Deborah Millar-Jervis and husband Robert Jervis were faced with a choice.
They could continue paying roughly $1,600 US a month for health insurance or leave the United States and move to Canada.
The staggering, and rising, cost of their insurance did not include doctors visits, dental care, prescriptions or the deductible amount they had to meet before accessing coverage.
So, four years ago, the couple packed up their home in Blaine, Wash., and moved four hours north to Penticton, B.C.
“We loved living there [in the U.S.], we had a great place,” Millar-Jervis said. “But we just decided that the cost of medical [insurance] in the United States was just prohibitive.”
The couple holds dual Canadian and American citizenship, so it was fairly easy for them to move to B.C., where Millar-Jervis is from.
Immigration lawyers on both sides of the border say it’s becoming more common for older couples who have lived for years in the U.S. to return to Canada during retirement because of the cost of health insurance.
But for Americans with no ties to Canada, moving north with the hope of accessing affordable health care isn’t that simple — and some say the rules around medical inadmissibility are too strict.
Immigration lawyer Lee Cohen says he’d like to see Canada offer more than one type of permanent resident application. (CBC)
“If there is a health issue with one of the family members, that can be fatal to an immigration application,” said Lee Cohen, an immigration lawyer in Halifax.
Michael Greene, a partner at immigration law firm Sherritt Greene in Calgary, said if one family member has a serious medical condition, the whole family can be refused: “And, yes, this happens very often.”
“It’s really quite crushing for people because they get nine-tenths of the way down the road and then they find out they’re being rejected,” he said.
Medical inadmissibility
For people applying to become a permanent resident in Canada, each family member must pass the medical exam. Applications can be denied if it is believed a person would put excessive demand on the health or social services in their chosen province.
That amount is updated annually. As of June 2018, the number is three times the Canadian average cost for health and social services — $102,585 over five years, or $20,517 per year.
If a family is assessed to exceed that amount, it receives a procedural fairness letter.
“They can challenge the basis for the calculation or the diagnosis of the prognosis,” Greene said.
“For instance they’ll look at blood sugar and say, ‘You’ve got kidney damage and we think you’re going to need dialysis or kidney surgery.’ You can sometimes get a doctor to give a competing opinion.”
But if the family is unable to show why the cost estimate is too high, the application will be denied.
“People want to come here because they can’t get care in their home countries and they think that they can take advantage of our health-care system,” Greene said.
“Unfortunately for them, it usually results in disappointment.”
Many Americans rely on crossing the border into Canada and Mexico to buy prescription drugs, which are often much cheaper outside of the U.S. (Shutterstock)
Cohen said he has seen applications rejected because a family member is deaf or there is a child with special needs, or there is a history of cancer.
“I think it can be very cruel,” he said.
But Cohen said when it comes to calculating the cost of excessive demand on the health-care system, it is often “subjective analysis that takes place — and it’s not always an accurate analysis.”
Cohen cited an example of a young American couple who approached him a few years ago, wanting to move to Nova Scotia. The female member of the couple had advanced breast cancer, he said, and the application was going to be denied because of it.
But they had strong academic backgrounds, “high-paying” jobs lined up and would be consumers and taxpayers. Cohen said they hired a medical economist to look at their financial contribution to the province.
“At the end of that study, the cost-benefit analysis weighed very heavily in granting permanent resident status to this couple,” he said, adding that the couple was eventually accepted.
“What it highlighted for me was the degree to which we pay attention to what we gain by having an immigrant family come into Canada, regardless of the illness — and what we lose by saying no to them.”
‘It just gets extremely expensive’
But many older families who have the option to move to Canada are doing so, says Len Saunders, a U.S. immigration lawyer based in Blaine, Wash., who is also a dual citizen.
He said insurance premiums in the U.S. increase as people age. Saunders turned 50 last month, which raised his monthly cost by $500 US.
“When people get into their 70s and 80s, it just gets extremely expensive. What I’ve seen over the last 10, 15 years.… If they’re dual citizens, they’ll decide to move back to Canada,” he said.
Saunders also said the attempts from the Trump administration to cancel Obamacare, which will be heard in the U.S. Supreme Court this fall, as well as the high rates of unemployment because of the COVID-19 pandemic are sending people in search of affordable health care.
U.S. immigration lawyer Len Saunders says when he turned 50, his health insurance went up to $2,500 U.S. a month.
“Costs have risen substantially,” Saunders said. “So you’re going to see a lot of people looking up to Canada for a much cheaper alternative to the U.S. health-care system.”
Millar-Jervis said there is no doubt in her mind that she and her husband are in “a better position” living in Penticton.
“In the U.S., everything is extra, extra, extra. And sure, it’s a great medical system — if you can afford it, if you have the money. And that’s why a lot of people don’t have it,” she said.
“So if you have the option to go to Canada, you go. We have a lot of friends who would still come to Canada if they could.”
VANCOUVER – Contract negotiations resume today in Vancouver in a labour dispute that has paralyzed container cargo shipping at British Columbia’s ports since Monday.
The BC Maritime Employers Association and International Longshore and Warehouse Union Local 514 are scheduled to meet for the next three days in mediated talks to try to break a deadlock in negotiations.
The union, which represents more than 700 longshore supervisors at ports, including Vancouver, Prince Rupert and Nanaimo, has been without a contract since March last year.
The latest talks come after employers locked out workers in response to what it said was “strike activity” by union members.
The start of the lockout was then followed by several days of no engagement between the two parties, prompting federal Labour Minister Steven MacKinnon to speak with leaders on both sides, asking them to restart talks.
MacKinnon had said that the talks were “progressing at an insufficient pace, indicating a concerning absence of urgency from the parties involved” — a sentiment echoed by several business groups across Canada.
In a joint letter, more than 100 organizations, including the Canadian Chamber of Commerce, Business Council of Canada and associations representing industries from automotive and fertilizer to retail and mining, urged the government to do whatever it takes to end the work stoppage.
“While we acknowledge efforts to continue with mediation, parties have not been able to come to a negotiated agreement,” the letter says. “So, the federal government must take decisive action, using every tool at its disposal to resolve this dispute and limit the damage caused by this disruption.
“We simply cannot afford to once again put Canadian businesses at risk, which in turn puts Canadian livelihoods at risk.”
In the meantime, the union says it has filed a complaint to the Canada Industrial Relations Board against the employers, alleging the association threatened to pull existing conditions out of the last contract in direct contact with its members.
“The BCMEA is trying to undermine the union by attempting to turn members against its democratically elected leadership and bargaining committee — despite the fact that the BCMEA knows full well we received a 96 per cent mandate to take job action if needed,” union president Frank Morena said in a statement.
The employers have responded by calling the complaint “another meritless claim,” adding the final offer to the union that includes a 19.2 per cent wage increase over a four-year term remains on the table.
“The final offer has been on the table for over a week and represents a fair and balanced proposal for employees, and if accepted would end this dispute,” the employers’ statement says. “The offer does not require any concessions from the union.”
The union says the offer does not address the key issue of staffing requirement at the terminals as the port introduces more automation to cargo loading and unloading, which could potentially require fewer workers to operate than older systems.
The Port of Vancouver is the largest in Canada and has seen a number of labour disruptions, including two instances involving the rail and grain storage sectors earlier this year.
A 13-day strike by another group of workers at the port last year resulted in the disruption of a significant amount of shipping and trade.
This report by The Canadian Press was first published Nov. 9, 2024.
The Royal Canadian Legion says a new partnership with e-commerce giant Amazon is helping boost its veterans’ fund, and will hopefully expand its donor base in the digital world.
Since the Oct. 25 launch of its Amazon.ca storefront, the legion says it has received nearly 10,000 orders for poppies.
Online shoppers can order lapel poppies on Amazon in exchange for donations or buy items such as “We Remember” lawn signs, Remembrance Day pins and other accessories, with all proceeds going to the legion’s Poppy Trust Fund for Canadian veterans and their families.
Nujma Bond, the legion’s national spokesperson, said the organization sees this move as keeping up with modern purchasing habits.
“As the world around us evolves we have been looking at different ways to distribute poppies and to make it easier for people to access them,” she said in an interview.
“This is definitely a way to reach a wider number of Canadians of all ages. And certainly younger Canadians are much more active on the web, on social media in general, so we’re also engaging in that way.”
Al Plume, a member of a legion branch in Trenton, Ont., said the online store can also help with outreach to veterans who are far from home.
“For veterans that are overseas and are away, (or) can’t get to a store they can order them online, it’s Amazon.” Plume said.
Plume spent 35 years in the military with the Royal Engineers, and retired eight years ago. He said making sure veterans are looked after is his passion.
“I’ve seen the struggles that our veterans have had with Veterans Affairs … and that’s why I got involved, with making sure that the people get to them and help the veterans with their paperwork.”
But the message about the Amazon storefront didn’t appear to reach all of the legion’s locations, with volunteers at Branch 179 on Vancouver’s Commercial Drive saying they hadn’t heard about the online push.
Holly Paddon, the branch’s poppy campaign co-ordinator and bartender, said the Amazon partnership never came up in meetings with other legion volunteers and officials.
“I work at the legion, I work with the Vancouver poppy office and I go to the meetings for the Vancouver poppy campaign — which includes all the legions in Vancouver — and not once has this been mentioned,” she said.
Paddon said the initiative is a great idea, but she would like to have known more about it.
The legion also sells a larger collection of items at poppystore.ca.
This report by The Canadian Press was first published Nov. 9, 2024.
