Monday, February 27, 2012

Imposed waiting period for insurance can make health problems worse, critics say

Newcomers can not OHIP coverage for the first three months they are in Ontario. Refugees should be covered by a special federal health plan, but it is not popular among doctors, who say it takes too long and too bureaucratic. The result, critics say, is that newcomers to delay seeking treatment until the wait is over, causing health problems worse and in some cases, danger to public health.

Recent research suggests that most newcomers arrive in Canada healthier than the native Canadians, think that the health advantage over time. Statistics Canada studies show that recently arrived Canadians born in Asia and Africa have much lower mortality rates than white Canadians, but the mortality rates for immigrants in Canada more than 30 years later, even when age comes from the equation

Last month the Ottawa Board of Health with the Toronto counterpart, health agencies and even the Ontario Medical Association in calling on the province to avoid the wait, especially when it comes to patients with tuberculosis.

Councillor Diane Holmes, president of the Ottawa Board of Health, a letter in January to Ontario Health Minister Deb Matthews informed her of the resolution of the council against the guards and the "lawyer of that new immigrants who tested positive for latent tuberculosis infection, are capable of immediate OHIP coverage to make timely and effective treatment to the development of active tuberculosis disease to receive. "

Tuberculosis is contagious and public health challenge worldwide. Potential immigrants must pass a test for tuberculosis before they are issued visas, but cases of latent TB may go unnoticed.

There are approximately 1,600 cases of active tuberculosis in Canada, half in Ontario. Most cases are found in immigrants from countries with high rates of TB, and they run the greatest risk of developing active tuberculosis in the first five years they are in Canada.

The waiting period applies to all new and returning residents and is intended to give the province time to a person eligible for the insurance to confirm, David Jensen, spokesman for the Department of Health and Long-Term Care, said Monday. "Providing an exemption from the three months waiting period for only certain groups can the fair and equitable application of the Ontario Health Insurance Act to other residents who also need medical care during the waiting period for health insurance to increase guarantee," said Jensen.

Only British Columbia, New Brunswick and Quebec have similar waiting times, and Quebec are exceptions for tuberculosis.

Dr. David McKeown, chief medical officer of health of Toronto, says that if a patient tests positive for TB, will OHIP pay for the drugs, but patients are still responsible for any other treatment costs, including hospitalization, which can amount to tens of thousands of euros . Even if the patient tests positive, he or she must pay the cost of the initial assessment.

"The three months waiting period should be abolished," says McKeown. "The dilemma of a newcomer with a bad cough that she must decide whether to wait out, or do the right thing and get evaluated."

The county advises newcomers to buy private health insurance but that is not always enough, says McKeown. He cited the case of a Toronto immigrant who bought private insurance. When he later was diagnosed with tuberculosis, the insurer denied his claim, arguing that a prior medical condition.

"He did the right thing for himself, his family and the general public, but he ended up with a bill for $ 20,000," says McKeown. "It is a particularly clear example in my head of how the three-month waiting period does not work."

Jensen points out that immigrants are welcome to treatment at community health centers, funded by the province to search. But one of the most vocal groups calling for an end to the waiting time is the right to health Coalition, of which 30 community health centers, hospitals, settlement agencies and others represent. Jack McCarthy, executive director of the Somerset West Community Health Centre is on the board of the Canadian Alliance of Community Health Centres.

"People are encouraged to come here and then they come right off the bat," said McCarthy, who is also head of the health committee of the Ottawa Local Immigrant Partnership, a planning group working on ways to integrate immigrants. "It is a massive bureaucratic barrier, especially for the vulnerable, overwhelmed newcomer."

The Ontario Medical Association examined the issue last year in response to reports of the physicians, says Dr. Stewart Kennedy, association president. They found that not only patients with tuberculosis who are trapped in the waiting period for insurance.

"Many emergency physicians be unloaded without OHIP coverage against immigrants," said Kennedy, a physician in Thunder Bay. "They were uncomfortable for anyone to turn away from the emergency department a part of their needs were acute - .. Things like diabetes and chronic diseases, the best managed in the office of a doctor"

The OMA released a paper last year to say that not to wait three months to bring taxpayer money, risk to the health store.

"The intention is to save money, but it is not because there is a peak in the OHIP bills after three months and more acute medical cases," says Kennedy, citing a 2004 study in the Canadian Journal of Public Health. "It just felt like - if it does not save any money, why?"

The waiting period is also intended "to a reason for people moving to Ontario recently exclusively for the acquisition of the insured medical services, without the plan to make Ontario their principal residence to create," says Jensen.



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