Permanent Removal of the 3 Month Waiting Period

Camilo G. Medina, Seth Lucenay, Gregory Wendt

Department of Health Sciences, Sault College

BSCN 2057: Professional Growth II

Professor Barb Engel

03/17/2022
 Permanent Removal of the 3 Month Waiting Period

As Canada begins to grow year-by-year, an influx of new residents arrive in Canada to

make a life of their own. Canada itself is very welcoming to this fact, offering multiple different

services and aid for these new immigrants to ensure an easy admittance (Canada, 2022).

However, after making the commitment to part from their homeland and head towards Canada

they still face one major hurdle; being left without healthcare for three months upon registration.

On top of all the hardships that are already present with moving to a new country, Ontario and

the rest of Canada adds one more through a test of commitment requiring them to stay in country

for at least three to six months’ time without healthcare. This is a topic important to nursing

because nurses are part of this healthcare system, on top of that, many of these permanent

residents are also healthcare workers as well. It is relevant because with the cost attached to the

healthcare may discourage new permanent residents from seeking out aid, even if it is necessary

as they simply do not have the funds for it. Which can result in compounded problems due to

being left untreated resulting in a further strain on the healthcare system in three months’ time

when they are granted their public health insurance. It unfairly discourages immigrants with

health conditions wanting to become permanent residents as now not only do they need to worry

about having all the necessary funds for lodging and other necessities, but they also need to

budget even more for their health if the need arises. Then finally there is the unnecessity of the

entire process, healthcare is a human right and permanent residents are being denied it for a

three-month waiting period for no beneficial reason. All the three-month waiting period does is

place an arbitrary wait time for people who need treatment. For these reasons and more are why

Ontario should permanently waive the healthcare wait period for new permanent residents.
 Background Discussion

The permanent resident status for any immigrant is the first step towards a Canadian

citizenship and is one of the most nerve-wracking times for a family or individual, because the

permanent resident process determines if one is allowed to stay or leave the country. In addition,

once a permanent resident status is acquired, newly Canadian permanent residents are left

without any health insurance at all, needing to rely on expensive coverages or simply paying out

of pocket. Ontario currently has a three-month waiting period for receiving a health card. This

allows access to Ontario Health Insurance Plan (OHIP), which pays for most of the health care

services in Ontario. This coverage includes doctor appointments, walk-in clinics, hospital stays

and surgery. They can apply for the at any time so long as they have all the proper

documentation, however, they cannot be accepted until three months elapse from the date they

are declared as a permanent resident and must remain in Ontario for 153 days out of the

following 183 days since that declaration (Government of Ontario, 2017). This information is

presented in a bureaucratic format that can be difficult and confusing for immigrants, and even

native speakers, to understand. The three-month waiting period in Ontario first came into effect

in 1994. It was introduced to save money as well as discourage immigrants coming to Ontario

just to gain access to expensive treatments (Bobadilla, et al., 2016). Throughout Canada, the only

provinces that have the three-month waiting period are Ontario, British Columbia, Saskatchewan

and Quebec, as well as the three territories of Yukon, Northwest Territories, Nunavut (Ontario

Government, 2017). The remaining six provinces provide immediate healthcare coverage to any

new permanent residents that arrive in Canada. That nearly fifty-fifty split shows that there is

even contention regarding the wait time for healthcare within Canada itself. Even though

Ontario, along with British Columbia and Quebec, have a three-month waiting period, about
80% of new immigrants to Canada choose to come to one of these three provinces. This means

that the overwhelming majority of immigrants to Canada will have to face the waiting period on

their journey to become a permanent resident (Caulford, & D’andrade, 2012).

The psychological stress of moving to a country for a new permanent resident is a

stressful experience faced with many hardships across the journey. New permanent residents

tend to be immigrants who come to Canada from countries that have different values, beliefs,

languages, and cultures so when navigating the Canadian lifestyle on top of needing to learn the

minor differences in the health care system can be extremely overwhelming and daunting. This

stress can be compounded if the permanent resident has a sick loved-one or has a chronic

condition requiring regular medical attention, as all cost must be out of pocket or through

expensive coverage programs. Needing to pay for medical treatment on top of all other monetary

commitments during the process of immigration can be an extreme deterrent as that may be an

expense they cannot afford. In addition, there is still the difficulty that many immigrants may

face seeking mental and physical aid due to the language barriers present and lack of language

specific outreach programs being largely available (Community Mental Health Journal, 2018).

This difficulty is only reinforced by a lack of accessibility to a primary healthcare provider

caused by the waiting period.

The existence of the three-month waiting period has been one of criticism for many

years, specifically from groups promoting immigration. Stating that it results in worse health

outcomes and further stigma towards people attempting to immigrate to Canada among other

topics of contention (Gangdev, 2021). Yet oddly enough, there is no official statement as to why
it continues to exist other than its anti-immigration roots from 1994. All of this can make one beg

the question of, “Why does the wait time still exist?”

Arguments

Healthcare as right/unnecessary

The three-month waiting period puts an unnecessary and unethical wait time on people

who are already committed to staying in Ontario for the long term, the wait affects those who

have prior conditions and works more as a deterrent to immigration. In addition, the wait period

only adds additional stress and regulation over these new residents as the idea of having to pay

out of pocket may be an expense they cannot afford. Since Canada was one of the countries to

sign the Universal Declaration of Human Rights, a United Nations document which promises

access to free health care for all its citizens, there should be no wait period for these new

Canadian citizens. Not to mention that private healthcare can be expensive for new immigrants,

especially if they have pre-existing health conditions (Caulford, & D’andrade, 2012). Canada

sees healthcare as a right, this is proven through such programs as the Interfirm Federal Health

Program (IFHP), which provides limited health coverage for refuge claimants and victims of

human trafficking. The problem arises when of these people attempt to obtain permanent

residence in Ontario, where they will lose their IFHP and instead have to transition to OHIP,

which includes the three-month waiting period. This can result in situations where human

trafficking victims attempting to become a Canadian citizen will have their Canadian healthcare

taken away for three-months, simply for trying to become said citizen (Government of Canada,

2020).
 Discrimination

For new permanent residents to Ontario, the three-month waiting period can have

potentially damaging effects. They may need care but are avoiding seeking medical attention

because of the financial repercussions. This leads to poor health and unnecessary hardships for

individuals who are already dealing with the stress of integrating themselves into a new country

and culture. Not only were many immigrants and permanent residents unaware of the mandatory

three-month waiting period until after they arrived, but many are also experiencing financial

stress over housing and finding employment to begin with. Some new immigrants even reported

that the experience of having to wait for health care left them with a negative view of Canada as

a whole (Goel, et al., 2013). This negative view could also be related to the three-month wait

period also creating a division between Canadians that are immigrants and those who are born in

Canada even more prevalent, which results in further tension by dividing Canadian citizens into

groups. Providing health care for uninsured immigrants can cause also challenges for health care

providers who feel a moral obligation to provide care (Caulford, & D’andrade, 2012). Along

with that, it is important that all Canadians have access to mental health care without being

forced to wait for several months as difficulty communicating and understanding Canada’s

health care system can be a deterrent for immigrants from seeking proper help for mental health

care. This is an important topic because ethnocultural minorities have been reported to have a

lower-than-average access to mental health care in comparison to the rest of Ontario, and Canada

as a whole (Grace, et al., 2016). Community health centers were often used by immigrants

during their waiting period, as it was a cheaper alternative. However, this resulted in an

overwhelming increase of patients that the health centers were often feeling overwhelmed by
influx of new patients (Bobadilla, et al., 2016). In addition to that, there are reports that the

typical care received by an insured and uninsured patient vary quite drastically, with the

uninsured patient receiving care of a much lower standard (Sachez, et al, 2016).

Compound cost
Even though the strongest argument for the three-month waiting period is that it saves the

government and taxpayers money, there was actually no evidence found by the Ontario Medical

Association that the wait period saved Ontario any money at all. Although the Ontario Ministry

of Health has claimed that the wait period saves $90 million each year, various coalition groups

have argued that it ends up costing about $80 million by limiting access to preventative care

(Bobadilla, et al., 2016). Studies in the United States have also proved this fact as it is shown that

health care costs decrease when primary care is provided to uninsured immigrants as a

preventative measure (Bobadilla, et al., 2016). Clinics within the Greater Toronto Area

discovered that recent permanent residents are one of the largest groups accessing health care

without insurance (Grace, et al., 2016). This demonstrates that many new permanent residents

will forgo getting any form of private healthcare coverage, most likely due to their exorbitant

costs. As it is not uncommon for new permanent residents to be overcome with sizable debts

related to healthcare due to the three-month waiting period. For example, it was found that

uninsured patients had a higher tendency of HIV from lack of proper preventative measures

(Sachez, et al, 2016). Women who are uninsured were found to have much lower quality of care

compared to those who were insured. Pregnancy and mental health issues were the most

common issues that came up during the three-month waiting period, yet they were not capable of

getting the proper treatments due to high expense which resulted in future problems for the

mother and child (Bobadilla, et al., 2016). In addition, permanent residents have reported that
they encouraged their family to stay inside the home and not take part in outdoor activities for

fear of injury and paying high medical costs out-of-pocket. They often felt alienated and

depressed as a result which is only further compounded after having to go through all the work

of the immigration process and still not being considered a full citizen with the benefit of OHIP

(Bobadilla, 2013). Even though immigrants are new to Canada, some may feel like they have not

attributed enough to be included in the health care system. However, they begin paying taxes as

soon as get to Canada, which should entitle them to receive all the benefits provided to a

Canadian tax paying citizen, including OHIP (Caulford, & D’andrade, 2012).

Conclusion

Removing the waiting period as a prerequisite to applying for OHIP by the Ontario

Government would benefit every new permanent resident coming to Canada by encouraging

long-term immigration, decreasing future medical problems, and providing them their right to

healthcare the same as any other Canadian. The insight gained from the perspective of new

permanent residents coming to Canada, needing to face the current hardships already present to

then also be informed that they will be spending their first three-months without healthcare

coverage would be dreadful. It is an unnecessary rule with the sole intention of anti-immigration

from bygone era, but now Ontario and Canada as whole have become a much more progressive

country that recognizes the importance of immigration for the future. However, it is still

important to view this situation from the unique viewpoint that healthcare staff such as nurses

have. People that have a goal to serve the public when sick and in need, and when the

government makes that goal harder to achieve it is important to discuss if the reasons behind that

hardship are justified. In this case, it is whether they deem the three-month wait period, which

discourages the ill from seeking the help, is worth it. With no solid reason behind its existence to
begin with it should be deemed unnecessary for the exorbitant stress it causes on the person, but

also the healthcare system itself. Therefore, the OHIP waiting period needs to be lifted

permanently for every new permanent resident because in Canada, healthcare should be covered

for all Canadian citizens.

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