Immigrants are members of society too !!

It's difficult for policy makers to organize social services for immigrants. Most nations historically have had dynamic populations, so therefore immigrants shouldn't be excluded from social systems. However, I understand the other side that, especially in large nations, such as United States, it is difficult to maintain organizational stability (costs, access, etc.) if there isn't proper identification and knowledge of population size. That's not the immigrant's fault though, that's the government's fault for not organizing social services more efficiently. I believe immigrants should never be excluded from social services, they are humans in society too.

However, in Canada, one problem is that because of the United States' faulty health care system, many Americans travel to Canada to seek medical services taking advantage of the free health care. This actually in turn could be weighing down Canadian's system therefore marginalizing immigrants who actually live in Canada, but also don't have proper identification.

I don't know to what extent this is an actual problem, but it's just a thought. I was thinking of the part in "Sicko" when the American woman travels to Canada and gets rejected a couple times by clinics because she didn't have proper identification which made me think of true immigrants who had moved to Canada. They shouldn't be rejected health care!

moving forward

I think one of the biggest things that struck me as I read the article is that no system is perfect. Here in the US, as we struggle with our own system, we frequently look at other systems especially ones like in the UK and Canada which have a national health system as ideals for own healthcare system to move towards, but when we do this we forget that with each system comes problems. Each country no matter what healthcare system has trouble dealing with immigrants, illegal or legal but still trying to be integrated into the new system. Many people go without healthcare, and frequently health insurance for a variety of reasons. Some people can't afford it, some people don't know how to access it, some people don't know how to apply for insurance, or maybe even how to correctly apply for a new citizenship. This shows several inherent problems. I understand that especially in today's world countries cannot support all the people that may want to immigrate into their country, but we do need to create easier more effective systems for people to attempt to apply for citizenship. There should also be a similarly easy and efficient process to apply for health insurance. Making an application so difficult to read that one needs a Master's level education to correctly fill out the form is also a type of cherry picking just like screening for chronic disease or previous injury. Second issue, I am unsure how to deal with the problem of people choosing to move into a country, and either not applying for citizenship or having applied and not received approval still choosing to stay.

Finally my most important issue is access to healthcare. People need healthcare, whether they are rich or poor, insured or not, and citizen or not. When people fall through the crack in the insurance system, in the healthcare system and even in the government system it creates a major issue. We have seen in the US that hospitals are struggling with people coming into the ER because they know they can receive healthcare there. Then the hospital is left with unpaid bills, and frequently lack the beds for other patients. Maybe a potential way to try to start working on the issue would be to create a system similar to ones in other countries which offer physicians benefits for the number of primary care patients they see, but instead offer physicians benefits for seeing the uninsured or non- citizens in their primary care clinics in exchange for dropping their fee or perhaps creating a payment plan for the patients that takes into account their financial status or potentially other ways they can pay. I believe I read a newspaper article about some physician and other professionals in the US who worked on a barter system for services. This way patients can still be seen in the appropriate healthcare facilities, and there is less chance of people sliding through the cracks.

Canada: "Universal" Health Care

This article is authored by a Canadian writer and is fundamentally about Canada's "universal health coverage" however, the author uses examples such as, "A study involving 1283 women from 10 European countries,² for example, revealed that, compared with women born in their country of residence, foreign-born women were 3 times more likely to receive inadequate prenatal care; those without health insurance, however, were 19 times more likely."to prove the inadequacies of universal coverage in countries where immigrants and refugees are under served and under represented.

It is apparent that even in seemingly functional universal health systems such as those in Canada and the UK, there are flaws and the under served are still falling through the cracks. It was mentioned that many physicians and caretakers in Canada donate a portion of their time or do not take their fee when dealing with non insured patients. I would suggest to the Canadian government that they create some sort of program where they pay physicians a reduced fee for a few hours or ask physicians for a small amount of donated time per year at a free clinic for immigrants and refugees. The population will be triaged assuring that pregnant women and the most sick are seen in order of importance and are assured that they will not be turned away.