The categories of exclusion in the migrant access to health care in Canada: a comparative approach.

Abstract

Within the field of social rights, a prototypical example of situations of vulnerability is the right to health protection of migrants and its complex realization through universal access to the right to health care. During the recent period of economic crisis, the conditions of access to health care for migrants have undergone important reforms in different liberal states. For example, in Southern Europe, countries such as Spain, Greece and Italy have restricted universal access to health care significantly and sometimes incompatible with international standards of protection. Thus, this proposal seeks to observe the effects of the biased and progressive restrictive «globalization» of the right to health care for migrants at a different geographical latitude: Canada. On the one hand, it is proposed to review the different legal categories of migrants and those associated with the «sick immigrant» paradigm with a view to justifying why they are excluded despite the situation of vulnerability in which they find themselves. On the other hand, the categories of exclusion from the right to health of migrants are analyzed with special emphasis on the most important reforms and counter-reforms in Spain and Canada. From 2012, with the approval of the controversial Real Decreto 16/2012 and the effects of the Bill C-31 in the IFHP reform both have marked in qualitative terms a turning point in the protection of the right to health care for migrants and refugees in the Canadian and Spanish territory. However, despite the parallels, the fragmented access «by categories» to health care and the impact of the sick immigrant paradigm has given evidence of the dangerous tendency to perpetuate sine die through exclusionary categorization processes, serious situations of vulnerability, discrimination and social exclusion in global migratory contexts.

Summary

Introduction 1. The «migrant» and «sick migrant» categorization processes. 1.1 Different categories of exclusion associated with migrants and refugees in Canada. 1.2 The «sick/threat immigrant paradigm» and its accommodation in the migration and asylum law. 2. Restrictions in accessing health care among migrants and refugees in Canada: a trending topic, not only European. 2.1. The origin and nature of reform on the health care systems access in Spain and Canada. 2.2. Examples of exclusionary categorization in health care access in the IFHP 2012 reform and the Royal Decree Law 16/2012. 2.3. The Trudeau v. Sánchez «counter-reforms» and the scope of the sick immigrant paradigm in the case-law. Final Remarks