Health care for Canada's medically uninsured immigrants and refugees: whose problem is it?

In 1999, community health workers informed us that large numbers of immigrants and refugees lived and often worked in our Scarborough, Ont, community while being denied access to publicly funded health care. Our inquiries uncovered empirical evidence that Scarborough’s uninsured experienced health care access inequities, health disparities, financial hardships, and delayed acculturation. Scarborough’s only community health centre (CHC) reported a waiting list of 3000 uninsured newcomers seeking access to health care. In May 2000, an interprofessional team of primary care providers and community workers responded by establishing 2 community-based, volunteer-run health clinics in Scarborough to provide free front-line health care to this vulnerable group. We have since recorded more than 20 000 patient visits. Our subsequent research confirmed that Canada permits large numbers of medically uninsured immigrants and refugees to reside across the country. Canada is not alone among industrialized nations with publicly funded health care schemes in struggling with this reality.1