Cruel health care cut targets the most vulnerable

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By the mid-1990s, it was common for analysts to lament a rising culture of meanness. Public anger and government cutbacks seemed aimed at punishing those already struggling. Worse, the mood took hold at the very time the wealth and income gaps between the rich and the rest was expanding.

There’s a strong taste of that mood in the decision by Doug Ford’s government to wind down a pandemic program, established in March 2020, to give uninsured Ontario patients access to medically necessary care.

It was a program of the Health Network for Uninsured Clients, in a report released last week, said it had improved health outcomes and reduced financial hardships for those without insurance.

Under the program, clients — those on temporary work or study permits and those without legal immigration status — were less likely to wait until medical issues became severe or life-threatening to seek care.

The network recommended the program be made permanent. Instead, the government has decided to shut it down at the end of March.

The HNUC said the uninsured will again have to engage in lengthy negotiations with hospitals or advocacy groups — with the risks of worsening health that delays present — to find funding to pay for care.

Those delays in seeking care can mean a health condition that can literally make the difference between life and death. “Earlier access to care contributes to better outcomes for serious conditions like cancer and HIV,” the report states.

As of 2016, the HUNC report said, there were about 500,000 uninsured people living in Ontario. The reason someone is uninsured is often tied to their immigration status and can include those on temporary work or study permits and people who are “undocumented” or without legal immigration status, the report said.

Many of them, though often voiceless, perform important work. “I always say it’s people who are putting food on your table, people who clean your houses, clean your buildings, clean your garbage,” one clinic director told the network.

A social worker said the program relieved clients of the terrible choice between getting necessary care or paying for rent and groceries.

The fear, for the uninsured, is constant, the network was told. “You’re afraid to trip on the street, you’re afraid your child might fall.”

They face significant barriers to accessing health care, from unaffordable out-of-pocket fees, to systemic discrimination against racialized groups, low income people, immigrants and newcomers in general, the report said.

The Ontario Medical Association told the CBC that it estimated physicians in the community billed the province about $15 million under the program and there would be further costs for patients seen in hospitals.

For a government crowing about the windfall tax revenues pouring into its accounts to the tune of billions of dollars, the cost of this program is a pittance, a reasonable price for the considerable benefits in both health and peace of mind.

To have taken the ax to a small program supporting some of the most vulnerable people in Ontario said a lot about the Ford government, none of it good.

Former US President Franklin D. Roosevelt once said that the test of progress is not whether “we add more to the abundance of those who have much, it is whether we provide enough for those who have too little.”

The observation stands many decades later as a sensible means of identifying a government’s soul.