The perils and possibilities of citizenship transformation: health-based claims and the Canadian Interim Federal Health Plan Reform debate by Lucia Frecha

Picture: Russell Watkins/Department for International Development

Picture: Russell Watkins/Department for International Development

LUCIA FRECHA is an MA Candidate in Public Issues Anthropology with the Department of Sociology and Anthropology at the University of Guelph.


Abstract

Seyla Benhabib and Aiwha Ong point to an increasing disaggregation and re-articulation of traditional notions of citizenship which have the potential to produce new spaces and opportunities for social change. Taking their work as a starting point, I first explain citizenship transformation theory, and then explore the way in which this theory is practically relevant in the current Canadian citizenship context. In particular, I draw on the notions of Benhabib and Ong’s citizenship transformation and Petryna, Rose and Novas’ biological citizenship to analyse the use of health-based claims for state membership and resources. I apply these notions to the debate over the 2012 Interim Federal Health Plan (IFHP) cuts for refugees and refugee-claimants in Canada, where health-based claims for resources can be said to have generated responses from the government (which initiated the cuts) and refugee advocates and health-care providers (who largely opposed these cuts).

I argue that most opinions expressed during the IFHP reform debate, despite having different underlying intentions, are disconnected from the realities of many refugees and refugee-claimants, and perpetuate long-standing, oppressive ideologies linked to Canadian identity narratives. Investigating citizenship transformation and biological citizenship theory in this context highlights the ways these processes might also reproduce existing citizenship models, and/or create new avenues for oppression and social exclusion. These differing Canadian views do not necessarily destabilize citizenship for refugees and refugee-claimants as in some of Benhabib’s and Ong’s examples. They do, however, present an opportunity to re-examine contemporary Canadian identities of social membership and to consider the reasons that including refugees and asylum seekers in the discourse and deliberations that affect them is so important. This can be considered a kind of citizenship transformation in itself.

Key words: citizenship, refugee, immigration, health claims, Canada, IFHP

Introduction

As a consequence of the increasing and changing flows of capital, information, technology, and people across the globe, scholars have begun to explore changes in traditional notions of citizenship. Some have considered alternatives like moral cosmopolitanism[1] and post-national citizenship[2], while others have deconstructed citizenship into political, social, and individual dimensions in order to understand how it may be re-negotiated.[3],[4],[5]

Benhabib and Ong suggest that citizenship, as a concept and as a practice, is transforming. They refer to citizenship transformations as changes in the relationship between the various elements that the West traditionally associates with the composition of de jure citizenship, or rights and entitlements tied to the state.[6],[7] As a result of massive global flows, they claim, these elements are becoming increasingly disassociated and re-articulated in ways that transcend state borders and sovereignty. This re-articulation or re-association can produce new spaces and opportunities for social and political change on a local, national, and global scale.

One of the ways that citizenship transformation is changing, they note, is through health-based claims to membership in the nation-state, and to state resources. Such claims are making increasingly important contributions to citizenship transformations around the world, and can be theorized as examples of biological citizenship, described in detail later in this paper. While there is great potential in a theory that helps us to think about the ways in which citizenship may be disaggregated and re-articulated in order to generate opportunities for political and social change, it is essential to consider how these processes might also reproduce existing citizenship models, and/or create new avenues for oppression and social exclusion.

In Canada, health-based claims to state resources are particularly relevant in the debate over the 2012 cuts to the Interim Federal Health Plan (IFHP). Here, the issue of access to state health resources underlie the positions of all those that are involved in the debate. However, the potential for refugee and refugee-claimants’ claims to health-based resources to inspire citizenship transformation that creates solidarity, empowers access, or more broadly challenges citizenship models seems to be lost among the actions and reactions around the IFHP cuts. On one side, the Federal Government has used refugees’ bodies and the health care allocations made to them (embedded in changes to the IFHP) to delineate the boundaries of the nation-state and to limit those that might partake of its resources. Those who oppose the cuts, on the other, point to refugees’ health-related vulnerabilities in order to help promote the reversal of this reform. Immigrants, refugees, and refugee-claimants[8] have joined in the efforts of the latter groups, but their involvement seems to have received only limited attention.

While I agree with Benhabib and Ong regarding the potential of health-based claims to produce citizenship transformations, I argue that in this particular context most of the opinions offered on reform in fact perpetuate oppressive ideologies linked to long-standing Canadian identity narratives, and are therefore problematic. Still, I suggest that the IFHP debate provides opportunities to challenge these narratives and to include refugees and refugee-claimants within the discourse and deliberations that affect them.

Citizenship Transformation and Biological Citizenship Theory

Benhabib and Ong offer a useful theoretical framework for understanding how citizenship transformations based on health-based claims can emerge. The notion of “disaggregated citizenship” refers to the way in which rights and entitlements to the benefits of citizenship are becoming increasingly dependent on conditions other than citizenship status itself.[9],[10]

Contemporary citizenship in the West is conventionally thought of as “membership in a bounded political community”[11], but the authors posit that massive flows of people, technology and information across the globe, challenge this bounded model. As a result, they present citizenship as something that can be disaggregated into three components: collective identity, privileges of political membership, and social rights and benefits.[12] For example, an individual might identify as a national of one country by birth, and enjoy social benefits (e.g. health care) in a host country, but be unable to vote or run for office in that host country.[13],[14] Disaggregated citizenship allows individuals to “develop and sustain multiple allegiances across nation-state boundaries” and to connect with each other despite differences in language, ethnicity, religion, and nationality.[15]These re-articulations are not bounded by conventional geography.[16] Instead, they occur in “global assemblages,” or new zones of political mobilization and political entitlement.[17]

Individuals and groups have begun to mobilize around shared experiences of health and illness, and this trend is also well-captured by the concept of biological citizenship.[18],[19] Petryna, Rose and Novas define this as the process by which shared experiences of suffering or, more generally, biological existence as human beings, become the basis for social membership and citizenship claims to state resources. In post-Chernobyl Ukraine, for example, when state resources were particularly scarce, those who had been visibly affected by the nuclear explosion were able to secure biomedical and welfare resources based on their shared identity as sufferers.[20] In France, undocumented migrants who can prove that they are seriously ill and cannot access appropriate treatment in their home countries may qualify for residency papers under the “illness clause,”[21] an immigration policy exception that authorizes immigrants with life-threatening pathologies to reside in France while they seek appropriate treatment.[22] In Southeast Asian countries, where economies are largely reliant on low-cost foreign labor, migrants can access immigration permits and protection from abusive employers by leveraging their identities as healthy and able-bodied workers.[23]

When citizenship is rearticulated in terms of biology, health and health care, the zones of political mobilization and entitlement can be national, transnational or international. These “global assemblages” can emerge in city streets, places of employment, and health care institutions.[24] Citizenship transformation theories that draw on shared human experiences of health and illness are appealing because they allow us to think about how citizenship can be expanded, and how we might move towards citizenship models that treat all people with the “dignity of universal personality”.[25] Under such models, migrants would be treated not as criminals but as human beings in search of greater freedom and better living conditions.[26]

While there is great potential in a theory that helps us to think of the ways in which citizenship may be disaggregated and re-articulated in order to generate opportunities for political and social change, it is essential to consider, as Benhanbib and Ong do, how these processes occur in particular contexts and whether biological citizenship genuinely transforms contemporary Western models of citizenship.[27],[28] Are the new biosocial ‘citizen’ identities that result limited because they are bounded by biology? If we use specific biological criteria to allot health care resources, then who might be excluded? In order to respond to these questions, the following sections will explore the relationship between health-based claims to health care resources and the Canadian response, highlighted in an analysis of the debate over IFHP cuts.

The Canadian Context and the IFHP Debate

Over the last two years, Canadian immigration policy reforms have placed immigrants and refugees in increasingly vulnerable positions.[29] Recent policy changes include a focus on temporary (versus permanent) migration[30], an emphasis on economic priorities over improvements to the family reunification program and refugee protection, greater barriers to obtaining immigration status and citizenship, and a more restrictive refugee determination system.[31] The latter change, in particular, has stirred widespread debate.

A new refugee determination system came into effect in December 2012 when Bill C-31, known as the Protecting Canada’s Immigration System Act, was incorporated into Canada’s Immigration and Refugee Protection Act, SC 2001, c. 27, (IRPA). This new system was introduced by the Federal Government and Citizenship and Immigration Canada under the pretense of improved efficiency and fairness in the refugee determination process. The key changes introduced under the bill were a shorter timeline for processing applications and a two-tier determination system which separates refugee-claimants from designated “safe” countries (designated countries of origin, or DCOs[32]) from those that come from non-DCO countries. In addition to these legislative reforms, certain categories of claimants and refugees had their access to health care reduced through cuts to the Interim Federal Health Plan (IFHP).[33]

The IFHP is a temporary health insurance program available to refugees, protected persons,[34] and refugee-claimants in Canada who are not otherwise covered by a provincial, territorial, or private health insurance plan.[35] Prior to the reform, the IFHP provided health care coverage similar to that provided by provincial and territorial governments for Canadians receiving social assistance.[36],[37]With these new reforms, IFHP coverage was reduced for all refugee-claimants, and certain subgroups became ineligible for any care.[38],[39] One of the most significant changes is in coverage of “supplemental benefits,” such as vision, dental and counselling services. These services are now only covered for subgroups that qualify for “expanded health coverage,” such as Government-assisted refugees (GARs)[40] or victims of trafficking who have been granted temporary residence permits.[41],[42]Refugee-claimants from non-DCOs receive “health care coverage,” including hospital, physician, and ambulance services, but those from DCOs, along with rejected refugee-claimants, are only allotted these services if their health condition is deemed to pose a public health threat.[43] The category “health care coverage” has thus become more ambiguous, and only applies when these services are deemed to be of an “urgent or essential nature.” [44], [45]

The impact of Bill C-31 is manifold. The reduction of hearing preparation timelines can create greater stress for claimants because it gives them less time to gather appropriate documentation and prepare for a hearing.[46] Claimants from DCOs now have 15 days from the date they enter Canada to file their asylum claim and provide all supporting documentation, which in some cases requires translation.[47]Distinguishing between DCO and non-DCO applicants contributes to generalization within the refugee determination process, obscuring or ignoring the particular circumstances of each applicant, such as age, geographic location, sexual orientation, or ethnic background.[48] This is problematic, for example, for individuals of Roma communities, who are being persecuted or socially and politically excluded even within countries deemed to be DCOs.[49],[50]

The IFHP cuts to healthcare, in particular, have been recently called “cruel and unusual punishment” and judged to be inconsistent with the Canadian Charter of Rights and Freedoms by the Federal Court of Canada (Cdn Doctors v. AGC 2014 FC 651). The Federal Court gave the government four months to revise the changes made to the IFHP before it would strike them down. The Government appealed this ruling to the Federal Court of Appeal on the last available date, and the outcome of this appeal is still in process. While the Federal Court’s finding was a positive development for those that opposed the health-care cuts, both the Federal Court’s ruling and the government’s appeal have created further uncertainty around what types of coverage are and should be available for refugees and refugee-claimants.[51],[52]


The Federal Government’s Position

The Federal Government and Citizenship and Immigration Canada[53]clearly recognize “too many people” (including those who are deemed undeserving) making claims to the state’s health care resources as problematic, and a threat to Canada’s immigration system and to Canadian citizenship.[54] As a result, they have, with the IFHP cuts, narrowed the groups of people who can make such claims based on biological citizenship. In order to justify Bill C-31 and the subsequent cuts, they have relied on a discourse of efficiency and fairness. Shortly after the bill was introduced, Jason Kenney, then Minister of Citizenship, Immigration, and Multiculturalism, addressed the House of Commons. He explained that Canada’s “generous asylum system has been abused by too many people making bogus refugee claims”.[55] The reforms to the asylum system, he noted, would serve to fix a “broken” immigration system and to send an important message: “if you do not need Canada’s protection…you will not be allowed to remain in Canada for years using endless appeals at the expense of Canadian taxpayers”.[56] Prime Minister Stephen Harper further defended the reforms by stating that Canada’s immigration system was subject to abuse under the existing policies and that this is “not acceptable to Canadians”.[57]

Similar rationales were also offered when the IFHP cuts were officially announced in a press release by the Canadian government on April 25, 2012. The press release explained that the objectives of the cuts were to ensure that refugee-claimants did not receive better health services than Canadians, and to help contain health care costs.[58] In a more recent news conference, Immigration Minister Chris Alexander responded to the Federal Court’s ruling that the IFHP cuts constituted “cruel and unusual punishment” by asserting that the government “vigorously defends the interests of taxpayers” and seeks to protect “genuine refugees”.[59]


Response to Bill C-31 and the IFHP Cuts

A wide range of groups who oppose the IFHP cuts have been quick to respond to the Federal Government’s claims regarding the inefficiencies of the immigration system and the notion of “bogus” refugees. In the House of Commons, New Democratic Party (NDP) immigration critic Don Davies called Bill C-31 “a serious step backward”[60] and Liberal immigration critic Kevin Lamoureux said the reform would “punish the most vulnerable” and “has no place in Canadian society”.[61]New Democrats also expressed concern over the fact that the bill places “too much power in the hands of the Minister” to designate DCOs; and to thereby singlehandedly determine who does or does not have access to the IFHP.[62],[63]Many national organizations, such as the Canadian Council for Refugees, the Canadian Civil Liberties Association, Amnesty International, and the Canadian Association for Refugee Lawyers, publicly denounced the bill.[64], Media headlines across the country also reflected negative responses to the changes to be borne under Bill C-31.[65],[66],[67]

Health care professionals and health care organizations have taken a prominent role in the public response to the IFHP cuts. In May of 2012, organizations including the Canadian Medical, Dental and Pharmacists Associations[68] sent an open letter to Minister Jason Kenney to express their concern over the potential health impacts of the cuts, and this letter is representative of the concerns of many who oppose the bill. The letter cited three main reasons for the need to revise or rescind the policy reform: to ensure timely treatment and disease management and thereby avoid future complications and increased health care costs, to protect the health and well-being of Canadians and Canada’s vulnerable populations, and to uphold Canadian values of compassion and inclusiveness.[69] The authors claim that limiting and/or cancelling health benefits for refugees and refugee-claimants will not decrease health care costs, and will place the burden of care on provincial and community-level social programs. Drawing on their medical expertise, the participant organizations also claim that undiagnosed and untreated health problems like chronic and communicable diseases may lead to more severe and costly health complications, overburdened emergency services, and potential public health threats for all Canadians. Finally, they ask: “Are we as a country willing to risk the health of a pregnant mother who is receiving required medications before June 30 by telling her she is no longer eligible after June 30?”.[70] Health care professionals have also led public protests, spoken with the media and written op-ed pieces, often citing the imminent health care needs and particular vulnerability of specific groups of refugees and refugee-claimants. They have focused on pregnant women, children, people with diabetes, cancer, or HIV/AIDS, and victims of abuse.[71],[72],[73],[74],[75]

Immigrants, refugees, and refugee-claimants have joined in these efforts, but have received less media attention than health care professionals. Many have told their health care stories in order to illustrate the negative impact of the reformed IFHP (for instance, Cdn Doctors v AGC 2014 FC 651). These stories are often accompanied by images of visibly sick or disabled individuals.[76],[77],[78]Different from individuals and groups in Chernobyl, France, and Southeast Asia, who have been able to claim state resources based on shared ‘biological identities,’ the potential for immigrants, refugees, and refugee-claimants in Canada to do the same seems to have been overtaken by back-and-forth actions and reactions of the Federal Government, and migrant and refugee advocates around the IFHP.


Canadian Identity Narratives and the Limitations of Health-based Claims in the IFHP Debate

The Canadian master narrative is one that is founded on ideas of pluralism and tolerance. [79],[80] In this narrative, Canadians are generally presented as “responsible citizens, compassionate, caring, and committed to diversity and multiculturalism”.[81] The ‘other,’ which in the Canadian context includes not only immigrants but the territory’s aboriginal people, is imagined as “virulent, chaotic, criminal, and sometimes even deadly”.[82] Subject formation in Canadian society, according to Thobani, is “triangulated”: nationals and citizens represent the apex, immigrants receive only conditional inclusion, as abject recipients of Canadians’ benevolence, and Aboriginals are “marked for their loss of sovereignty”.[83]Such a history provides a wider context in which to view the role of health-based claims and the possibilities for citizenship transformation in Canada.

This master narrative can be traced as far back as the Royal Proclamation of 1763, when British and French settlers began to cast Aboriginal populations as primal and lawless in order to justify their colonization efforts.[84] In doing so, they also promoted the “Benevolent Mountie” myth; the idea that Canada is a more compassionate and benevolent state than others, such as the United States.[85] Mackey suggests that the Benevolent Mountie myth constitutes the foundation of the modern Canadian identity. The myth has become embedded in the symbolic Immigration Act(1976-1977) and Multiculturalism Act (1988), which elevated Canada’s status on the global scale, positioning it as one of the most generous and compassionate states in the world.[86] At the same time, Mackey claims, these policies drew attention away from English-French Canadian disputes, the continued marginalization of Aboriginal peoples, and the crystallization of immigrants and refugees as “a cultural stranger to the national body”.[87]

The result of this long-term mythmaking comes to bear when we analyse the actions and responses of the Canadian government and the Canadian people vis-à-vis refugees and refugee-claimants in the IFHP debate. The intentions of those supporting IFHP reforms (cuts) and those against them differ, of course, in that the state has constructed these new barriers, and advocates and health-care providers are responding negatively to the barriers. While their intentions are clearly different, however, they share the attribute of largely speaking on behalf of those who have made health-based claims to state resources, and do so in language that adopts a similar Canadian narrative. Despite their opposing views, therefore, I argue that the reactions to health-based claims described above may be seen as two sides of the same coin. Both are linked to similar Canadian identity narratives and both may prevent the progressive types of citizenship transformation that Benhabib and Ong describe. As noted earlier, the potential for citizenship transformation lies in the ability for migrants, including refugees and asylum seekers, to claim to state resources (such as healthcare) outside of a western citizenship paradigm. Investigating the theory in this context, however, highlights the potential of state response, and even the response of those who advocate for refugees and migrants, to be consumed with finding and reacting to new legal barriers to resources, and to rely on familiar depictions of the ‘other’.

The Federal Government has effectively separated the bodies that are more and less worthy of state assistance by introducing tiers to a health insurance scheme that had previously been available to all refugees and refugee-claimants. The language of “expanded health coverage” versus “health care coverage” serves to delineate the groups that the government perceives to be more or less vulnerable, and therefore more or less genuine and worthy of care. Refugee-claimants from DCOs, those whose asylum claims have been rejected, and those who are waiting to appeal rejected claims are categorized as the least worthy, deserving of care only in dire circumstances, and otherwise a geographic rather than health-based determination. The rhetoric of the ‘bogus’ refugee, the refugee claimant who the government determines is not a refugee and does not deserve state health-care resources, draws further attention to the ‘least worthy’ groups, and has the potential to fix a negative, generalized image of refugees and refugee-claimants in the public imagination.

Many of those who oppose the IFHP cuts, however, also draw on a discourse of vulnerability and focus on the most vulnerable bodies to make their calls for reversal. Healthcare professionals and organizations have made multiple references to refugees and refugee-claimants as the most vulnerable in Canadian society. Moreover, many of their responses, largely made on behalf of those subject to the reforms, focus on people who are either generally considered to have the most serious health conditions (cancer, HIV/AIDS, diabetes) or to be the most defenceless (pregnant women, children, victims of abuse). The prominence of health care professionals as advocates, combined with the personal stories and images of refugee’s negative health care experiences in the media, elicit a powerful/powerless binary and helps to fix a pitiable image of refugees and refugee-claimants in the public imagination.

Both calls for reform and calls against reform combine an element of vulnerability vis-à-vis refugees and refugee-claimants, and compound this with an element of benevolence, either with respect to Canadian citizens or Canadian refugee-claimants. Both narratives “exalt”[88] Canadian nationals as Benevolent Mounties, whether they wish to assist more or fewer migrants, and, at least in these responses, appear to regard refugees and refugee-claimants as a well-defined other. For the Government, refugees and refugee-claimants appear to be either ‘genuine’ or ‘bogus’ others, as defined by health care allocation in the IFHP. For immigrant and refugee advocates, they seem to be ‘pitiable’ others, as warranted by their perceived vulnerabilities, serious health conditions, and defencelessness. Both viewpoints may result in drawing attention away from the individual realities of migrants, and step away from the conversation around the potential for citizenship transformation. In the process, they also obscure Canada’s history of violence, dispossession, marginalization, and discrimination against others. The debate fails to fully engage with the forms of structural injustice that persist, and in doing so, provide an example of the difficulties that concepts of biological citizenship and citizenship transformation face.


Conclusion

Rather than constituting the basis for the possibility of citizenship transformation, health-based claims for services in Canada, as emphasised within the IFHP debate, seem to reproduce Canadian identity narratives and focus conversation on vulnerabilities instead of new ways of considering citizenship via biological or health-based lines.

This reality has political and other implications for those who support the cuts, those who oppose them, and those most directly affected by them. If the IFHP cuts are sustained, the “bogus” refugee rhetoric and the systematic marginalization of refugees and refugee-claimants by the Federal Government will likely persist. However, if the cuts are reversed based on an imagined, shared identity of refugees as biologically vulnerable others, we may see what Ticktin calls the “antipolitics of care”.[89] While emphasizing the importance of health-based claims to refute the IFHP cuts may be a well-intentioned political strategy, it does not fundamentally challenge long-standing power relations and conceptions of refugees as others.

It is notable that, as a result of the joint efforts of health care professionals, immigrants, refugees, and other advocates against the IFHP cuts, various provincial governments have agreed to help reconcile gaps in care, and the Federal Court has requested that the cuts be revised (Cdn Doctors v AGC 2014 FC 651). This is an indication of the opportunities within the IFHP debate for re-examining the institutions, ideas, and assumptions that constitute contemporary Canadian identity narratives and the limited partnerships that sustain them. In so doing, it may be possible to carve out a space for refugees and refugee-claimants to participate equally in the discourse and deliberations that affect them. Instead of engaging in the limitations of the binary bogus/vulnerable debate, it may be possible to address the disconnect between those who are making claims for health care and other services and their conceptualization by those who seek to represent them.

  

REFERENCES

Baluja, T. (16 February 2012). Tories unveil bill to thwart ‘bogus’ refugees. The Globe and Mail. Available at: http://www.theglobeandmail.com/news/politics/tories-unveil-bill-to-thwart-bogus-refugees/article2340521/?from=sec431 . Accessed January 15, 2015.

Barnes, S. (2012). The real cost of cutting refugee health benefits. Available at: http://www.wellesleyinstitute.com/wp-content/uploads/2012/05/The-Real-Cost-of-Cutting-Refugee-Health-Benefits.pdf . Accessed February 10, 2014.

Benhabib, S. (2002a). The Claims of Culture: Equality and Diversity in the Global Era. Oxford: Princeton University Press.

Benhabib, S. (2002b). Transformations of Citizenship: The Case of Contemporary Europe*. Government and Opposition, 37(4): 439-465.

Bragg, B. (2013). A Guide to Canada’s Changing Immigration Policy. Available at: http://www.ecccalgary.com/wp-content/uploads/Immigration_Policy_Guide_06-13.pdf . Accessed April 2, 2015.

Canadian Association for Refugee Lawyers (CARL). (2015). Press Release: Doctors And Lawyers Challenge Federal Health Cuts To Refugees. http://www.carl-acaadr.ca/our-work/issues/IFHP#Press Release. Accessed April 2, 2015.

Canadian Council for Refugees. (2010). Refugees and Immigrants: A glossary. Available at: http://ccrweb.ca/en/glossary Accessed April 19, 2015.

Canadian Council for Refugees.(2012a). Myths and facts. Available at: http://ccrweb.ca/sites/ccrweb.ca/files/mythsandfacts2012c31en.pdf . Accessed November 20, 2013.

Canadian Council for Refugees. (2012b). Protect Refugees from Bill C-31: Joint statement. Available at: http://ccrweb.ca/en/protect-refugees-c31-statement . Accessed November 20, 2013.

Canadian Council for Refugees. (2013). Refugee health care: Impacts of recent cuts. Available at: http://ccrweb.ca/sites/ccrweb.ca/files/ifhreporten.pdf . Accessed November 20, 2013.

Canadian Council for Refugees. (2014a). 2013 in Review: Refugees and immigrants in Canada.. Available at: https://ccrweb.ca/en/2013_review . Accessed March 10, 2014.

Canadian Council for Refugees.(2014b). Refugee Health Care.Accessed March 10, 2014. https://ccrweb.ca/en/ifh .

Canadian Doctors for Refugee Care. 2014. Home. Available at: http://www.doctorsforrefugeecare.ca/. Accessed March 10, 2014

Canadian Doctors for Refugee Care, The Canadian Association for Refugee Lawyers, Daniel Garcia Rodriques, HanifAyubi and Justice for Children and Youth v. Attorney General of Canada and Minister of Citizenship and Immigration (Cdn Doctors v AGC). 2014 FC 651. Available at: http://cas-ncr-nter03.cas-satj.gc.ca/rss/T-356-13%20Cdn%20Doctors%20v%20AGC%20Judgment%20and%20Reasons.pdf . Accessed January 30, 2015.

Canadian Healthcare Association. (2012). Changes to the Interim Federal Health Program: Position Statement. Available at: http://www.healthcarecan.ca/wp-content/uploads/2012/11/IFHP-reform-policy-statement-November-2012.pdf . Accessed January 24, 2015.

Canadian Pharmacists Association, Letter to Jason Kenney. (2012). Available at: http://www.pharmacists.ca/cpha-ca/assets/File/cpha-on-the-issues/SuppBenefitsKenneyEN.pdf . Accessed November 21, 2013.

Carens, J. (1995). Aliens and Citizens: The Case for Open Borders. In Theorizing Citizenship. Ronald Beiner (ed.). Albany: State University of New York Press, pp. 229–55.

Caulford, P and D’Andrade, J. (2012). Health care for Canada’s medically uninsured immigrants and refugees: Who’s problem is it? Can Fam Physician, 58:725-727.

CTVNews.ca. (16 February 2012a). Tories aim to fix ‘broken’ immigration system. Available at: http://www.ctvnews.ca/tories-aim-to-fix-broken-immigration-system-1.769664 . Accessed January 15, 2015.

CTVNews.ca. (16 February 2012b). Refugee system faces ‘unprecedented dismantling’. Available at: http://www.ctvnews.ca/refugee-system-faces-unprecedented-dismantling-1.769837 . Accessed January 15, 2015.

CTVNews.ca. (17 June 2013). Canadian doctors stage ‘day of action’ to protest refugee health care cuts. Available at: http://www.ctvnews.ca/health/health-headlines/canadian-doctors-stage-day-of-action-to-protest-refugee-health-care-cuts-1.1328775#ixzz3QlkNvZw0 . Accessed January 15, 2015.

CTVNews.ca. (11 December 2014). Woman fears no coverage for breast cancer treatment
Available at: http://edmonton.ctvnews.ca/woman-fears-no-coverage-for-breast-cancer-treatment-1.2144039#ixzz3QliSQr1W . Accessed January 15, 2015.

Citizenship and Immigration Canada(CIC).(2015a). Health care – Refugees. Available at: http://www.cic.gc.ca/english/refugees/outside/arriving-healthcare.asp . Accessed January 20, 2015.

Citizenship and Immigration Canada(CIC).(2015b). Government-assisted refugee program. Available at: http://www.cic.gc.ca/english/refugees/outside/resettle-gov.asp . Accessed January 20, 2015.

Citizenship and Immigration Canada(CIC). (2015c). Interim Federal Health Program: Summary of benefits. Available at: http://www.cic.gc.ca/english/refugees/outside/summary-ifhp.asp . Accessed January 21, 2015.

Citizenship and Immigration Canada(CIC).(2015d). Fact Sheet – Temporary Foreign Workers Program. Available at http://www.cic.gc.ca/english/resources/publications/employers/temp-foreign-worker program.asp. Accessed April 2, 2015.

Citizenship and Immigration Canada(CIC).(2015e). Citizenship and Immigration Canada. Available at: http://www.cic.gc.ca/ENGLISH/department/index.asp . Accessed April 19, 2015.

Citizenship and Immigration Canada (CIC).(2015f). Designated Countries of Origin. Available at: http://www.cic.gc.ca/english/refugees/reform-safe.asp . Accessed April 19, 2015.

Elkouri, R. (20 February, 2012). Les Parasites. La Presse. Available at: http://www.lapresse.ca/debats/chroniques/rima-elkouri/201202/18/01-4497403-les-parasites .php. Accessed, January 15, 2015.

Elliot, L and Payton, L. (15 February, 2012). Refugee reforms include fingerprints, no appeals for some. Available at: http://www.cbc.ca/news/politics/refugee-reforms-include-fingerprints-no-apeals-for-some-1.1191505 . Acessed January 5, 2015.

Fassin, D. (2001). The Biopolitics of Otherness: Undocumented Foreigners and Racial Discrimination in French Public Debate. Anthropology Today, 17(1):3-7.

Fitzpatrick, M. (July 3 2012). Refugee health cuts ‘clarified,’ not reversed, Kenney says. CBC News. Available at: http://www.cbc.ca/news/politics/refugee-health-cuts-clarified-not-reversed-kenney-says-1.1133956 . Accessed January 20, 2015.

Government of Canada.Citizenship and Immigration Canada (CIC). (2012a). Speaking notes for the Honourable Jason Kenney P.C., M.P. Minister of Citizenship, Immigration, and Multiculturalism. Available at: http://www.cic.gc.ca/english/department/media/speeches/2012/2012-02-16.asp . Accessed March 15, 2014.

Government of Canada, Citizenship and Immigration Canada (CIC).(2012b). News Release. Reform of the Interim Federal Health Program ensures fairness, protects public health and safety. Available at http://www.cic.gc.ca/english/department/media/releases/2012/2012-04- 25.asp

Government of Canada, Department of Justice.(2012). Order Respecting the Interim Federal Health Program (SI/2012-26).Available at http://lawslois.justice.gc.ca/eng/regulations/SI-2012-26/FullText.html .Accessed January 24, 2015.

Government of Canada, Department of Justice. (2012). Order Amending the Order Respecting the Interim Federal Health Program (SI/2012-49). Canada Gazette, June 28. Available at: http://canadagazette.gc.ca/rp-pr/p2/2012/2012-07-18/html/si-tr49-eng.html . Accessed January 30, 2015.

Immigration and Refugee Protection Act.2001, c.27. Available at: http://laws-lois.justice.gc.ca/eng/acts/I-2.5/ . Accessed February 14, 2014.

Mackey, E. (2002). The House of Difference: Cultural Politics and National Identity in Canada. Toronto: University of Toronto Press.

Molnar Diop, P. (2014). The “bogus” refugee: Roma asylum claimants and discourses of fraud in Canada’s Bill C-31. Refuge, 31(4):67-80.

Office of the High Commissioner for Human Rights.(2011). Better protection against discrimination for Roma and victims of caste systems. Available at: http://www.ohchr.org/EN/NewsEvents/Pages/BetterprotectionforRomaandvictimsofcastesystems.aspx . Accessed January 30, 2015.

Ong, A. (2006). “Mutations in Citizenship.”Theory, Culture & Society, 23(2-3): 499-531.

Payton, L. (4 July, 2014). Federal government to appeal ruling reversing ‘cruel’ cuts to refugee health. CBC News. Available at: http://www.cbc.ca/news/politics/federal-government-to-appeal-ruling-reversing-cruel-cuts-to-refugee-health-1.2696311 . Accessed January 15, 2015.

Protecting Canada’s Immigration System Act.2001, c. 27. Available at: http://laws-lois.justice.gc.ca/eng/annualstatutes/2012_17/page-1.html . Accessed January 30, 2015.

Petryna, A. (2002). Life exposed: Biological citizens after Chernobyl. Princeton, N.J.: Princeton University Press.

Rose, N. and Novas, C. (2005).“Biological citizenship”.In Global Assemblages: Technology, Politics, and Ethics as Anthropological Problems. Aihwa Ong and Stephen J. Collier, eds. Pp. 439-463. Oxford: Blackwell Publishing.

Soysal, Y. (1994). Limits of Citizenship: Migrants and Postnational Membership in Europe. Chicago: University of Chicago Press.

The Federal Liberal Agency of Canada, the Liberal Party of Canada.Stop Bill C-31, the Anti-refugee Bill. Available at: http://petition.liberal.ca/stop-bill-c31-antirefugee-bill/ . Accessed January 15, 2015.

Thobani, S. (2007).Exalted subjects: Studies in the Making of Race and Nation in Canada. Toronto: University of Toronto Press.

Ticktin, M. (2011).Casualties of Care: Immigration and the Politics of Humanitarianism in France. Berkeley: University of California Press, Ltd.

[1]Joseph Carens, Theorizing Citizenship (Albany: State University of New York Press, 1995).

[2]YaseminSoysal,Limits of Citizenship: Migrants and Postnational Membership in Europe (Chicago: University of Chicago Press, 1994).

[3]SeylaBenhabib, The Claims of Culture: Equality and Diversity in the Global Era (Oxford: Princeton University Press, 2002).

[4] Adriana Petryna, Life Exposed: Biological citizens after Chernobyl (Princeton, N.J.: Princeton University Press, 2002).

[5]Aihwa Ong, “Mutations in Citizenship,” Theory, Culture & Society, 23(2-3) (2006): 499-531.

[6]Benhabib, The Claims of Culture, 179.

[7]Ong, “Mutations in Citizenship,” 500.

[8]A refugee-claimant or asylum seeker is a person who has fled their country and requests protection in another country (Canadian Council for Refugees, 2010). I will use the term refugee-claimant rather than asylum seeker throughout this paper, but their conceptual meaning is the same.

[9]Seyla Benhabib, “Transformations of Citizenship: The Case of Contemporary Europe*,” Government and Opposition, 37(4) (2002), 453.

[10]Benhabib, The Claims of Culture, 179.

[11] Ibid.

[12] Ibid.

[13]Benhabib, The Claims of Culture, 179-180.

[14] “Globalization changing nature of citizenship, says scholar,” accessed Feb 12, 2014.

[15]Benhabib, “Transformations of Citizenship,” 462.

[16]Ong, “Mutations in Citizenship,” 500.

[17]Ong, “Mutations in Citizenship,” 499.

[18]Petryna, Life Exposed.

[19] Nikolas Rose and Carlos Novas, “Biological citizenship,” in Global Assemblages: Technology, Politics, and Ethics as Anthropological Problems, eds. Aihwa Ong and Stephen J. Collier, (Oxford: Blackwell Publishing, 2005), Pp. 439-463.

[20]Petryna, Life Exposed.

[21]A 1998 provision of France’s Conditions of Entry and Residence of Foreigners.

[22]Ticktin, Casualties of Care, 89.

[23]Ong, “Mutations in Citizenship,” 504.

[24] Ong, “Mutations in Citizenship,” 502-504.

[25] Benhabib, “Transformations of Citizenship,” 464.

[26] Ibid.

[27] Ibid, 461.

[28] Ong, “Mutations in Citizenship,” 503-504.

[29]2013 in Review: Refugees and immigrants in Canada,” accessed March 10, 2014.

[30]The Temporary Foreign Worker Program (TFWP) “allows Canadian employers to hire foreign nationals to fill temporary labour and skill shortages when qualified Canadian citizens or permanent residents are not available” Citizenship and Immigration Canada [CIC], 2015a). It is very difficult for low-skilled Temporary Foreign Workers to gain Permanent Residence because they can only stay in Canada for four years. Beyond that, they must return home and wait another four years to return to Canada. Notably, the number of Temporary Foreign workers in Canada has tripled since 2000 (Bragg, 2013).

[31]“2013 in Review: Refugees and immigrants in Canada.”

[32]DCOs are defined by Citizenship and Immigration Canada (2015f) as “countries that do not normally produce refugees, but do respect human rights and offer state protection”. DCOs are designated based on qualitative and quantitative data about asylum claims made in Canada by individuals from each country. As such, DCO designations made by Citizenship and Immigration Canada are particular to the Canadian context; however, ‘safe country’ lists are also used as part of immigration policy elsewhere.

[33]Ibid.

[34]According to the Immigration and Refugee Protection Act (SC 2001, c.27), a person who has been determined to be either (a) a Convention Refugee as per section 96 of the IRPA or (b) a person in need of protection (including, for example, a person who is in danger of being tortured if deported from Canada), as per section 97 of the IRPA

[35]“Health care – Refugees,” accessed January 20, 2015, http://www.cic.gc.ca/english/refugees/outside/arriving-healthcare.asp .

[36]These benefits included coverage for primary care, prescription drugs, and dental and vision care (Barnes, 2012).

[37]“The Real Cost of Cutting Refugee Health Benefits,” accessed February 10, 2014.

[38] Ibid.

[39]Refugee health care: Impacts of recent cuts,” accessed November 20, 2014.

[40]According to Citizenship and Immigration Canada, Convention Refugees abroad whose initial resettlement in Canada is entirely supported by the Government of Canada or Quebec (CIC, 2015d).

[41]Order Respecting the Interim Federal Health Program (SI/2012-26),” accessed January 24, 2015.

[42]Changes to the Interim Federal Health Program: Position Statement,” accessed January 24, 2015.

[43]Interim Federal Health Program: Summary of benefits,” accessed January 21, 2015.

[44]Order Respecting the Interim Federal Health Program” (SI/2012-26), accessed May 2015.

[45]Changes to the Interim Federal Health Program: Position Statement,” accessed May 2015.

[46]“2013 in Review: Refugees and immigrants in Canada

[47]Petra Molnar Diop, “The ‘bogus’ refugee: Roma asylum claimants and discourses of fraud in Canada’s Bill C-31,” Refuge, 31:4 (2014), 72.

[48]Ibid, 73.

[49]Better protection against discrimination for Roma and victims of caste systems,” accessed January 30, 2015.

[50]Myths and facts,” accessed November 20, 2013.

[51]Press Release: Doctors and Lawyers Challenge Federal Health Cuts to Refugees,” accessed April 2, 2015.

[52]Canadian Doctors for Refugee Care,” accessed March 10, 2014.

[53] Citizenship and Immigration Canada also known as the Department of Citizenship and Immigration, is a division of the Government of Canada, responsible for: facilitating the arrival of immigrants, providing protection to refugees, offering programming to help newcomers settle, granting citizenship, issuing travel documents, and promoting multiculturalism Citizenship and Immigration Canada, 2015e).

[54] “Speaking notes for the Honourable Jason Kenney P.C., M.P. Minister of Citizenship, Immigration, and Multiculturalism,” accessed March 14, 2014.

[55]Ibid.

[56] Ibid.

[57]Tories aim to fix ‘broken’ immigration system,” accessed January 15, 2015.

[58]News Release. Reform of the Interim Federal Health Program ensures fairness, protects public health and safety,” accessed March 14, 2014.

[59]Federal government to appeal ruling reversing ‘cruel’ cuts to refugee health,” accessed January 15, 2015.

[60] Ibid.

[61]Stop Bill C-31, the Anti-refugee Bill,” accessed January 15, 2015.

[62]Refugee reforms include fingerprints, no appeals for some,” accessed January 15, 2015.

[63]Tories unveil bill to thwart ‘bogus’ refugees,” accessed January 15, 2015.

[64]Protect Refugees from Bill C-31: Joint statement,” accessed November 20, 2013.

[65]Les Parasites,” accessed, January 15, 2015.

[66]Refugee system faces ‘unprecedented dismantling’,” accessed January 15, 2015.

[67] Supra, “Tories unveil bill to thwart ‘bogus’ refugees”

[68]Other signatories included the Canadian Association of Social Workers, the Canadian Association of Optometrists, the Canadian Dental Association, the Canadian Pharmacists Association, the College of Family Physicians of Canada, the Royal College of Physicians and Surgeons of Canada, the Canadian Medical Association, and the Canadian Nurses Association.

[69]Letter to Jason Kenney,” accessed November 21, 2013.

[70] Ibid.

[71]Refugee health cuts ‘clarified,’ not reversed, Kenney says,” accessed January 20, 2015.

[72] Supra, “Canadian Doctors for Refugee Care”

[73] Supra, “Federal government to appeal ruling reversing ‘cruel’ cuts to refugee health”

[74]Canadian doctors stage ‘day of action’ to protest refugee health care cuts,” accessed January 15, 2015.

[75] Paul Caulford and Jennifer D’Andrade, “Health care for Canada’s medically uninsured immigrants and refugees: Who’s problem is it?” Can Fam Physician, 58 (2012), 725-727.

[76] “Refugee health care: Impacts of recent cuts”

[77]Woman fears no coverage for breast cancer treatment,” accessed January 15, 2015.

[78] Supra, “Canadian Doctors for Refugee Care”

[79] Eva Mackey, The House of Difference: Cultural Politics and National Identity in Canada, (Toronto: University of Toronto Press, 2002).

[80]SuneraThobani, Exalted Subjects: Studies in the Making of Race and Nation in Canada. (Toronto: University of Toronto Press, 2007).

[81]Ibid, 7.

[82] Ibid.

[83]Ibid, 15.

[84]Ibid, 12.

[85] Mackey, The House of Difference, 15.

[86]Thobani, Exalted Subjects, 97.

[87] Mackey, The House of Difference, 23.

[88]Thobani, Exalted Subjects.

[89]Ticktin, Casualties of Care, 4.

 

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