Written by Dr. Dominic Moran, Settlement Advisor (Economic), Saint John Newcomers Center
Canada promises newcomers comprehensive free healthcare but is struggling to keep that promise in the middle of a historic expansion of immigration.
Unfortunately, the country’s health systems are in a profound crisis that will impact your immigration experience.
A hidden problem, only known to newcomers and those providing settlement support, is that shifts in status between immigration streams and extreme application processing delays are leading to gaps in Medicare (New Brunswick’s health care) coverage due to the expiry of temporary cards. My wife and I are amongst the thousands impacted, having lost coverage months ago as we await new cards.
I recommend that clients look into private medical or travel insurance for early and interim Medicare waiting periods. The right policies can be challenging, with employer-supported coverage usually only providing supplementary care to Medicare.
Systemically, extreme access challenges are emerging, with many provincial and territorial systems on the verge of collapse due to a lack of medical practitioners.
The most obvious result for the general public has been the ballooning of wait times in emergency (ER) departments. Where the admissions staff deems cases not to constitute an immediate crisis, wait times can reach extremes across the country.
Here in Saint John, New Brunswick (NB), I’ve heard of ER waits from 12 to 14 hours. Several hospitals in smaller centers in the province were forced to close overnight ERs due to the absence of available nurse practitioners and/or doctors. For the local populations, this has often led to hours-long drives for emergency care in larger centers.
These problems are country-wide and are of particular concern for newcomers as we are often reliant in our early months in the country on clinics and ERs for essential medical services.
Once you are in the system, the delays continue. A recent annual survey found a record 27.4-week average wait for medical treatment over the last year.
COVID impacts and a failure to predict the required staffing levels necessary for a growing population by Service New Brunswick (SNB) has created a massive processing backlog for Medicare cards which newcomers require for free healthcare. Wait time estimates have reached eight months, with SNB workers unable to tell those applying when their cards will arrive. Similar card delays exist across the country.
In most instances, the retroactive payment of healthcare bills wracked up in this interim period is possible once the Medicare card finally arrives. However, there have been instances where coverage has been refused, resulting in medical debts for newcomers not dissimilar to those seen in the US.
Shifting gears, a significant issue faced by newcomer health professionals are identifying pathways to recognition of their professional credentials. These pathways differ from province to province depending on the biases of powerful professional associations. The fragmentation of authority between the provincial health authority and these associations makes this issue particularly fraught.
There is broad recognition that a lack of fundamental reform to allow newcomers to transition their international health experience to Canada at a professional level similar to what they had in their home countries will doom Canada’s health systems to terminal decline.
Nonetheless, it is essential to acknowledge the good.
When you have a valid Medicare card, a broad swathe of high-quality health services is free, including family doctor visits, specialist referrals, and hospital stays.
As settlement agency workers, we are here to help you negotiate these issues and ensure you and your family gain and retain access to free comprehensive healthcare.
Dr. Dominic Moran is the Settlement Advisor (Economic) of Saint John Newcomers Center (NB). The organization was founded in 2009; the purpose of the SJNC is to improve the cultural, social, and economic well-being of citizens and newcomers of all backgrounds to Greater Saint John and to promote equality for all cultural groups.