Healthy Nations Need Healthy Boundaries

Commentary, Healthcare, Lee Harding

Are you a big-hearted person who likes to help everyone? If so, you probably suffered a phase where you offered too much of yourself—heart, time, and money. Then you realized if you gave out too much, you would just plain give out. Despite your best efforts, there would always be more people in need and you might as well not make yourself one of them. You had to respect yourself and your loved ones, then offer only what you could—not more. Healthy people establish healthy boundaries and develop the strength to say no. Yet, if Canada were a person, the United Nations would tear down her fence, duct tape her mouth, and put her arms in chains to serve without payment every stranger who knocked on her door.

This was recently proven in the case of Nell Toussaint, a citizen of Grenada who came to Canada on a six month visitor’s visa and never left. It wasn’t until 2008 that she applied for permanent residency. Perhaps, she was purportedly too tied up before that due to poverty and deteriorating health. This claim parroted by the media seems dubious, given that court records show she worked under the table as a cleaner, caregiver and babysitter willingly out of the government’s sight. In 2006 an abscess and chronic fatigue took her down.

By 2008, a host of poverty and rights groups were ready to help her get everything she could for nothing. Toussaint applied for permanent residency but declined to pay the $550 fee. She claimed because she suffered poverty due to discrimination, she deserved it. Toussaint was refused. No fee, no permanent residency. Low Income Families Together, and the Charter Committee on Poverty Issues took her case to the federal court, but lost. She also applied to be a temporary resident, again without the fee, and was refused.

In the meanwhile, Ontario gave her welfare, though not health care. At that point, she applied to the Interim Federal Health Program for refugees, even though she had not claimed to be a refugee and had no basis for such a claim. Upon refusal, she went to the Federal Court, then the Federal Court of Appeal, losing both times. The Supreme Court wouldn’t hear the case.

Right on cue, the NGOs cried out, “Rights, rights,” for Toussaint, and “Shame, shame” on Canada. Lawyers from the Social Rights Advocacy Centre, appealed to the United Nations (UN) Human Rights Committee, as did Amnesty International (AI). AI reminded the U.N. that in 2004, in the International Convention on the Elimination of All Forms of Racial Discrimination, it decreed that “xenophobia against non-nationals, particularly migrants, refugees and asylum-seekers, constitutes one of the main sources of contemporary racism.” Therefore, nations had to “respect the right of non-citizens to an adequate standard of physical and mental health by…refraining from denying or limiting their access to … health services.”

According to AI, Canada could not say “no,” or even the word, “illegal.” Its submission continued, “The use of the term ‘illegal’ is incorrect and inappropriate. It reinforces negative stereotypes against migration and legitimates a discourse of the criminalization of migration.” This means everyone who wants into Canada should get there, get unlimited care. Any discussion on open borders is illegitimate.

After taking three years to think about it, the United Nations decided to agree with itself. In mid-August, its Human Rights Committee declared, “Member states cannot make a distinction, for the purposes of respecting and promoting the right to life, between regular and irregular migrants.” Therefore, Canada should compensate Toussaint and “review its national legislation to ensure that irregular migrants have access to health care.”

The federal government should reject this non-binding decision. Canada has a long history of relatively open immigration with generous supports. If the world has anything to teach Canada, it’s not how to treat migrants, but how to deliver health care for its own.

European countries cover a broader range of medical services but usually require users to cover a portion. In Canada, users pay nothing or everything, depending on what it is. For doctors and hospitals, it’s taxpayers all, users zero. Here, the principle of moral hazard applies: any service offered for free will be overused. Perfectly socialized services mean few choices and no guarantees except long lineups for mediocre care. This already sends 63,000 Canadians to spend money in other countries each year as “medical tourists,” and will unlimited free health care to “irregular” migrants lessen that total?

Strangely, Canadians must pay the entire bill for certain health services, with no federal coverage. Dentistry, eye care, medications, and ambulance services are but a few. Even here, however, taxpayers will cover those with rights: status Indians, prisoners, and refugee claimants. Irregular indeed.