Red tape leaves expectant B.C. mom with no medicare

A B.C. couple about to have their first baby said the best time of their lives has been marred by fear and frustration — because red tape has them facing up to $20,000 in hospital bills.

“Seeing how the system has failed in this case is the most frustrating thing,” said father-to-be Kevin Ganshorn, who lives in Vancouver with his wife Susana Bustes.

“We’re talking about people’s lives here…I'm a fifth-generation Canadian; I've been paying taxes for two decades now.”

Bustes is from Peru. She has no B.C. health coverage because her application for permanent residency in Canada is stuck in a huge federal government backlog.

“My friends there, my family there [in Peru], they can't believe this is happening to me,” said Bustes, who earned a law degree before coming to Canada.

Canadian baby, still no coverage

“The baby is Canadian — so I don't really understand. This is really sad.”

Ganshorn met Bustes four years ago at a friend’s wedding in Peru. She moved to Vancouver as his wife two years later.

She is about to give birth to a Canadian baby boy — still, the province has refused to cover her medical costs because it wants a letter from the federal government confirming her application for residency is being processed.

“It was a bureaucratic mess — that I tried to solve,” said Ganshorn. “I am caught between two bureaucracies that aren’t working together.”

Citizenship and Immigration Canada’s website shows it received the application last summer, and that Ganshorn’s sponsorship is “in process.”

However, it’s a two-step approval — the sponsorship, then the residency. B.C.’s Medical Services Plan requires confirmation that phase two — the residency — is being worked on.

“As far as we know, it's just sitting on someone's desk in a pile of other of applications waiting to be looked at,” said Ganshorn.

Brick walls at both levels

He said he’s spent hours in frustration trying to resolve this, but that CIC told him the only option is to keep checking their website or have B.C. officials call for status updates.

Ganshorn said a B.C. enrolment officer refused to make that call and continued to insist he needs the letter.

“It’s pretty ridiculous, considering the [CIC] website it says ‘we received your application on August 15, 2013,’” said Ganshorn.

The federal website estimates it will be at least another eight months before Bustes is granted residency status.

She could go back to Peru to have the baby, but it's not an easy option to choose.

“It’s no possibility go there and have the baby alone without Kevin — and he has to work,” said Bustes.

She doesn’t have private health insurance, because when she came here she was healthy and Ganshorn expected she would be covered by his provincial plan.

“Susana is entirely eligible to be added to my MSP account,” he said. “We are in a genuine relationship. I mean we're starting a family here.”

The couple now plans to have their baby at home — in their tiny Vancouver condo, with a midwife — to avoid the bills.

“It’s a lot of money to go to the hospital, so that is why finally we decide to have the baby at home. It was hard. We thought a lot about it,” said Bustes.

Worried about home birth

“I was thinking always to have the baby at the hospital, with the nurses. Everything traditional.”

She said her family in Peru is quite worried, because no one there gives birth at home. She said she’s still excited, but also quite scared.

“I am worried about the pain. I am worried something happen wrong with the baby after I give birth,” she said, pointing out they will go to hospital if necessary.

“I hope everything will be OK with a home birth, but you don’t know.”

Ganshorn is a biologist with a good salary, but said if he has to fork out $20,000 he won’t be able to take paternity leave to spend precious time with his new son.

That would leave [Bustes] by herself without family support," he said. "You only get to have a first child once, and I would like to be a part of watching the early development, for sure.”

It’s estimated thousands of foreign-born spouses of Canadians are without health coverage across the country. There are countless postings about this problem on immigration forums online. A group of affected people has just put out a petition, hoping to get the federal government to make changes.

Common dilemma

Go Public asked CIC several times exactly how many spousal applicants are stuck in the backlog, but received no answer. The current processing time for applications is 17 months.

The midwife delivering the B.C. couple’s baby said one of her clients went back to Japan alone to have her child. Another from Korea had complications with her home birth and was slapped with a $15,000 hospital bill she couldn’t pay.

“It ends up putting a lot of pressure on women to feel that they have to be able to do this naturally and at home,” said Marijke de Zwager.

“Even with the backlog of bureaucracy, there should at least be some consideration when you are pregnant.”

The immigration minister’s office blamed earlier Liberal governments for the backlog, and said wait times are improving.

“While we empathize with [this couple], it is important to understand that files are processed by highly trained visa officers in accordance with Canadian immigration law, and in the order they are received. It would be unfair to individuals already in the queue to expedite one file over another,” said Alexis Pavlich, spokesperson for Immigration Minister Chris Alexander.

“It is also important to note that health care in Canada is a provincial responsibility.”

CBC News tried several times to talk to the immigration minister about this, but he wasn’t available.

B.C. and Ontario suggested they are hamstrung by rules requiring the federal government to grant residency.

Rules and requirements

“The federal government sets the rules around immigration and visa requirements, and this may affect the wait time for MSP coverage for new residents of B.C.,” said a ministry of health spokesperson. 

“Ontario health insurance coverage is provided to this group at the point in the process when CIC has confirmed (CIC confirmation letter) that the individual meets CIC’s eligibility requirements,” said a spokesperson from Ontario’s ministry.

A Victoria immigration lawyer who deals with these cases said the CIC letter requirement is over and above what provincial law requires for residency. Jim Turner accused governments of making up rules just to deny coverage.

“I think, frankly, this is disgraceful. You know, when the [B.C.] Medical Services Plan was brought in, it was with the intention of helping people. Not coming up with every rule in the book as a way of cutting them off,” said Turner.

“I think this is going to continue until somebody sues them.”

In the meantime, as a result of Go Public’s inquires, B.C.’s health minister said there is some flexibility, so it appears Bustes can expect coverage after all.

“The services of British Columbia hospitals would be there, and we would worry about the details later,” said Terry Lake.

“If there is a problem involved with bureaucracy, we will be very compassionate and work with them. And if they can demonstrate that the process is happening, then we will extend coverage.”

Ganshorn said it’s sad he had to go public to get that response.

“This was the last resort, and I think it's sad that it has to come to this in a country like Canada.”

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