Friday, March 28, 2014

Canadian Healthcare: Not as Universal as Some Might Think

In Canada, every baby born in Canada, is Canadian (*with the exception of some babies who might be born to diplomats). It doesn't matter where that baby's parents are from - and as a Canadian every baby born in Canada is entitled to access to the publically funded Canadian healthcare system. But, when should that baby's right to publically funded healthcare begin? Should that baby have different access, because of the origin of one or both of it's parents than another baby also born in Canada? Should it matter if that baby's mother is Canadian or if it's father is Canadian? Should it make a difference if, at some future point, that baby's mother will be eligible for publically funded Canadian healthcare?

It may come as a surprise - but, access to publically funded healthcare in Canada is not universally available to all pregnant women in Canada.

There are pregnant women in Canada who are uninsured and must pay out of pocket for healthcare services related to pregnancy and childbirth - many of whom intend on making Canada their home, many of whom are carrying the children of Canadians, many of whom will ultimately have access to publically funded health services.

The fact that these women will bear Canadians, and might well become Canadians or otherwise entitled to access to publically funded healthcare seems a fact that has gone unrecognized by whoever thought it was a good idea to exclude access to publically funded health services from these women.

I imagine the intent was to save healthcare resources for the Canadians who pay for the system - but I will argue that this policy is not only cruel, it is short-sighted and might well cost the very same healthcare resources it was intended to save.

Pregnancy and childbirth are exceptional times in a woman's life - at no other point is the health of both woman and child more vulnerable. At no other time is the health of the child so intertwined with the health of its mother. Care during pregnancy and childbirth matters - a lot. What is done or not done - echoes for the rest of that woman and that child's life. If access to high quality care is delayed or denied, there are consequences - both physical and psychological. Access to that care should not depend on the mother's ability to pay for it.

Right now, the policy is that unless you are Canadian or a landed immigrant you are not entitled to publically funded health care, and if you happen to be in either British Columbia or Ontario there is a three-month waiting period for eligibility - so if you were a Canadian living abroad who recently returned, you might also find yourself excluded from publically funded health services. It doesn't matter that there is a massive back log that impedes the processing of immigration applications. It doesn't matter that you may be married to a Canadian or that the baby's father is a Canadian. It doesn't matter that you would ultimately become eligible for publically funded health insurance or that the services that you are seeking to access are considered "basic care".

So what does this mean?

This means that the health and well-being of mothers and children in Canada might be at risk. This means that basic care might be foregone if the mother cannot afford to pay for it or if doctors and charities are inadequately resourced to provide it. This means that conditions that can be managed or diagnosed prenatally might go undiagnosed and unmanaged. This means that a mother might decide to give birth unassisted or at home, even though a hospital based birth might be better suited to her needs and those of her child. This means that some of the truly adverse consequences of pregnancy and childbirth - some of which might be avoided with better care - will be realized.

Who will pay for those left disabled as a result of inadequate care during pregnancy and childbirth?

Here's a hint, pregnancy and childbirth is far more dangerous for babies than it is for mothers. Those babies are Canadians. They are likely to pay with their lives or their health - and if they pay with their health, guess who is on the hook? Guess which resources will be used? Further, if the mothers eventually become eligible for access to publically funded healthcare - who will pay for the longer run consequences of inadequate care during pregnancy and childbirth?

Is it not better, to pay for an ounce of prevention? Is it not more fair to give every baby born in Canada the same access to healthcare - even before their births - regardless of whether it happens to be their mothers who are Canadian or their fathers who are Canadian?

Pregnancy and childbirth are exceptional - and are deserving of an exceptional policy response that recogizes the need to meet these health needs for these women and these children.

I encourage my reader's to sign the following petition demanding change to this shameful policy.

Background information:

- Uninsured mother's likely to have inadequate prenatal care.

- Tyee article on uninsured mothers in Canada.

- Mother gives birth in Hotel due to uninsured status.

- Canadian doctors call for action on uninsured.

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