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- Health
These Gazan families came to Quebec for safety. Now, they face life without health coverage
When Nidal Zaqout arrived in Montreal last September from Gaza, he hoped to have a chance to rebuild his life. But safety didn't mean the struggle was over. He soon realized that he and his family would only receive public health coverage for three months after arrival — despite having fled Israel's deadly attacks on Gazans and their homeland. It's a bad feeling, I'm thinking about everything every day, Zaqout said from the living room of his West Island home, where he lives with his parents, two of his sisters, his wife and his two children. I have a big family, big responsibility. Zaqout fears what might happen if someone in his household becomes ill. His father suffers from severe knee pain and his mother from migraines and issues with her back, shoulder and neck. Without Quebec health insurance (RAMQ), going to a hospital is not an option, and the options are scarce and expensive. Not all the people have money, they cannot cover for the health because the people came from Gaza, said Aya, Zaqout's 15-year-old sister. Everything is destroyed, they don't have nothing. They lost everything. As Zaqout and his sister spoke, their mother served dates and coffee. The family gathered close and gently helped one another tell their story in Arabic, French, and English, attentive to every detail. Zaqout expressed gratitude toward the Canadian and Quebec governments and said he was happy and feels safe here, but wishes he and his family could have access to care. I can't live without a medical card, he said. 'I need health care after the war' Zaqout and his family arrived in Canada as temporary residents through the temporary residency program for Gazans (new window) . Their visas are valid for three years and they initially received three months of health coverage through the Interim Federal Health Program (IFHP) — after which the federal government says it's up to the provincial government to take over. But Quebec has faced criticism for failing to do so. More than 70 civil society and health-care groups in the province published an open letter in La Presse (new window) last month calling out the province for not providing health-care coverage to Gazans. Quebec remains the only province refusing to insure their health care, the letter stated. According to federal data, 823 Gazans have made it to Canada between October 2023 and May 2025. These families are among the Palestinians affected after Israel's army killed more than 54,000 Palestinians, according to Gaza's health authorities, and displaced 90 per cent of the enclave's population. That same month, a United Nations report (new window) concluded that Israel is deliberately inflicting conditions calculated to bring about the physical destruction of Palestinians as a group, one of the categories of genocidal acts in the Rome Statute and the Genocide Convention. Everything got destroyed, my house, my everything, my business, my jobs, said Zaqout, showing a video of his former home in Gaza — a house with elegant architecture and a palm tree that once stood tall beside it. Enlarge image (new window) Jehan Elsayyed, left, a Gazan living in Sherbrooke, Que., with her husband and her daughter, broke her arm after she slipped on ice. Her health coverage expired shortly after and now, she continues to struggle with her recovery. (Submitted by Jehan Elsayyed) Photo: (Submitted by Jehan Elsayyed) Jehan Elsayyed, another Gazan who has been living in Sherbrooke, Que., since December, is all too familiar with Zaqout's loss. She tears up over videoconference as she recalls witnessing an old man forced to strip by an Israeli soldier and her time living in Gaza with 180 people in a single house without water, food or electricity. When she finally made it to Quebec, she slipped on ice and broke her arm. Her health coverage expired shortly after and now, she continues to suffer. I need health care after the war, she said. I don't want my health situation to be worse. Elsayyed is learning French and said she is trying to integrate into society, grateful for the help she's received from Quebecers. But she finds it very frustrating to live without health insurance. I hope that I can have the right to live as a respected person … and to be equal like other immigrants in Quebec, she said. 'We're making them even more vulnerable,' says doctor In the open letter, the 75 organizations pointed out a double standard after Quebec extended Ukrainians' health-care coverage (new window) — initially set to expire in March last year — until March 2028. The same protection has so far been denied to Palestinian families, including children, fleeing a situation described by many experts as genocide, read the letter. Sophie Zhang, a member of Quebec Doctors Against Genocide, was among the physicians who signed it. Our governments do play a role in what's happening to these Gazan families and the reason why they're here in the first place, said Zhang. So I do think we need to take this responsibility and at least give them basic rights like health care. Khadijé Jizi, a Montreal-based genetic counselor and member of the Health Worker Alliance for Palestine, highlighted that Gazan patients suffer from chronic conditions, gynecological and fertility issues and PTSD. These are all things that didn't disappear when they left Gaza. They're still there and they need medical attention, said Jizi. She also warned that without public coverage, Palestinian children won't be supported for potential developmental issues or language delays. These are vulnerable families, so them leaving a country during a genocide and coming to a whole new country … has its set of challenges, said Jizi. When we add not having access to health care, we're making them even more vulnerable. Conflicting explanations from Quebec and Ottawa In response to CBC's request, Quebec's immigration and health ministries issued a joint statement, declaring that provincial health coverage eligibility depends on documents issued by federal immigration authorities related to Gazans' status. The statement noted that the visa granted under the federal government's temporary public policy for Gazans does not include any specific designation, unlike the Canada-Ukraine Authorization for Emergency Travel. Instead, the province said it is a general document allowing a foreign national to stay in Canada for a limited period, regardless of origin. The provincial ministries said they've asked the federal government to extend coverage under the temporary public policy to avoid a lapse and allow [Gazans] to regularize their status to qualify for the plan, but they say they have yet to receive a response. Immigration, Refugees and Citizenship Canada, meanwhile, said public health-care coverage is primarily a provincial/territorial responsibility and that provinces and territories were also encouraged to consider extending access to health. Comparisons between Gaza and other crises, such as in Ukraine, oversimplify complex realities that must be considered, including provincial capacity to support newcomers, the ease of movement out of conflict zones, and the targets set by the 2025–2027 Immigration Levels Plan, the federal ministry wrote in a statement responding to CBC's follow-up questions. Dr. Sophie Zhang is a Montreal-based physician and member of Quebec Doctors Against Genocide. (Submitted by Sophie Zhang) Photo: (Submitted by Sophie Zhang) Zhang described the sentence as shocking and questioned why Ottawa would cite immigration targets in this context. She said she interpreted both governments' statements as attempts to deflect responsibility for an issue that is very easily solvable. Haya Alsakka, an organizer with the Palestinian Youth Movement in Montreal, described the lack of extended health coverage for Gazans as a policy of racism and discrimination, targeting Palestinian and Arab communities. She noted Quebec very quickly provided health coverage to Ukrainians. How are we supposed to believe that it really is an administrative issue that is barring Quebec from giving these families health-care access? asked Alsakka. Zaqout still has loved ones trapped in Gaza, including one of his sisters, along with her husband and child who remain in a tent. He explained that they were living in a different part of the enclave. When they tried to escape, the road was bombarded by the Israeli military. He also added that they didn't receive visas from the federal government. His family cries every day, longing for news and a chance to reunite. As he watches videos of himself treating Palestinian children inside tents in Gaza, he shares his experience as a nurse. Now, in Montreal, he hopes to put that same care to work for Quebecers. I want to succeed in my life. I want to provide all my experience, all my everything to these people here, said Zaqout. I hope to complete my family here and I hope to have a medical card. Hénia Ould-Hammou (new window) · CBC News
CBC
17-05-2025
- Health
- CBC
Quebec's hearing aid plan for seniors only covers 1 ear. Critics are calling for change
Seniors experiencing hearing loss in Quebec are calling on the province to reverse a long-standing policy that compensates them for only one hearing aid, even if they need two — one for each ear. "It's an insult. It's really not fair, and I think it should stop. It should be that you're allowed to have two hearing aids," Martha Perusse, a 71-year-old with hearing loss, told CBC in an interview. For decades, Quebec's health insurance board, the Régie de l'assurance maladie du Québec (RAMQ), has covered the cost of two hearing aids — one for each ear — for children 18 and under, adults who need hearing aids for their studies or work and people who are also visually impaired. But for anyone else — mainly seniors and unemployed adults — the RAMQ only covers the cost of one hearing aid, even when someone requires them for both ears. "How does that make any sense?" Marina Souranis, an NDG resident who wears hearing aids and who's set to retire next month, told CBC in an interview. Souranis has used hearing aids since she started experiencing hearing loss in her 30s. One for each ear was always covered by the government. Now she'll see her coverage reduced to covering the cost of just one hearing aid when she retires. "It's bizarre. Instead of giving you things when you retire, they take things away," Souranis said. Perusse says "it was like a slap in the face" when she realized she wasn't going to have two hearing aids covered. She ended up paying out of her own pocket so she could have a hearing aid for each ear. But she wasn't happy about it. "I had done good work all my life and I was continuing to do good work as a volunteer," Perusse said. "I think people our age should still be considered valuable members of society." 'Having 2 ears is not a luxury' Quebec's order of hearing aid specialists, the Ordre des audioprothésistes du Québec (OAQ), and Hear Quebec, an advocacy group for people living with hearing loss that serves primarily Quebec's anglophone community, are calling on the province to cover the cost of two hearing aids for everyone who needs them. "Having two ears is not a luxury. It's just a basic need in terms of hearing correction," OAQ president David Gélinas told CBC. "It's important to correct both ears in order to restore localization, to have better performance and basically to be more comfortable," he said. Heidy Wager, president of Hear Quebec, says one hearing aid is "like wearing one prescription glass lens and then still expecting to see properly." WATCH | Cut to coverage: Gélinas said the most basic hearing aids cost $1,500 per ear. "The majority of our members are seniors on fixed income and can't afford that," Wager said. "They're left behind. They fall through the cracks. We have to look at our population right now — it's aging, and hearing loss is huge," Wager said. The OAQ estimates expanding coverage would cost the province $133 million over five years. Gélinas said that would be money well spent. "We know that hearing loss is linked to an increased risk of cognitive decline, increased risk of falls, increased risk of depression," he said. Wager notes all of those things combined have a significant impact on our health-care system. Hearing aids a social lifeline Wager said hearing aids are also an important way for seniors to remain connected to the world. "There's already a huge issue and stigma around accepting that you have a hearing loss," she said. "So that in itself is a barrier. And now the government only supplying one out of two is another barrier." Perusse says many seniors also already have trouble adapting to wearing hearing aids. "They just don't have the confidence to put up with it for a couple of weeks until they can adapt," she said. "I really believe that two hearing aids will help people to adapt faster, and then they'll continue to wear them." Wager said seniors with hearing loss tend to isolate themselves, and that effective hearing aids can help prevent that. "If you want to be socially active and included in your community and part of family gatherings, then you're most likely going to want to purchase that second hearing aid," she said. Quebec more generous than other provinces Sonia Bélanger, the minister responsible for seniors, did not respond to CBC's request for comment. But a spokesperson for Bélanger told Radio-Canada that the province was looking at "modernizing" the funding model for hearing aids, but was not ready to discuss details. Wager said while RAMQ covering only one hearing aid for seniors doesn't make sense and should be changed, the situation is even worse in other provinces. "For treatment of hearing loss, we are one of the better provinces in terms of getting hearing aids and having different options," she said. Ontario offers coverage for two hearing aids for seniors, but the coverage maxes out at $500 per device, which overall is less generous than Quebec. Most other provinces only subsidize the cost of hearing aids for some low-income seniors. "More than a billion people across the world have a hearing loss right now. It's huge and it's not going anywhere," Wager said.
CBC
25-02-2025
- Health
- CBC
They came to Canada to escape political instability in Iran. Now, Quebec is denying them health coverage
When a metal ladder fell and hit Somayeh Ahmadiseddigh in the head at work earlier this month, she was dizzy, nauseous and had trouble standing up. A colleague drove her to the hospital in Quebec City, but when she arrived, she was told it would cost $1,200 to see a doctor because she did not have a provincial health-care card. Although she had private insurance, the hospital receptionist said she'd have to pay upfront and claim the cost with her insurance company later. "I didn't know if I would get my money back," said Ahmadiseddigh. She and her brother tried a few other hospitals, but got the same response. She returned home not knowing the extent of her injury. "My brother stayed up all night beside my bed in fear that something would happen to me," said Ahmadiseddigh. The following day, she paid $250 to be seen at a walk-in clinic, which diagnosed her with a minor concussion. The whole experience left her feeling angry and vulnerable. WATCH | Iranians decry ineligibility for health coverage: Due to the political instability in Iran, Ahmadiseddigh moved to Quebec City with her daughter, Céline, last year. "I couldn't stay because I didn't want to wear a hijab and there were several occasions that I had an incident with the morality police and I didn't feel safe and my family was worried," said Ahmadiseddigh. She obtained an open work permit, which is valid for three years. But, in Quebec, this group of workers is not eligible for public health insurance coverage, known as RAMQ. "It's discrimination in my opinion," said Ahmadiseddigh. "I think it's not humane." Special measures for Iranian nationals In 2022, an Iranian woman named Mahsa Amini was arrested for failing to properly wear a hijab. She later died in police custody. Protests followed and there was a brutal crackdown by the Iranian regime. In response, the Canadian government made it easier for Iranians to stay in the country if they were already here to study, work or spend time with family. The government also allowed Iranians, like Ahmadiseddigh, who came to Canada on a visitor visa, to apply for an open work permit, which could help them earn permanent residency. This temporary immigration policy was introduced in 2023 and is in place until the end of February 2025. But it is up to each province to determine eligibility criteria for public health and drug insurance plans. "The harmonization between what's done in the province of Quebec and what's done at the federal level in terms of immigration isn't always perfect," said Nicolas Simard-Lafontaine, an immigration lawyer and vice-president of the Canadian Immigration Lawyers Association. Quebec is more accommodating if immigration is driven by economic needs and benefits Quebec businesses, but isn't as eager to have temporary residents it didn't specifically ask for, said Simard-Lafontaine. "Quebec has a tougher stance on immigration," he pointed out. But there are exceptions. When it comes to open work permits, both post-graduate open work permits and the dependents of international students in Quebec are eligible for RAMQ. The province also extended health-care coverage late last year for Ukrainian refugees who also have open work permits, said Simard-Lafontaine. 'Maybe I chose the wrong place to immigrate' A RAMQ spokesperson told CBC the Ukrainian situation is unique. But Sahar Soltani doesn't understand why Iranian nationals are being treated differently.. At the end of 2024, nearly 11,000 Iranians had open work permits in Quebec, according to statistics from Immigration, Refugees and Citizenship Canada (IRCC). Soltani moved to Quebec City with her husband and four-year-old daughter last year. She works and pays taxes in Quebec and takes French classes part time. A few months ago, she qualified for supplemental health coverage through her job at Dollarama, but can't take advantage of it because she has to have RAMQ to access it. Friends who settled in other provinces have not had the same kind of challenges. "I feel like I am falling behind," said Soltani, who is constantly worried about getting sick or seriously injured. She looked into private insurance, but it is too expensive and only intended for emergencies. She and her husband were told to change their work permit to a closed permit or apply for permanent residency, but that is not an easy option for newcomers and it can take years to get permanent residency. The hardship comes at a time when Quebec is re-assessing its immigration policy. Last year, it froze some of the immigration paths for people to become permanent residents. The freeze targeted skilled workers and foreign students. Immigrants say they're forced to 'gamble' on health decisions without medical coverage Premier François Legault, who has long maintained that cultural practices of immigrants, particularly from Muslim countries, pose a threat to Quebec's values, also called on Ottawa to redistribute asylum seekers in the province elsewhere, including people who have already settled here. "Maybe I chose the wrong place to immigrate," said Soltani. After CBC Montreal placed a message on an Iranian chat group, dozens of Iranians reached out to share similar frustrations, including people who have delayed starting a family because of the lack of health support for pregnancy and childbirth. Another man with blood cancer said he'd had coverage under a post-graduate work permit, but it was set to expire, leaving him just an open work permit and no access to RAMQ. He had no idea how he would get the medical follow-up and scans he needs to monitor his condition. Easier to qualify in other provinces In Ontario, temporary residents may qualify for health-care coverage if they have a valid work permit – either open or closed – and work full-time for an Ontario employer for at least six consecutive months. Similar rules apply in British Columbia Although there are a few exceptions, Quebec has long denied coverage to people who have an open work permit, said Y. Y. Chen, an associate professor at the University of Ottawa's faculty of law and expert on the intersection of international migration and health. "This is not a new issue," said Chen. "Prior to this particular community, there were plenty of other communities who experienced the same thing." Chen suspects Quebec may be worried the worker isn't going to stay in the province or work for a company in Quebec. They may also be concerned about so-called medical tourism. Unlike most other work permits, an open work permit does not list the name or location of a specific employer. "It takes a lot of effort to move from one country to another," said Chen. "To think that people are willing to go through all that just to access health care and then they will just move back? I think, at least for a majority of people, that seems unlikely." He empathizes with workers who are not able to access health care and said it can feel quite exclusionary when they are paying into the system. "There's a lack of reciprocity, a lack of equality," said Chen. "If these individuals are eventually going to be part of our community, then why not set them up on good footing, allow them to thrive as opposed to putting them in such a precarious situation that they develop poor health." But Chen said there could be several simple solutions. The interim federal health program (IFHP) provides limited, temporary health-care coverage for refugees and refugee claimants. Due to the unstable situation in Iran, the same benefits could be extended to the Iranians, Chen said. The federal immigration minister also has discretionary authority under this program to provide coverage on a case by case basis, but Chen is unsure how people would apply. In 2009, Citizenship and Immigration Canada sent out an operational bulletin about the lack of health-care coverage for post-graduate work permit holders in Ontario and Quebec. At the time, both provinces required the name and location of a specific employer. Ontario relaxed its rules and required the foreign worker be employed full-time by an employer for a minimum of six months. Quebec also agreed to make RAMQ available to post-graduate work permit holders and asked the federal government to flag it in the remarks section of the work permit. "Perhaps a similar arrangement could be an acceptable solution for the challenges facing Iranian nationals under the temporary program," said Chen. Answers not forthcoming The federal government did not respond to questions about whether the Iranians could be included in the IFHP. "In Canada, provinces and territories manage health care," said IRCC spokesperson Julie Lafortune in an email. "As part of the government's efforts to ensure transparency and provide necessary information, we communicate relevant details to people through client outreach and web updates." RAMQ said the eligibility criteria for health-care coverage is determined by Quebec's Health Ministry. The ministry did not answer CBC's questions about its policy concerning open work permit holders like these Iranian temporary residents. Ahmadiseddigh left Iran because she wanted a better life for her family. She hopes Quebec will reconsider to help make that a reality.
