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协商脆弱性:加拿大安大略省的新移民对等待公共医疗保健的看法。

Negotiating precarity: Recent immigrants' perceptions of waiting for public healthcare in Ontario, Canada.

机构信息

Canada Excellence Research Chair in Migration & Integration Program, Toronto Metropolitan University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada.

York Region Transit, The Regional Municipality of York, 50 High Tech Rd, 4(th) Floor, Richmond Hill, ON L4B 4N7, Canada.

出版信息

Health Policy. 2023 Jul;133:104843. doi: 10.1016/j.healthpol.2023.104843. Epub 2023 May 27.

Abstract

Canada is widely known for its universal publicly funded health care system. While its health care system is an important part of Canadian identity, recent immigrants living in some provinces and territories are not covered by the publicly funded healthcare system until they have met a minimum residency requirement. This article seeks to understand the multiple manifestations of financial and emotional precarity that recent immigrants face as they navigate a lack of access to health care during their first three months of arrival in Ontario. This paper draws on qualitative semi-structured interview data from 46 recent immigrants who came from 12 different countries and had been living in Ontario, Canada. We found that the wait period to obtain health care often added to the prohibitive costs associated with immigration and settlement. During the wait period, recent immigrants faced financial burdens and their inability to access publicly funded hospitals and medical services when needed which resulted in feelings of vulnerability, anxiety, and emotional hardship. Given the financial and emotional precarities faced by recent immigrants during the wait period, we argue that the Canadian 'universal' healthcare system excludes and creates barriers to timely and equitable access to healthcare services for recent immigrants. We recommend to permanently eliminate the wait period policy to ensure the health and wellbeing of recent immigrants.

摘要

加拿大以其普及的公共资助医疗保健系统而闻名。虽然其医疗保健系统是加拿大身份的重要组成部分,但最近在一些省份和地区居住的移民在满足最低居住要求之前,无法享受公共资助的医疗保健。本文旨在了解最近移民在安大略省抵达的头三个月内由于无法获得医疗保健而面临的经济和情感不稳定的多种表现形式。本文利用来自来自 12 个不同国家的 46 名最近移民的定性半结构化访谈数据,这些移民已在加拿大安大略省居住。我们发现,获得医疗保健的等待期往往增加了与移民和定居相关的过高费用。在等待期间,最近的移民面临经济负担,并且在需要时无法获得公共资助的医院和医疗服务,这导致了脆弱感、焦虑和情感困难。鉴于最近移民在等待期间面临的经济和情感不稳定,我们认为加拿大的“全民”医疗保健系统将最近移民排除在外,并为他们及时获得公平的医疗服务设置了障碍。我们建议永久取消等待期政策,以确保最近移民的健康和福祉。

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