Immigration policy demeans the disabled
Canada has a long-standing policy of refusing entry to immigrants expected to place an “excessive demand” on health care. Disability advocates are asking the government to take a second look at how this approach demeans people with disabilities and overlooks their contributions to society.
This week, the House of Commons standing committee on citizenship and immigration heard submissions on medical inadmissibility criteria in the Immigration and Refugee Protection Act. Excluding applicants based on excessive demand, they concluded, is deeply flawed.
Not only does the provision violate Canada’s obligations under the United Nations Convention on the Rights of Persons with Disabilities, according to disability and HIV/AIDS advocacy groups, the criterion also is based on outdated stereotypes and faulty math.
A joint submission by the HIV and AIDS Legal Clinic Ontario (HALCO) and the Canadian HIV/AIDS Legal Network notes the threshold for excessive demand — set at $6,655 — is based on average annual costs for health and social services. While the Act specifies “excessive” financial strain, in practice, the cut-off targets “an anticipated health care cost of even one dollar more than the average per capita health cost.”
Medical expenses slightly above the mean average hardly qualify as “excessive.” Assumptions underpinning future costs also fail to account for the possibility applicants could switch to less expensive generic medications, or obtain private insurance coverage through an employer, once they are in Canada.
Merely raising the threshold, advocates agree, is not the answer. They argue assessing applicants through the filter of excessive demand effectively reduces individuals to the price of their treatment. This perpetuates badly dated and hurtful stereotypes of people with HIV and other disabilities as a burden to society.
This reductive approach fails not only morally, but also from a costbenefit perspective. As a tool for immigration, it undermines its own efforts to attract global talent by discounting the contributions of an entire class of skilled workers.
The Council of Canadians with Disabilities agrees assessing immigration candidates based on excessive demand is outdated and discriminatory. A more modern approach, it notes, would acknowledge many of the difficulties faced by people with disabilities are directly related to societal barriers.
Treating some expenses as a product of disability, rather than barriers to accessibility, is a bit like an employer trying to pin the price of installing ramps and accessible washrooms on employees who use a wheelchair.
Meanwhile, for HIV-positive applicants, the cost of medications is dropping, while advances in antiretroviral therapies have dramatically improved both longevity and productivity. “It is increasingly difficult to argue that people living with HIV incur greater costs to the destination country compared to the benefits they could contribute over a long-term stay,” UNAIDS noted in its 2014 Gap Report.
Tinkering with the formula for excessive demand is not enough, advocates contend, arguing the criterion should be repealed.
The standing committee’s current examination of medical inadmissibility takes place in the context of a sharp uptick in asylumseekers turning to Canada’s borders.
Our immigration policy rightly strives to maximize the economic, social and cultural benefits of immigration. This means supporting a strong economy with skilled workers in a variety of medical circumstances. It’s a good time to re-examine barriers to attracting the best and the brightest.