.

Mohamed, who was born in a refugee camp in Kenya and came to Canada in 1997, attended the event at the Alberta Aviation Museum to protest the federal government’s cuts to refugee health care. “I waited until around the end of his speech, the applause died down and I stood up,” he said. “I couldn’t get past the first sentence when a guy came up … and dragged me out.”

Update 1:04pm. Huffington Post has video of the disruption.

Q&A: Dr. Philip Berger

By Aaron Wherry - Monday, July 16, 2012 at 8:00 AM - 0 Comments

On Friday afternoon, I spoke over the phone with Dr. Philip Berger, one of the organizers behind Canadian Doctors for Refugee Care, about the recent demonstrations by doctors against the Harper government’s changes to refugee health care. The following is a condensed transcript of that conversation.

Q: How organized are these demonstrations?

A: Well, they’re only organized to the extent that when we find out about events, we pass on the information to our physician contacts in the particular locale where the event is happening and leave it up to them to decide if they’re able to show up on short notice and how to conduct themselves—with certain guidelines, like to be respectful of the event itself. Tthe purpose is not to disrupt the event or to show any antagonism to the Pan-Am Games or the Olympics or seniors or kids or anything like that, we make it very clear, then to make a judgment about whether they should interrupt the minister speaking or wait until afterwards, it depends on the situation. But to clearly get our message across that if the government refuses to speak to doctors, including organized national medical organizations, then we’re left with no choice but to use these venues, these public venues.

Q: The decision to pursue this, was this based on something? Was there an example of this having been done in the past? Where did the idea come from?

A: The idea is it’s a number of different strategies that our group is pursuing at a national level, to be quite frank. The first action similar to this was the sit-in at minister Joe Oliver’s constituency office on May 11. That idea originated amongst a few of us in Toronto. This is just a natural extension of that sort of action. Continue…

The shouting continues

By Aaron Wherry - Friday, July 13, 2012 at 2:46 PM - 0 Comments

Bal Gosal was interrupted again this morning.

See previously: Another news conference crashed, Bal Gosal gets interrupted, The Conservatives vs. the doctors and ‘Members of the Conservative government will be disrupted from this point on’

Another news conference crashed

By Aaron Wherry - Friday, July 13, 2012 at 10:00 AM - 0 Comments

A doctor attempted to interrupt Bal Gasol, Minister of State for Sport, yesterday.

While two conservative ministers were speaking, Ottawa family doctor Doug Gruner interrupted the announcement yelling at the men.”I’ve been a physician for almost 20 years, I can tell you as a doctor on the front line of health care, that these refugees are going to be incredibly affected by these cuts,” he said. Gruner said he didn’t want to interrupt Whitfield’s announcement because he’s a big fan of the “amazing athlete” and he wept when the triathlete won a silver medal in Beijing in 2008. ”I didn’t interrupt the flag ceremony, I didn’t interrupt anyone else except for the minister right now,” he said.

See previously: Bal Gasol gets interrupted, The Conservatives vs. the doctors and ‘Members of the Conservative government will be disrupted from this point on’

Bal Gosal gets interrupted

By Aaron Wherry - Tuesday, July 10, 2012 at 5:53 PM - 0 Comments

Doctors opposed to the government’s cuts to health care for refugee claimants confront a third cabinet minister.

Amateur Sport Minister Bal Gosal was speaking at a promotional event for the 2015 Pan Am Games in Toronto when he was interrupted by four doctors wearing their white coats who approached the stage yelling. ”What about health care for refugees? What about medications for our patients?” yelled the protesters. ”How can you look your cabinet colleagues in the face?” added Gary Bloch, who identified himself to reporters later in a scrum as a family physician at St. Michael’s Hospital in Toronto. ”Ask Minister Kenney why diabetics can’t get insulin,” another doctor added as Gosal stopped his remarks.

See previously: The Conservatives vs. the doctors and ‘Members of the Conservative government will be disrupted from this point on’

Jason Kenney invites you to thank him

By Aaron Wherry - Monday, July 9, 2012 at 1:21 PM - 0 Comments

The Internet is currently laughing about this petition set up on Jason Kenney’s website.

We, the undersigned, thank Jason Kenney for his efforts to streamline benefits afforded to refugees claimants under the Interim Federal Health Program (IFHP) and bring them in line with the benefits received by tax-paying Canadians, including new Canadians.

Mr.  Kenney seems to have sent the petition around in search of support.

The rabbis, the nurses, the doctors and the Nobel Peace Prize winner

By Aaron Wherry - Saturday, July 7, 2012 at 12:05 PM - 0 Comments

Elie Wiesel has joined with the Toronto Board of Rabbis to express concern about the Harper government’s changes to the health care provided to refugee claimants.

Meanwhile, in a letter—pdf here—to Immigration Minister Jason Kenney, representatives of the Canadian Association of Optometrists, the Canadian Association of Social Workers, the Canadian Dental Association, the Canadian Medical Association, the Canadian Nurses Association, the Canadian Pharmacists Association, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada applaud the recent clarification to the minister’s reforms and urge him to make further reconsider. They also offer to work with government officials to explore ways in which services for refugee claimants could be delivered more efficiently and effectively.

‘It’s a clarification’

By Aaron Wherry - Friday, July 6, 2012 at 12:15 PM - 0 Comments

The CBC obtains documents that add to the mystery of Jason Kenney’s refugee health care reforms.

A notice of looming cuts to health services for refugees was mailed to more than 104,000 beneficiaries — including about 14,000 the federal government now says won’t be stripped of their supplementary medical services — and opposition MPs say it shows the government has flip-flopped on a contentious policy change … ”The Interim Federal Health Plan has been reformed. As of June 30, 2012, benefits will be reduced for all current and future beneficiaries,” the notice reads. It goes on to say that “prescription drug benefits are being reduced for all beneficiaries,” and that “vision care, dental care, devices to assist mobility, home care and long-term care will no longer be covered.”

Canada to failed refugees: here’s a one-way plane ticket and $2,000

By macleans.ca - Thursday, July 5, 2012 at 10:49 AM - 0 Comments

The federal government is offering up to $2,000 and a one-way plane ticket to any failed refugee claimant who will voluntarily leave Canada. The program began in the GTA this week, and is said to be a humane and ultimately cost effective solution to the often drawn-out process of deporting failed asylum seekers.

Often, failed applicants remain in Canada for years after their refugee claims have been refused, and the federal government spends millions to track, monitor and then deport claimants who have gone “underground” to avoid deportation.

There are guidelines as to how the money can only be used by claimants who opt for this program. It can be used towards school, starting a business or finding work. Applicants receive more money if they apply for the program soon after their refugee claim is rejected.

To be eligible for the program, refugees must have no criminal record.

Did Jason Kenney change his mind?

By Aaron Wherry - Tuesday, July 3, 2012 at 10:37 AM - 0 Comments

Maybe.

There was no press release pointing to an eleventh-hour turnaround. In fact, in an an email to Postmedia News, the minister’s press secretary firmly denied there had been any change and said government-assisted refugees were never expected to lose supplemental benefits. “Minister Kenney has said multiple times that GARs would be treated the same as they are now,” including pharmaceutical coverage, said spokeswoman Alexis Pavlich, Kenney’s press secretary.

“We follow this very closely and we’ve never heard that from Minister Kenney,” says Dr. Med Rashid, a Toronto family physician and member of Doctors for Refugee Health, an ad hoc group formed to fight the changes. “We’ve called them out on this many times, pointing out that GARs are affected, and we’ve never had a statement from them on it.”

See previously: Kenney vs. Matthews, The Conservatives vs. the doctors and ‘Members of the Conservative government will be disrupted from this point on’

Kenney v. Matthews

By Aaron Wherry - Saturday, June 30, 2012 at 12:51 PM - 0 Comments

Ontario Health Minister Deb Matthews has written to Jason Kenney and Leona Aglukkaq—pdf here—to protest the government’s changes to health care for refugees claimants. The Canadian Press, CBC and Sun cover the back-and-forth. The Montreal Gazette explains the situation.

Under the changes to the Interim Federal Health Program, refugees from countries the minister deems safe, called Designated Countries of Origin, will only be covered for hospital services, services of a doctor or registered nurse, laboratory, diagnostic, and medications and vaccines if these are required to prevent or treat a disease posing a risk to public health or a condition that poses a risk to public safety.

Settled refugees or claimants from countries not deemed safe would be covered for all of the above, except medications and vaccines, which again would only be covered when public health or safety is at risk.

The Star editorializes.

Below, a partial transcript of Mr. Kenney’s comments yesterday. Continue…

The amazing milk machine sold one refugee on Canada

By Gabriela Perdomo - Saturday, June 30, 2012 at 6:40 AM - 0 Comments

Seen through the eyes of an 11-year-old, it was an adventure: escaping from Budapest; dodging military checkpoints; crossing the border into Austria, traversing cornfields at night; spending three months at a refugee camp. For Michael Newman, it was the trip of a lifetime when he and his parents left Hungary in the midst of a revolution against Soviet rule to emigrate to Canada. One snowy night in January 1957, his family and another 80 refugees landed in a military plane at the base in Goose Bay, Labrador, to refuel before continuing on to Ottawa. At 3 a.m., as the group was served a breakfast of eggs and sausages, Newman watched, incredulous, as a member of the Royal Canadian Air Force walked over to a dispenser and poured a glass of milk. The boy copied him, lifting the lever, letting the white, frothy liquid fill half a cup. He drank it quickly and ran back to his parents, mesmerized by the “amazing milk machine.” The soldier then approached with a large jug, gesturing toward the milk dispenser. “He took me by the hand and led me back to the machine,” Newman says, “and together we filled the jug to the brim.” He was sold on Canada. “Here was a country where you could drink all the milk you wanted,” he says. “No standing in line with your ration card.”

Fifty-five years on, Newman still sees that night as the beginning of a rewarding life. His family settled in Toronto, where he became a successful businessman, husband, father and grandfather. Recently retired, he now plans to work with refugees. “I know what they’re going through, and I want to help them,” he says. Newman still drinks milk every once in a while, and it always reminds him of the automatic cow and how happy he was to be in Canada.

Health-care coverage for refugees is about to change in Canada

By Julia Belluz - Thursday, June 28, 2012 at 4:44 PM - 0 Comments

Adrian Wyld/CP

“These reforms (to refugee health coverage) allow us to protect public health and safety, ensure that tax dollars are spent wisely and defend the integrity of our immigration system all at the same time.”—Immigration Minister Jason Kenney, June 27, 2012

When refugees or asylum seekers arrive in Canada, they receive basic health-care coverage and access to supplemental services such as pharmaceutical, dentistry, and vision care. But beginning on June 29, under reforms to the Interim Federal Health Program, this coverage will be scaled back. Way back. The biggest change is that refugees who are brought to Canada or who arrive here from countries the government considers “unsafe” will lose their supplemental health care benefits, such as the drug coverage. As well, rejected refugee claimants who are waiting to go home and those who arrive from countries the government has declared “safe” will basically lose all access to health care, unless their condition poses a risk to public health and safety.

Health professionals across the country are incensed about the changes, saying they amount to an inhumane, public-health disaster. Our Immigration Minister, Jason Kenney, maintains that this is a cost-cutting measure that will lead to $100 million in savings over the next five years, not to mention that the changes will actually protect public health and safety and deter health tourists from gaming the system.

Leaving impassioned rhetoric aside, Science-ish wanted to consider the evidence for refugees and health tourism, and what happens when you take health-care coverage away from people. Unfortunately, there wasn’t much: these reforms, it seems, are more ideology-based than rooted in good evidence.

Dr. Merrick Zwarenstein, senior scientist at the Institute for Clinical Evaluative Sciences, noted that the paucity of experimental studies speaks to a wider problem concerning our evidence for policies: it’s poor. “There’s a complete contradiction between how we decide what drugs work and how we decide on what policies and programs work,” he said. With the drugs, we use science, testing them with randomized controlled trials to try to get unbiased answers about their effectiveness. Not so with policies. We may do follow-up studies or track outcomes, but we usually don’t bother with randomization.

He thinks there are a few reasons for this, the major one being the lack of political will. “Policymakers are elected and promoted not on the basis of whether a policy works, but whether a policy is popular and electable,” says Dr. Zwarenstein. “So they are less interested in outcome, which often occurs years down the tracks after they have moved on.” Plus, he added, “Citizens are partly to blame because we don’t insist on a society in which we make the best use of the resources we have. We make decisions often on ideological grounds, when often these are not ideological questions. These are questions of pure pragmatism.”

The refugee health example is a case in point. Those who study evidence-informed policy making suggested looking to the U.S., since they’ve done some of the most robust experimental studies on the impact of moving people with no health-care insurance to coverage. This could be similar to the situation many refugees find themselves in when they arrive in Canada. One ongoing study in Oregon, which looks at citizens who are randomly assigned to health insurance, found that the insured spent an average of 25 per cent more on health care than the uninsured. So, it seems, leaving people without coverage could save on upfront costs, as Minister Kenney suggested.

Still, the insured in the Oregon study reported feeling healthier and happier than those who did not get coverage. They were less anxious about their well being, and there was a sharp decline in their medical debt and medical bills being sent to collection agencies. In other words, they were both more financially and physically sound. This left Katherine Baicker, an economist on the study, to note: “It’s up to society to determine whether it’s worth the cost.”

Our federal government grappled with the question of coverage for refugees and asylum seekers, and determined that it wasn’t worth the cost. Dr. Zwarenstein suggested that while other countries—including the U.K. and the U.S.—are moving to answer policy questions with the same rigour as pharmaceutical ones, Canada lags behind. At a time when we know more about the effects of drugs on our bodies than policy changes on our collective well being, the decision to chip away at the Interim Federal Health Program was made on the basis of political and ideological grounds. We should do better, especially with questions that determine who gets to live and who dies.

Science-ish is a joint project of Maclean’s, the Medical Post and the McMaster Health Forum. Julia Belluz is the associate editor at the Medical Post. Got a tip? Seen something that’s Science-ish? Message her at julia.belluz@medicalpost.rogers.com or on Twitter @juliaoftoronto