Pearl Eliadis • Special to Montreal Gazette Publishing date:Oct 13, 2020 • Last Updated 1 month ago • 3 minute read
Quebec-born Psalm is only one of many children living in this province who are unjustly being denied coverage because of parents’ status.
Little Psalm lives with his parents in Montreal, where he has lived every day of his nine months. He is a Canadian citizen and Quebec born.
But the Régie de l’assurance maladie du Québec (RAMQ) insists that baby Psalm cannot be considered a resident because his parents are not permanently residing here. It has refused him access to public health insurance.
Psalm’s parents are from Ethiopia. His dad is an award-winning PhD student and a former Sauvé Scholar, now in his second year at Concordia University. Him mom holds a valid work permit and is currently on maternity leave. Both are lawfully in Quebec and would like to stay. For now, both parents pay for their own medical care and will continue doing so until their status changes.
But Psalm, like any child, needs his regular checkups. He also has specialized medical needs following a shoulder injury sustained at birth. The costs are beyond his parents’ financial means.
Quebec’s Civil Code says that a minor child under parental care who lives in Quebec is considered “domiciled” and therefore resident in Quebec. The law was changed in 1999 — yes, almost 20 years ago — to ensure that such children would receive the care they need based on their own, independent status in law, and not that of their parents.
But the practice of refusing health care to those in Psalm’s situation has persisted, first under the Parti Québécois, then the Quebec Liberal Party, and now under the Coalition Avenir Québec.
Quebec doctors, lawyers and people working for social justice in health care have denounced the RAMQ’s practice.
In 2018, Quebec’s ombudsperson Marie Rinfret issued an investigative report urging the RAMQ to register all children born in Quebec who are residing here
provided they meet the rule the rest of us must respect: physical presence in the province for 183 days of the year.
A year later, nothing had changed and a second report was issued.
In April 2019, an initiative funded by the Lucie and André Chagnon Foundation, the Obervatoire des tout-petits, prepared a comprehensive research file on the impacts of RAMQ’s practices on children, families, women and health-care providers.
The situation has forced doctors like those at Médecins du monde to provide volunteer clinical services to children who have been denied public health services. And another group, the Caring for Social Justice Collective, has launched the campaign #RAMQpourTLM (“RAMQ pour tout le monde” — RAMQ for everyone). Extending health care to Quebec-born Canadians is just the first piece of a complex puzzle to get all children registered, but it is a place to start.
On July 9, the Montreal law firm Trudel, Johnston & Lespérance filed a class action lawsuit on behalf of Canadian children excluded by the RAMQ’s allegedly discriminatory practice.
There is nothing like a class action lawsuit to focus the mind.
On July 23, the Quebec government quickly announced its intention to reverse its practice and do the right thing, but as it turned out, celebrations were premature.
On Aug. 5, Psalm’s parents received a letter from the RAMQ refusing medicare again. And that refusal was reiterated a month later.
For now, the government’s feel-good announcement is just that, an announcement with no teeth. Psalm and his parents will continue to take administrative and constitutional steps to obtain public health insurance under the current rules and hope that swift government action will make this step redundant.
The government of Quebec should act immediately to extend full rights to Psalm and to all children living in Quebec, to have access to health insurance regardless of their parents’ status and origin.
Pearl Eliadis is Montreal lawyer affiliated with the Centre for Human Rights and Legal Pluralism at McGill University. Along with Arielle Corobow and Julius Grey, she is providing pro bono support to Psalm’s parents.
Postscript: On October 28, 2020 the Quebec government announced, again, that it would be modifying the law to address the lack of access to health care for Canadian citizens.