A while back, I wrote a post begging the Canadian Government to open it’s borders to Americans with Disabilities as refugees from a slow-motion genocide. Someone left a comment on that post to which I’ve been meaning to respond for a long time.

CYNTHIA: I had previously mentioned this to Michael.

Reluctantly, as a fellow Canadian, I cannot fully support this.

As you know, the United States has 10x the population of Canada. It is a first-world country.

There is no way that the math works for Canada to be able to support the complex heath care needs of Americans with pre-existing conditions. As you mention, the system is already at capacity when it comes to providing proper health care with disability support programs for Canadians. No system can function unless you have a large base of relatively healthy people paying into the system to cover the costs of those who are using it more.

Of course, in a situation of someone being a genuine refugee from any country, humanitarian considerations should come into play. That can’t be extended to American “medical costs refugees”, though, because it would break our system.

In the long run, Canadians need a system that is sustainable – and ultimately, that benefits all Americans as well. Americans are looking at us to see how our single-payer system is functioning. If it works relatively well, that increases political support for it. If it doesn’t, that increases the dire warning about “socialized medicine”. The most vulnerable Americans ultimately need an American health care system that works, and they are less likely to get it if the Canadian health care system breaks or if ordinary American voters stop fearing the consequences of repealing Obamacare because they think that free health care will always be available to them in Canada. Right now, that fear has managed to stop the repeal attempts, to the benefit of all Americans who will ever need health care.

Dear Cynthia,

Thank you so much for effectively demonstrating exactly what I was saying, while also entirely missing the point.

Your whole comment is predicated on the idea that disabled people and chronically ill people are a drain on society.  Literally that we are a burden. It buys into the lie that our system is somehow overloaded and struggling because of too many patients. Neither of these two ideas are true.

I’m going to start with the latter lie: the one that the system is struggling due to insufficient resources to handle the sheer number of people needing them.

It’s not true. The reason our system is struggling is because of systemic cuts to both social spending and health care spending and coverage over the last several years. These were cuts were done by governments, provincial and federal, with a goal towards privatization. The idea was if they could starve the system of public money and claim it was the result of an overloaded system, then they could propose changes to the system that would allow rich people to cut the line. So congratulations on buying into that particular conservative lie.

Cutting services, cutting nurses, closing hospitals, all of these were acts taken rights here in Ontario over the last twenty years. Cuts, meaning they took money OUT of the system, then claimed that there wasn’t enough money.

In addition to cutting the number of resources available, they cut coverage, meaning that suddenly people were forced to pay for what had previously been covered. This unanticipated expense meant that many patients had to do without adequate care and meant that suddenly those same practitioners were suddenly earning less across the board. Earning less also meant they were paying less in taxes, effectively further cutting the available funds. It’s the same self-perpetuating shortage that is always the result of “trickle-down economics” which have consistently been proven not to work for the last several decades and yet which still get treated as “fiscal responsibility.”

But wouldn’t this still mean that our current system cannot handle a sudden influx of refugees needing medical services?

One of the major aspects of immigration that is always ignored by xenophobic pundits, and let’s be clear ALL anti-immigration policies are based on xenophobia and racism, is that immigration forces systems to become more efficient.

Let me say that again: Immigration, especially a large sudden influx of refugees especially, forces systems to become more efficient.

A sudden influx of people, a sudden stress if you will, on the existing social systems instantly reveal their critical shortcomings and areas that need improvement. The resulting emergency need to improve these services finally forces governments to DO something about the problem and not just wax poetic for political points. In past years when this issue has come up, it has led to a hiring of more nurses, an increase in healthcare spending, building new hospitals, and so on and so forth.

These resulting changes, moreover, have very positive effects overall social fabric at that. The new hospitals that need to be build create an influx of jobs for existing Canadians as well as new ones: In construction and Infrastructure, in food services, janitorial services, transportation. The sudden rise in nurse employment means less Canadian Nurses are forced out of the country to find work. The increase in available services benefits those Canadians who have been here for years as well as those newly arrived. This is just one of many ways that increased social spending has huge positive impacts on the overall economy.

More working people means more collectable taxes which in turn means more availability for social spending. IT becomes a positive feedback loop. And the proof is in the fact that THIS IS EXACTLY WHAT WE’VE SEEN HAPPEN EVERY SINGLE TIME!

In addition to the fact that existing systems often find themselves being improved in response to a rapid increase in the serviced population, many pre-existing conditions do not actually tax medical systems unduly. Many of the pre-existing conditions that are included on exclusion lists include but are not limited to: autism, deafness, Down’s syndrome, diabetes, blindness, and many other conditions that while they may have a significant impact on the person’s need for accessibility, but do not actually necessitate unusually high levels of medical intervention.

One could argue that the main discouragement that many of these people pose, in terms of infrastructure is that if you accept a large number of people who require accessibility, you are going to need to actually make accessibility a priority.  As long as medical records are a private matter, the government can pretend that the need for accessibility is relatively low. That we’re enough of a minority to safely ignore.

Immigration records however, which include medical checks, would mean the government would know first hand that disabilities are more prevalent than they like to pretend. The need to find accessible housing for these refugees for example could drive home the massive shortage of accessible housing. A shortage unlikely to be improved as long as governments make laws that delay imposing the requirement for new units to be accessible, as though disabled people can jus delay their need for said housing until it is convenient to businesses.

Even those conditions that do necessitate more active medical intervention would in many cases not unduly burden the existing healthcare system. If one of the impediments to healing was regular access to treatment, then having that access could in some cases eliminate a lot of the ailments experienced. This means that literally allowing some people with pre-existing conditions to come to a place with socialized medicine could reduce their overall impairment and so these same immigrants would become indistinguishable from those who did not have pre-existing conditions.

With regards to social assistance for those who may require some additional aid or who would qualify for disability – increasing the number of people ON disability would likely force changes that have been needed for quite some time.

When Ottawa took in an increased number of Somali and Syrian refugees, the racist complaint was about how this would lead to shortfalls for Canadians on disability. In actuality what happened is that it led to the government addressing the EXISITING shortfalls. Not nearly enough, and now that Ford is in power I suspect we are going to see more cuts, but the fact remains. Even though refugees NEVER received more than Canadians on Social Services no matter what the racists claimed, their arrival led to more in the pot for Canadians.

The reason our current system struggling has nothing to do with the number of people on disability but rather with the common perception of disabled people. We are treated as worthless, incompetent, and so on. We are literally treated like social burdens rather than human beings with just as much to offer the world as anyone else. In many cases, the need for disability assistance isn’t because of a lack of desire to work or even because of a complete inability to work. Rather it has to do with the way these same biases surrounding disabled people end up influencing employers.

I’ve had countless interviews where the employers are very excited about me as an employee, they make allusions to me having the job, only to never hear from them again the moment they find out that I have a chronic illness. I believe the statistic for say autistic people is that 60% of those actively looking for work are unemployed – not because of lack of ability but simply because there is an active bias against autism in the workforce. Those so called personality tests, for example, have a clear bias against any type of neurodivergence, but actively score autistic individuals as unhireable.

Many places of employment are also unprepared to consider any type of accessibility measures, assuming incorrectly that the job is not compatible with disability. One pop-culture example of this very issue appears in the Netflix show Switched at Birth, where the chef at a restaurant goes on a whole rant on how being deaf is a hazard in the kitchen and that there were no possible solutions. An idea disproven a short time later when the character is able to solve the problem with mirrors and indicating it’s just one possible solution.

So am I burden because I can’t work somewhere with stairs, or is the building management the burden in demanding that employees they can’t hire because of their unwillingness to provide accessibility be otherwise supported?

Although the whole idea that a person’s productivity is in any way tied to their worth as a person is bullshit, the fact is that many of us on disability are not idle. Many are involved in community projects, in lobbying various governments for various issues, many are artists or work on businesses. Many of us pay taxes as well. Even if we are not gainfully employed, we are not worthless.

The idea that we are social burdens moreover is NOT as some would claim an evolutionary imperative either. Archeological records exist that show prehistoric human tribes sustained disabled members, even though it meant providing a means of feeding them, transporting them, and so on, without any hope of the person being able to contribute in the form of hunting or gathering.

Statistically speaking, Refugees and immigrants tend to benefit their asylum nations. Many become involved in community projects, organizations, and so on. Many work hard to make themselves beneficial members of their communities. We shouldn’t expect that this would be less true of people with pre-existing conditions. If anything, given how often people on disability assistance themselves often feel the need to overwork themselves to PROVE they’re not burdens, I would hazard that those who are also here trying to escape persecution and death at the hands of their government would probably be just as eager to prove their worth.

Finally, Whether the US is a first world nation or not is irrelevant to that fact, Nazi Germany was also a “first world nation”.

The objection to immigrants with disabilities, like the objection to immigration, is based on bias rather than any real concern for disabled Canadians. Saying that disabled immigrants are in any way less worthy of entry into Canada versus abled ones is a categoric statement that you think disabled people are Worth Less. To say that on a post discussing GENOCIDE against disabled people is literally saying that disabled people aren’t worth saving.    That’s pretty fucking ableist. Ableism kills.