In Quebec, about 50,000 people do not have access to health insurance coverage because of their precarious immigration status, according to an estimate by the SHERPA University Institute.
Posted at 10:00 a.m.
Among them are women like Paula, for whom pregnancy has turned into a nightmare. Paula lives, works, pays taxes in Quebec, but she is waiting for a sponsorship, which does not allow her to have access to care covered by the Régie de l’assurance maladie du Québec (RAMQ) . The joy of the first moments with her baby quickly turned into anguish. How do you pay for each visit to the clinic or the emergency room when you live on minimum wage and you already have a family to feed? How do I raise $10,000 for the deposit required before giving birth? How to pay off debts related to childbirth billed three times as much – up to $20,000 and even more?
Recognizing this critical situation following the adoption of Bill no.oh 83, the Minister of Health and Social Services, Christian Dubé, mandated an interdepartmental working group led by the RAMQ to identify possible solutions for pregnant women without health coverage.
However, women’s right to health cannot be limited to the moment when they are pregnant. They must also have access to the other essential sexual and reproductive health services they need throughout their lives: family planning, termination of pregnancy, gender-based violence, prevention, screening and treatment of sexually and sexually transmitted infections. blood (STBBI) and cancers of the reproductive system.
Each year, nearly 300 migrant women – pregnant or not – who do not have health coverage or the means to pay for care present themselves in a critical situation to the Médecins du Monde clinic in Montreal. This was the case of Angelina, aged 54 and originally from Grenada, who had lived and worked in Canada for 30 years, without status, as a domestic helper. In 2019, she was diagnosed with advanced cervical cancer, which took her away two years later. She would still be alive if she had been able to receive care in time.
These women are therefore even more precarious. They bear a disproportionate economic and social burden that has consequences on other determinants of their health, such as access to housing, healthy eating and social inclusion, in addition to having repercussions on public health. For example, risk of development and spread of infectious diseases and STBBIs.
For this reason, Doctors of the World and a coalition of health organizations have made recommendations in a brief1 sent to the Ministère de la Santé et des Services sociaux (MSSS) and the RAMQ on March 17, in order to demonstrate that all women should have access to health services related to pregnancy, but also to other essential sexual health services and reproductive.
An economic, public health and solidarity issue
Unlike many American states and European countries, Quebec leaves out many women who work and live here. Denying them access to healthcare makes no sense from a medical, economic or public health point of view.
Guaranteeing coverage of Quebec’s public health and drug insurance plans for all women living there, with regard to essential sexual and reproductive health services, can alleviate the pressure on the health system.
On the one hand, by reducing the work of the healthcare teams, and on the other hand, by avoiding late and therefore heavier and more expensive care. This is a humane and effective solution that should be part of the plan to overhaul the health care system between now and the next election.
Last year, the Government of Quebec showed political courage by providing access to health care to all children living in Quebec. As professionals committed to the right to health, we hope that the government will continue its leadership by guaranteeing access to essential sexual and reproductive health services for every woman living in Quebec, regardless of her immigration status. It is a fundamental right whose implementation will clearly benefit society as a whole.
* Co-signatories, volunteer doctors: Noémie Johnson, Loree Tamanaha, Nicole Seben, Charles Giroux, My Lan Graziani, Marie-Claude Goulet, Minh Thi Nguyen, Vanessa Bombay, Louis-Christophe Juteau, Anne-Sophie Thommeret-Carrière, Suzanne De Blois, Agnès Cailhol, Clairelaine Ouellet-Plamondon, Marie-Hélène Marchand, Christine Arsenault, Audrey Cournoyer-Roy, Carole Balthazard, Marie-Claude Moore, Maude Bernard, Élise Gonthier, Myrill Solaski, Sara Vadnais-Dionne, Sophie Poissant, Chiraz Chaalala, Camille Gérin, Lucie Maynard, Samir Shaheen-Hussain, Caroline Grégoire, Eve Blais, Delphine Boury-Simoes, Juan Carlos Luis Chirgwin