On the medical inadmissibility issue, your suggestion is that since they've been approved to come to Canada, and while they're waiting to come or the sponsorship application is being processed three years later, during that period--since they have already been approved to come to Canada and are arriving in Canada already, you don't need to....
They don't have germs, because they're clean, so to speak, or are cleared when they arrive in Canada. Do we now still ask them to do another medical, even though they're already in Canada and have a visitor visa? Do we still ask them for a medical clearance?