On January 24, Mr. W. died in a Montreal hospital. Originally from Saint Vincent and the Grenadines, this 62-year-old illiterate man, appreciated by all, did not have access to the Quebec health insurance plan given his precarious migratory status. In July 2018, after more than 10 years in Quebec, he filed, with the help of a lawyer and community workers, an application for permanent residence for humanitarian consideration due to his fragile state of health.
For a long time, Mr. W. suffered from heart problems and complex diabetes, which led to infections, amputation and significant loss of sight, and which led to him being in the emergency room several times without any possibility of medical follow-up. It was not until December 2020 that he was finally taken care of by a healthcare team, who found that his condition had greatly deteriorated, to the point where only palliative care could be considered.
Shortly after this diagnosis, he tested for COVID-19, which came back positive. Despite the progress of his immigration procedures and the obtaining of discretionary access to the Régie de l’assurance maladie du Québec (RAMQ) one month before his death, it was already far too late for Mr. W. to be able to do so. to be saved.
This is just one case among thousands of others: according to an estimate from the SHERPA University Institute, 40,000 to 70,000 people do not have health insurance in Quebec.
Ontario did it
However, the situation is quite different in the province of Ontario which, as of March 23, 2020, extended its health insurance coverage to all people living in its territory, regardless of their immigration status.
Even today in Quebec, people waiting for their permanent residence or the regularization of their status, certain temporary workers as well as international students are still excluded from provincial health insurance. .
If, since March 31, 2020, these people have good access to screening tests and health care strictly related to COVID-19, this is far from sufficient in a context of health emergency. Indeed, the technical distinction between care and services directly linked to COVID-19 and other general care and services weighs down the work of frontline healthcare teams and places health professionals before a very difficult choice. .
These extremely cumbersome administrative procedures in a context of health crisis and lack of resources, in addition to causing significant and unacceptable inequities, are not without impact on the health of the population and on public health efforts.
After more than a year of pandemic, it is time for the Quebec government to ensure that no one falls through the cracks!
We need a humanist approach
The current crisis exacerbates the vulnerability of people with precarious migration status and multiplies the obstacles they encounter in accessing health care: slowing down of immigration procedures; Job Loss ; ineligibility for government assistance programs; employment in essential sectors exposing them to COVID-19, etc.
Indeed, their fear of authorities and the financial implications of health care prevents them from using available services. Did you know that people who do not have health insurance are billed for health care and services received with a 200% mark-up? Or that because of the curfew, many of them avoid the travel necessary to access health care, or sleep in their workplace for fear of being checked by police officers? This context of crisis requires a more humanistic approach, especially towards these vulnerable people who make a real contribution to our society.
We therefore ask the Government of Quebec to show humanism and guarantee, without delay, access to health coverage for all people living in Quebec, regardless of their migration status.
Dr David-Martin Milot, President of Médecins du Monde Canada
Dre Alex-Ane Mathieu, President of Young Doctors for Public Health
Alliance of cultural communities for equality in health and social services (ACCÉSSS)
The Anonymous
Quebec Association of Preventive Medicine Specialists (ASMPQ)
Quebec Association of Dependency Workers (AIDQ)
Quebec Association of Immigration Lawyers (AQAADI)
Quebec Public Health Association (ASPQ)
Center for women from here and elsewhere
Fair Solutions Legal Clinic
L’Actuel medical clinic
Collective Together with migrants against racism
Montreal Diet Dispensary
Quebec Federation for Family Planning (FQPN)
League of Rights and Freedoms
Inter-sectoral group of community organizations of Montreal (RIOCM)
SHERPA University Institute
Table de concertation des organizations serving refugees and immigrants (TCRI)
Table of Montreal Community AIDS Organizations (TOMS)
May Chiu (lawyers)
Janet Cleveland PhD (researcher)
François Crépeau (Professor, Faculty of Law, McGill University)
Marie-Andrée Fogg (lawyer)
Julius Grey (avocat)
Marianne Léaune-Welt (social worker)
Robert Leckey (Professor and holder of the Samuel Gale Chair, Faculty of Law, McGill University)
Claude Provencher (lawyer)
Cory Verbauwhede (avocat)
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