Evidence of meeting #84 for Citizenship and Immigration in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was costs.

A video is available from Parliament.

On the agenda

MPs speaking

Also speaking

Lorne Waldman  Barrister and Solicitor, Lorne Waldman and Associates, As an Individual
John Rae  First Vice-Chair, Council of Canadians with Disabilities
Brent Diverty  Vice-President, Programs, Canadian Institute for Health Information
Michael Battista  Barrister and Solicitor, Jordan Battista LLP
Adrienne Smith  Barrister and Solicitor, Jordan Battista LLP
Maurice Tomlinson  Senior Policy Analyst, Canadian HIV/AIDS Legal Network
Meagan Johnston  Staff Lawyer, HIV & AIDS Legal Clinic Ontario
Mercedes Benitez  As an Individual
Toni Schweitzer  Staff Lawyer, Parkdale Community Legal Services
Clerk of the Committee  Ms. Erica Pereira

7 p.m.

Liberal

The Chair Liberal Rob Oliphant

Okay. Thank you.

Mr. Maguire.

7 p.m.

Conservative

Larry Maguire Conservative Brandon—Souris, MB

Thank you, Mr. Chair.

I want to thank the witnesses for their excellent presentations this evening.

I have several questions in a short amount of time.

Mr. Rae, can you give me an example of the numbers? I've heard of as many as 900 applicants a year who are declared inadmissible. Do you have a more accurate number?

7 p.m.

First Vice-Chair, Council of Canadians with Disabilities

John Rae

I'm afraid I don't. We've heard those numbers as well. It sounds like a lot to us, but we've heard those numbers.

7 p.m.

Conservative

Larry Maguire Conservative Brandon—Souris, MB

The number I have is 900, and that is supposed to be 0.2% of the persons who are brought into the country. That seems like a rather small number.

I want to go back to your comment and to Mr. Waldman's comment.

Could you expand on that, Mr. Waldman? I think you both had a solution to this, and I wonder if you would put it on the record again.

7 p.m.

Barrister and Solicitor, Lorne Waldman and Associates, As an Individual

Lorne Waldman

You pointed out the fact that it's such a small number. The cost of medical processing of all of these applications is very high. Each person has to go through a medical check, and then the application is reviewed by a medical officer. To screen out, effectively, 900 applicants, one wonders, from a cost-benefit point of view, whether it makes any sense to do that.

In any event, the argument I made was that we should probably just eliminate medical inadmissibility because the number is so small, the costs associated with it are very high, it impedes our ability to compete for the immigrants we need, and it creates a lot of hardship.

7 p.m.

Conservative

Larry Maguire Conservative Brandon—Souris, MB

Mr. Rae, could you add to that?

7 p.m.

First Vice-Chair, Council of Canadians with Disabilities

John Rae

We agree. The numbers you quoted, sir, bear out my earlier comment that Canada is not likely to be flooded with a huge number of additional applicants should this discriminatory provision be repealed.

7 p.m.

Conservative

Larry Maguire Conservative Brandon—Souris, MB

Thank you.

What types of disabilities are the main ones that people are rejected for? Are they physical or mental? Where are we with that? Is there a divide in that?

7 p.m.

First Vice-Chair, Council of Canadians with Disabilities

John Rae

I don't think I have a breakdown for you, but I know that a lot of the cases that have come through the doors of our national office seem to be on the ground of intellectual disability.

7 p.m.

Barrister and Solicitor, Lorne Waldman and Associates, As an Individual

Lorne Waldman

I agree. In our office we see people with medical issues, such as heart attacks. That's part of it, but many of the cases also involve people who are supposedly mentally disabled in some form or another.

7 p.m.

Conservative

Larry Maguire Conservative Brandon—Souris, MB

Thank you.

Mr. Diverty, I noted in your presentation that basically health care spending is going up 3% for hospitals, 5% for drug spending, and 4% for physicians in 2017. I don't doubt that, but it also says that 2% of the health spending per year comes from normal population growth and aging. There's not much we can do about that I suppose. It's quite a good thing that our population is growing.

That certainly narrows down the overall cost of real increases in a particular item. Can you elaborate on that?

7:05 p.m.

Vice-President, Programs, Canadian Institute for Health Information

Brent Diverty

Obviously, there's both the additional services that are provided, and then there is the price of those services. It starts with that. As you see more people, you have more services, there are more costs, and there's also more on the price side.

We're seeing, I think, modest growth on both of those. We have an aging population demanding more services. We have more people of all ages with more services. We do, obviously, see wage and price inflation in there as well. That's really added up over, I would say, the last four or five years to about a 3% average increase in spending.

It was a bit lower a few years before that. We have basically seen health spending move in lockstep with the economy typically over the last 20 or 30 years. When the economy is going well, you see more health expenditure, and it slows down in times when the economy is not going so well.

7:05 p.m.

Conservative

Larry Maguire Conservative Brandon—Souris, MB

Thank you.

Mr. Waldman, you said there are two reasons for inadmissibility: danger to the public and excessive demand on services.

Is the danger to the public a small portion of the overall...or is the excessive demand on services the major one? Is that correct?

7:05 p.m.

Barrister and Solicitor, Lorne Waldman and Associates, As an Individual

Lorne Waldman

I think that's right. From my experience, it's a very small percentage.

People who get medical exams sometimes have conditions. They are required to have them treated, and then once they are treated and people are cleared, they come to Canada.

7:05 p.m.

Conservative

Larry Maguire Conservative Brandon—Souris, MB

We've seen that there are huge costs, and they are growing, but they are not growing perhaps as much as the overall when we take into account the physicians, drug spending, and that sort of thing as the basis or the 2% as the health spending per year on aging.

What would be a fair compromise or a fair solution? Canada is a pretty fair and generous country, as we all know, in these areas. Is there a limit? How would we deal with this? Given that there are huge costs already for these 900 persons, there's some suggestion here that there may be a saving from not having to put them through all the paperwork we put them through.

What would be a reasonable process here? Is there a compromise with the provinces in regard to this, so if the provinces decide they want to fund a particular case, they can go ahead and do that?

7:05 p.m.

Barrister and Solicitor, Lorne Waldman and Associates, As an Individual

Lorne Waldman

That used to be the way it was done. For example, Manitoba had a scheme whereby you could pay an amount of money as a bond for future expenditures. That was cancelled.

There are ways one could move forward and look for compromises such as people offering to pay bonds or provinces agreeing to allow people to come into Canada.

Obviously immigration is a shared responsibility, so any decisions you make you are going to have to discuss with the provinces as well, especially given that the medical expenditures are provincial.

I think when you look overall at the number of people we're talking about, 900, even when some of them have significant costs as a factor of the total amount of money you're spending, it's insignificant in terms of health care dollars, and it creates a whole series of impediments both to family reunification and to having the best and most skilled people come into Canada.

When we look at all of these things, I wonder whether it makes sense to continue with this program.

7:05 p.m.

Liberal

The Chair Liberal Rob Oliphant

Thank you, Mr. Waldman.

7:05 p.m.

First Vice-Chair, Council of Canadians with Disabilities

John Rae

If I can just add.... If that were to occur, it could set up a patchwork of eligibility province to province. I don't think that's something we want in Canada.

7:05 p.m.

Liberal

The Chair Liberal Rob Oliphant

Thank you, Mr. Rae.

Ms. Kwan, go ahead.

7:05 p.m.

NDP

Jenny Kwan NDP Vancouver East, BC

Thank you very much, Mr. Chair.

Thank you to all the witnesses for their comments.

I certainly appreciate and agree with the suggestion that we should get rid of this criterion altogether. If you look at it, you see that it is an issue around picking and choosing, and saying to the world that people who have different abilities are not welcome in Canada, because at the end of the day, that's what we are talking about.

Just to build on this notion, the idea of fixing the issue somehow, somewhat with a patchwork approach.... Mr. Rae, you've expressed very clearly that this would not work. Mr. Waldman, I think we've heard from you as well that, given the context of the small number of people who would fit into that category, it is perhaps not the right approach to take.

I want to touch on this issue, too. We had officials who came forward and advised this committee that in fact they don't evaluate the contributions of individuals and their family units. You could be a family unit with somebody deemed to have “excessive demand” or even an individual with a different ability. They don't evaluate the contributions of those individuals; they look strictly at the cost side.

Mr. Waldman, can you comment on the problem with that kind of evaluation? Not to mention that, as you said in your opening statement, it has been found through various media reports that IRCC's approach to assessing the cost is fraught with problems....

7:10 p.m.

Barrister and Solicitor, Lorne Waldman and Associates, As an Individual

Lorne Waldman

The point is well taken, in the sense that if we are trying to compete for the most skilled workers but we make it difficult for them to come in by saying that they can't come because someone in their family has some kind of disability, we are not going to be able to get the workers we require. An approach that looks only at the medical cost and doesn't look at the human capital that this person is bringing into Canada is fundamentally flawed and, I think, harmful overall to our ability to attract the most skilled immigrants over the long term.

7:10 p.m.

NDP

Jenny Kwan NDP Vancouver East, BC

Thank you very much.

Mr. Rae, do you have anything else to add?

7:10 p.m.

First Vice-Chair, Council of Canadians with Disabilities

John Rae

I totally agree with you. It seems to me a very arbitrary process that when a particular disability is identified, chances are that this person is automatically excluded.

That does not take into account the fact that telling you that a person has a given disability tells you a lot less than many people think it does. It doesn't tell you the particular degree of that disability, nor the person's background, attributes, and how they deal with the realities of their particular disability, nor does it speak to the contributions that this person might make if they come to Canada. I think those are contributions our society wants and needs.

7:10 p.m.

NDP

Jenny Kwan NDP Vancouver East, BC

Mr. Waldman, I'm wondering if you have come across cases where someone was denied based on the excessive demand provision by just a small amount of dollars. Given the fact that we now know that how the government came up with the figure to determine what is deemed to be the appropriate measure is flawed, I wonder if you can share with us your experiences of how often this has happened, where people are denied because, by a fraction of the dollars, they exceeded the amount that was deemed to be the average cost.

Given that this is the reality, what should the government do about those kinds of cases, if anything?

7:10 p.m.

Barrister and Solicitor, Lorne Waldman and Associates, As an Individual

Lorne Waldman

I think probably it's too late to really deal with past cases. They've been refused based upon data we think is inaccurate. We see it in two ways. First of all, the government has to estimate what they think the likely cost will be for the individual who's applying to come to Canada. That's based upon arbitrary assessments of services the government believes they might need.

I'll give you an example. We have people who have some kind of a mental handicap and the government says they're going to need special education, and they factor that into the cost. Special education is quite expensive for sure, but what we see, for example, is that people who come at a certain age don't speak English, and are not likely to be able to speak English, and the special education programs aren't offered in the language in which they speak, yet they're being costed as if these programs exist, when in fact they don't really exist.

That's the kind of arbitrariness we see in the system as it now develops. When you couple that with the fact that the number the government has been using for the average cost.... Because remember the average cost isn't the average cost of a Canadian, it's an average cost of a person of the same age group, so as you get older the cost goes up and the average goes up, but the government's estimates have been off.

When you put those two things together, there are a lot of people who are being rejected unfairly. If they've been rejected unfairly in the past, there's not much we can do about that, but we have to make sure that if this program continues—and I hope it doesn't but if it does—it's based on fair and accurate data.