Commentary
By David Macdonald

The federal government is seeking $60 billion in spending cuts to pay for the doubling of the Department of National Defence budget. It’s now clear that asylum seekers in Canada will be among the first to pay the price. Of that entire $60 billion in cuts, asylum seekers and refugees will pay $1 billion of it.

Buried in a footnote of a recently released Parliamentary Budget Officer report, we discovered that roughly half of the cuts planned for the Department of Immigration, Refugees and Citizenship Canada (IRCC) will just be a massive service cut to asylum seekers and refugee health care.

The department believes that these people who arrived in Canada with nothing can pony up a quarter billion dollars a year to pay 30 per cent of their dental care costs and cover a new prescription co-pay.

No, they can’t and they won’t.

The shocking part about this “plan” is that, while IRCC is levying higher costs for preventative treatments like prescriptions and dental care on asylum seekers, it will still cover 100 per cent of the costs to go to emergency rooms or to visit a physician. This is a bizarre accounting exercise where you “save” money through co-pays, but the costs add up on the emergency health care side of the equation, which IRCC also pays for.

So, regardless of how we evaluate the morality of this decision to withhold health care to a vulnerable group of people who have been welcomed into our country, it is economically short-sighted and will negatively affect Canada’s bottom line. Here’s how:

Asylum seekers come to Canada with little to nothing, since they’re escaping dangerous conditions. Most won’t be able to pay the extra costs and will simply avoid dental care and filling prescriptions—until an emergency arises. Then they’ll end up in Canada’s emergency rooms.

Treating major dental infections is actually the most common day surgery for Canadian children and is one of the reasons why we just implemented a new Canadian Dental Care Plan. Preventive dental care avoids needless suffering and expenses for Medicare down the road. While we’ve made strides in removing dental care costs for families without insurance, we’re now re-imposing them on asylum seekers and refugees.

Millions of Canadians struggle to afford prescriptions due to co-payments—the type of co-payments we’ll now be forcing on asylum seekers. The direct result of co-payments is that people don’t fill prescriptions and skip taking much-needed drugs. The downstream impact of not taking meds for diabetes, cardiovascular disease and chronic respiratory conditions alone led to a quarter of a million unnecessary emergency visits for Canadians, something that will become much more common for asylum seekers.

IRCC’s stated goal for these cuts was “rationalizing programming, while upholding the government’s long-standing commitment to resettle the world’s most vulnerable.” But this has nothing to do with “efficiencies” and rationalizing programming. It’s just a straight-up public service cut to health care provision for Canada’s most vulnerable.

These cuts to health care at IRCC are now all queued up and start May 1.

It’s more expensive to deal with a problem in an emergency than it is to prevent it in the first place. That’s called the social determinants of health and the government should be making evidence-based decision-making to help everyone in Canada prevent health care problems, rather than cut budgets that will only worsen health outcomes.

You can’t cut $60 billion in programs and avoid service-level impacts. Asylum seekers’ health care is our first peek at what these major cuts will mean. We’ll pay more in the long run, asylum seekers will endure unnecessary suffering, and the Department of National Defence will keep swelling in size.

This is a short-sighted decision that will impose long-term costs on Canada’s health system. The federal government must find another way to pay for its plan to balloon the amount we pay on national defence. Perhaps they should start by reconsidering that plan.

David Macdonald is a senior economist with the Canadian Centre for Policy Alternatives.