The Mandated 3-Month Wait for OHIP Coverage
By Shalu Atwal
While the Canadian health care system is widely touted for its universality, three provinces – Ontario, Quebec[1] and British Columbia – do not allow landed immigrants[2] to access provincial health care coverage until three months after their arrival.[3] According to a piece published by the Toronto Star, entitled “Ontario urged to eliminate OHIP wait,” there are two main rationales behind this policy.[4] First, the policy operates as a cost-saving measure. The three-month wait has supposedly resulted in $90 million in savings per year for Ontario. Second, delaying access to federally-funded health care serves to discourage medical tourism. In other words, the three-month wait disincentivizes persons moving to Ontario for a brief period of time solely for the purpose of taking advantage of free medical services. Instead, the Ontario Government provides alternatives for landed immigrants, including advising immigrants to obtain private insurance before arriving to Canada.[5] The government also funds several Community Health Centres (CHC), which provide primary care free of charge.[6]
However, critics of the policy maintain that these alternatives are inadequate. Private insurance is often not purchased because it is incomprehensive (e.g. emergency-oriented rather than preventative) or too costly.[7] The CHCs also have their barriers; for instance, Scarborough’s only CHC reported a waiting list of 3,000 uninsured newcomers seeking to access health care.[8] Regarding the policy itself, critics argue that it is not only arbitrary (why not impose a two-month wait instead?), but also ineffective. The Ontario Medical Association (OMA), which publicly advocates for the elimination of the wait, stated in a review paper that any immediate savings gained by not providing insurance to newcomers were subsequently depleted.[9] Immigrants without health coverage often seek primary medical care at hospital emergency departments, an expensive and already overcrowded part of the health care system.[10] Moreover, the OMA found that immigrants tend to delay seeking care until the three-month period is over.[11] Not only can this compound costs, as illnesses can worsen over time, but it also poses a danger to the broader community from a public health perspective. A former president of the OMA, Dr. Mark MacLeod, stated: “whether a person has an infectious disease, an urgent health event, an accident, or a chronic illness, the best possible outcomes will be achieved when the person seeks medical care as quickly as possible.”[12]
Critics also argue that the mandated three-month wait for health care coverage violates the right to health.[13] A right to health is recognized by numerous international instruments, including the Universal Declaration of Human Rights. However, while Canada is a signatory to the Declaration, it is not, in itself, binding law in Canada. In fact, Canada has not yet recognized a legal right to health.[14]
Even so, opponents of the three-month wait for OHIP coverage emphasize that its removal is the “right thing to do.”[15] When New Brunswick eliminated the wait, the Health Minister, Mary Schryer, echoed this sentiment, stating:
“Removing the three-month waiting period is the right thing to do… Our government recognizes that removing this barrier will enhance access to health-care services for immigrants…”[16]
[1] There are exemptions to the three-month wait in Quebec for infectious and communicable diseases and women are provided care for pregnancy, domestic violence, or sexual assault.
[2] This wait also applies to former residents returning from abroad.
[3] Caulford, Paul and Jennifer D’Andrade. “Health care for Canada’s medically uninsured immigrants and refugees.” Canadian Family Physician. 2012. 58: 725.
[4] Keung, Nicholas. “Ontario Urged to Eliminate OHIP Wait | Toronto Star.” Thestar.com. Toronto Star, 3 Feb. 2011. Web. 14 Jan. 2016.
[5] “OHIP Coverage Waiting Period.” Ontario Ministry of Health and Long-Term Care, 1 Dec. 2011. Web. 14 Jan. 2016.
[6] “Community Health Centres.” Ontario. Government of Ontario, 9 Sept. 2015. Web. 14 Jan. 2016.
[7] Elgersma, Sandra. “Immigration Status and Legal Entitlement to Insured Health Services.” Parliament of Canada. 2008. 7.Parliament of can not only compoitlement to Insured Health Services.”s oned: hese words: ruary 2012. , . This can not only compo
[8] Caulford, Paul and Jennifer D’Andrade 725.
[9] Ontario Medical Review. “Reviewing the OHIP Three-Month Wait.” 2011. 13.
[10] Ibid. 14.
[11] Ibid.
[12] “Three-Month Wait for OHIP.” Ontario Medical Association. 2016. Web. 14 Jan. 2016.
[13] “Right to Health Care Coalition.” Access Alliance. 2015. Web. 27 Jan. 2014.
[14] “The Health of Canadians – The Federal Role: Final Report” Parliament of Canada.
[15] Goel, Ritika and Michaela Beder. “Welcome to Canada…but don’t get sick.” CMAJ. 2012. 184(1): E103.
[16] Ontario Medical Review 17.
