Saturday, February 4, 2017

Canadian Effort to Bring Patients Banned from U.S. Faces Restrictions on Sick People Entering Canada

Canada can reject you based not just on how sick you are but how much the illness will cost the state.

By Ed Krayewski of Reason.
"Among the people banned from entering the United States for at least the next six months are many patients who had arranged for healthcare services in the country. The United States has among the best (and still the freest) healthcare systems in the world, and is the destination for many sick people with the need for specialized care often not available in their home countries.

More than 30 patients have been identified by hospitals around the country as being now unable to travel to the U.S. to receive care for which they had arranged. Canadian officials are stepping in, ostensibly to help these patients, especially those that are children, access healthcare in Canada instead.

"These children are being turned away solely because of where they were born," Ontario health minister Dr. Eric Hoskins said in a statement, according to Buzzfeed, which in its headline characterized Canada as stepping in despite Hoskins being a provincial minister. "As Ontarians, we have an obligation to respond when we know we have the ability to help."

What Buzzfeed doesn't mention is that Hoskins will likely have to get some kind of exemption from the Canadian federal government to actually get the patients into Canada. That's because Canada bans entry by foreign nationals who are sick, not only when they are "likely to be a danger to public health or public safety" but also if they "might reasonably be expected to cause excessive demand on health or social services," meaning if your illness is pricey you may not get in. This has led to a number of high-profile immigration rejections by Canada, including of a South African doctor who wanted to settle in Canada but was denied because her child's autism would cost taxpayers too much money, and a Costa Rican family whose child had Down's Syndrome.

Canada's draconian immigrant health policies are a reminder of what makes the American system so special, on immigration and healthcare. The U.S. has historically been more open to immigrants than countries like Canada that know how to posture when a political opportunity is present. A largely still private, if not heavily regulated, healthcare system means the government does not have to find itself making decisions on how to treat human beings based on how much their ailments cost.

President Trump's executive order, largely built on previous troubling policies and ideas, challenges America's special systems. His immigration policies are centered around the idea of "America First." For now, many people find that palatable, that the U.S. should "take care" of Americans before it takes care of foreigners. This is the start of a slippery slope, one neither party has been shy about before but which Trump approaches with unique non-chalance and without even lip service to the idea of America as a free country. First the government insists it'll "take care" of Americans first, eventually it will insist on which Americans to "take care" of first, relying on criteria like what you "contribute" to society or the State, and eventually, as the Canadian example illustrates for us, how much you cost the government. The idea that government owes Americans something other than staying out of their way and not violating their rights has been popular in the U.S. for a long time—Trump embraces this nanny state paternalism unabashedly and without pretense to higher ideals.

Patients unable to access healthcare for which they had already arranged are also an example of how President Trump's travel ban interferes not just with the lives of foreigners but Americans too—a government action has thwarted contracts into which free people entered voluntarily. The history of U.S. government, especially in recent decades, has largely been about inserting itself into the voluntary, peaceful relationships people have with each other, often under that guise of "taking care" of us. It's not less of a significant deterioration in the freedom of association, already in poor shape in this country, when it extends to foreigners. Neither do previous government attacks on that freedom justify current ones."

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