Temporary foreign workers need Medicare on arrival

The Canadian public health care system hasn’t been living up to expectations recently. Emergency rooms have closed, and surgeries have been postponed. Patients have died waiting for health care in New Brunswick’s emergency rooms. While accessing comprehensive public health care is a challenge for many across this country, many temporary foreign workers who work in New Brunswick’s seasonal industries must navigate illness and injury without a Medicare card.

In New Brunswick, those entering from outside Canada must prove they will reside in the province for at least one year. Many of the temporary foreign workers in our province work on six- to eight-month work permits and many return to their home countries during the off-season. This means that they may never qualify for Medicare.

The Madhu Verma Migrant Justice Centre has been told by representatives of Service New Brunswick and the Department of Health that the province considers Medicare applications of seasonal migrant workers who return every year on a case-by-case basis. Given the many barriers that migrant workers face accessing health care, the Madhu Centre would like the province to grant Medicare on arrival to temporary foreign workers.

The federal government requires employers of temporary foreign workers to provide their workers with private health care insurance. However, this private insurance is not nearly as comprehensive as public health care. Many private health care insurance plans cover the cost of many medical consultations and procedures at a rate of up to 80 per cent, but even still, the worker is left to pay the remaining 20 per cent of the balance out of pocket.

A hospital staff person at the Dr. Everett Chalmers Regional Hospital in Fredericton, who wishes to remain anonymous, told us the average fee for an outpatient visit is $626. A temporary foreign worker with the typical private health care insurance plan would be left to pay the remaining 20 per cent balance of $125.20. This amount represents more than what a worker would stand to make in one full day at a minimum-wage job. If a worker requires further treatment, they must also finance 20 per cent of those costs as well. All of these costs would be covered if the patient had Medicare coverage.

A number of horror stories are currently circulating in the media, including one temporary foreign worker who is required to pay $30 every time they visit the doctor, another worker who had to pay $1,000 out of pocket for an ultrasound, and a third who is currently fundraising to pay for dialysis treatments.

The inability to access Medicare coverage is not the only challenge temporary foreign workers face when attempting to access health care in Canada. The 2023 report, “Unfree Labour,” about migrant workers in New Brunswick’s seafood plants by Raluca Bejan at Dalhousie University, Kristi Allain and Tracy Glynn at St. Thomas University, and Paola Soto Flores at the Cooper Institute found that workers were not given adequate information about accessing health care.

Furthermore, workers often experience inadequate living conditions and occupational hazards, which put them at a greater likelihood of requiring health care, as noted in the 2022 report by Emilio Rodriguez with Citizens Public Justice and Tracy Glynn with the Canadian Health Coalition, “Work, Study, Pay Taxes, But Don’t Get Sick.” In addition, these researchers have noted many temporary foreign workers live in the more rural areas of the country with no public transit, making it harder for them to access health care services.

The argument against affording temporary foreign workers with Medicare coverage tends to be that these workers are not contributing to Canada’s economy because their inco mes are often sent back to their countries of origin to support their families. However, temporary foreign workers are in fact required to pay both provincial and federal income taxes on their earnings, as well as sales taxes on their purchases.

But what happens when someone loses their immigration status? Their home? Their ability to pay taxes? Do they not deserve health care?

Health care delayed is health care denied

A 2018 United Nations Human Rights Committee decision found Canada had violated Nell Toussaint’s right to life and non-discrimination by not giving her access to life-saving health care. Toussaint experienced workplace abuse and eventually lost her status to stay in the country. She went years without accessing the health care she needed. The plaintiff in a historic lawsuit to push Canada to grant irregular migrants access to essential health care died this year but her advocates are determined to realize Toussaint’s dream.

The current Canadian public health care system that prides itself on its universality neglects temporary foreign workers, often leaving them to pay out-of-pocket for health care or to forgo those services altogether, even though they are more likely to need these services. Health care is a right and should be accessible to all individuals, regardless of their immigration status.

Andrew Clark, Erin Cunningham, Seiku Diakite and Rylee Hopkins are students completing their Bachelor of Social Work degrees at St. Thomas University and a social action placement with the Madhu Verma Migrant Justice Centre. The Madhu Centre advocates for reforms and systemic changes aimed at protecting the rights, equality, and dignity of migrant workers in New Brunswick and beyond.