When Jasmine, a young engineer from Iran, arrived in Toronto, she immediately applied for the Ontario Health Insurance Plan (OHIP).
She knew she had to wait three months to receive her health card, but since she was generally healthy, it didn’t occur to her to look for an alternative health insurance while waiting for OHIP.
January, however, was extremely cold and just three weeks after Jasmine landed, she fell sick. She had a high fever and, due to acute laryngitis, lost her voice. Over-the-counter medicines didn’t work and she had to see a doctor.
Her visit to a walk-in clinic, as well as her treatment, cost more than $200. “This was so expensive,” she says, “but it could have been worse.”
Insufficient knowledge is one of the biggest barriers newcomers in Canada face when they seek medical help. Often, the mistakes they make can be prevented if they receive guidance and accurate information about the ways the Canadian health-care system works.
To avoid unexpected high medical expenses during the first three months after arriving to Canada, Marwan Ismail, executive director at Polycultural Immigrant and Community Services, advises newcomers to buy travel insurance.
“It is really important to be insured. Treatment is very expensive in Canada.”
“You go to the doctor,” he explains, “you pay, and then you send the claim to your travel insurance company, which will reimburse you.”
This is something Ismail’s team at Polycultural underlines for many newcomers who don’t know how health insurance works.
“It is really important to be insured,” Ismail continues. “Treatment is very expensive in Canada.”
Ismail cites, for example, that elderly people can easily fall and have a fracture. If they need a surgery and have to stay in the hospital for two or three days, the bill could reach about $50 000.
“Some newcomers think, ‘Why should I to pay $50 per month just to be insured?’ Well, $50 may save you $50 000 – you never know,” he says.
Seeking help
People who have no health coverage at all may be eligible for treatment at a community health centre, but these centres – depending on the location – often have extensive waiting lists and it may take several months to see a doctor.
Not knowing where to seek medical attention, many newcomers go to the emergency departments at hospitals – even if their conditions are far from critical.
The large number of new immigrants who go directly to the emergency departments has recently provoked discussions at Health Canada.
The large number of new immigrants who go directly to the emergency departments has recently provoked discussions at Health Canada.
“There are newcomers who don’t know how to find family physicians; some don’t even understand what an appointment means,” says Nadia Sokhan, director of monitoring, reporting and partnerships at Polycultural. “But they easily learn what 911 is and can also go to the emergency.”
Those who are not insured are often surprised with very high bills when they go to emergency. On the other hand, for those who have provincial coverage, their treatment costs much more to the government than if they had gone to family physicians or to walk-in clinics.
“Each visit to the emergency department costs the Ministry of Health about $975,” Ismail explains. “Even if the person just has a cold, the hospitals would send the Ministry a $975 bill – while if the patient goes to a walk-in clinic or to a family doctor, it would be about $30. So it is very important to educate the newcomers and make them understand the importance of having family physicians – this is in the best interest to everyone.”
Cultural sensitivities
Finding a family physician, however, can be challenging for newcomers.
There are some immigrants who prefer to be treated by doctors who come from the same countries of origins, speak their language and understand their culture.
Gender can also be an issue for newcomers from certain parts of the world – mainly the Middle East and South Asia Ismail says – as some would like to see a family doctor who is of the same gender.
For an immigrant living in a multicultural city like Toronto or Vancouver finding a family physician with the same cultural background is more likely, but even then the physician’s practice can be far from the place the immigrant lives.
Gender can also be an issue for newcomers from certain parts of the world – mainly the Middle East and South Asia, Ismail says – as some would like to see a family doctor who is of the same gender.
Some newcomers find family physicians by asking people from their ethnic communities. Others search online.
In Ontario, for example, the website of the Ontario College of Physicians and Surgeons offers an “all doctors search” option with information about physicians’ genders, the languages they speak, the areas they practise and their training and qualifications.
Not all the listed physicians accept new patients though and some of them have waiting lists. While waiting, newcomers can still use the walk-in clinics and, if necessary, find interpreters to accompany them.
While across Canada there are organizations that provide new immigrants with information about the Canadian health-care system, there is a growing number of newcomers who still don’t know about these resources. As such, this is the first of an occasional series by NewCanadianMedia.ca that will look into access to health care for immigrants.
