Defining Universal Access by Dr Regina Torres Quiazon | The Road to Abortion Equity

The Federal Senate has established an Inquiry into universal access to reproductive healthcare. The Inquiry was called because the government has acknowledged we have a crisis of sexual and reproductive health access.

On Wednesday 9 November 2022, we hosted an online forum to explore what the inquiry terms mean, how it applies in practice and provided a submission template which you can download here to assist people in writing their own.

Dr Regina Torres Quiazon gave the following speech “Defining Universal Access” at our webinar, which you can watch here.

I would like to acknowledge that I am speaking to you from the unceded lands of the Wurundjeri people of the Kulin Nation and I pay my respects to elders past and present.

The acknowledgment of two countries seems a really fitting segue to the topic of universal access.

Simply because in order to move towards universal access all people living in Australia, including First Nations people and all non-Indigenous people who have settled here through the forces of colonisation and migration, irrespective of country of birth, nationality, citizenship, length of residency or visa category, all must be considered and included in our definition.

All people living in Australia also includes people who don’t have or can’t have access to the national Medicare scheme.

The Multicultural Centre’s work over the last 44 years with migrant and refugee women has clearly shown that legal nationality or Australian citizenship, length of residency and visa category are often the unstated prerequisites for accessing health services.

To put that another way, while it is fairly well-known that English language proficiency, health literacy, and socio-economic factors play a part in peoples’ ability to access health, those on particular visa categories encounter multiple barriers to accessing information, treatment, and services because of their residency status.

So many migrants spend years working precariously in Australia often moving from one bridging visa to another.

The average time is ten years before gaining permanent residency and before gaining the full ability to access health rights.

For example, temporary visa holders who do not have access to Medicare face restrictions and challenges when accessing contraceptives and reproductive health care due to various factors including being subject to restrictive waiting periods, and exorbitant upfront costs.

A very clear case in point which we conducted quite a bit of advocacy on and continue to do so is on behalf of international students or partners of international students do not currently have access to pregnancy-related care if they fall pregnant within the first 12 months of migration.

Pregnancy-related care has been defined by those Medicare items pertaining to pregnancy including childbirth, anti-natal, other outpatient pregnancy related services and other gynaecological items.

Throughout the years, we have received many calls to support distressed students without the necessary healthcare and support and who are therefore exposed to a whole range of health risks because they didn’t meet the 12 month waiting period.

This restriction has been a longstanding clause of the Overseas Student Health Cover deed, which is the agreement between the Commonwealth Department of Health and Insurance providers who choose to sign onto that deed.

That particular deed sets out the conditions with which registered health funds have to comply in order to provide insurance products and policies and there is no requirement or incentive to waive these waiting periods.

Now this is just one of the many many fine print issues to consider in relation to responding to the needs of those made most vulnerable by our current systems.

So when writing your submissions, I urge each of you to focus on the many ways colonisation, racism, xenophobia, homophobia, ableism and other types of discrimination and structural forces intersect and prevent universal access.

Now how can we ensure that this inclusive concept of universal access translates into inclusive and equitable policy?

We have three key asks that directly relate to this concept and two key areas of reference.

Firstly, in relation to cost and accessibility:

1) Extend Medicare to include all migrants irrespective of visa category.

In effect, this can abolish waiting and residency periods to health access, especially those directly linked to visa status and including those contained in the Overseas Student Health Cover deed and access to other forms of income support as outlined, for example, in the newly arrived residents waiting period.

How can we do this?

We suggest moving away from free market and neo liberal approaches in our migration program and health services delivery.

For example, there are already billions of dollars spent on private health insurance rebates which could be allocated to fund equitable forms of public health.

Same to the prohibitive costs relating to visa processing fees, English language entry requirements and the recognition of overseas qualifications, which all new migrants must shoulder.

So extending Medicare in this way should not be regarded as a radical or innovative solution but should be seen as a necessary requirement for universal access for all people living in Australia.

Universal access and universal health coverage are for us, the two sides of the universal access coin.

So along with that number one ask we have two other asks in relation to workforce development and best practice approaches.

2) Include migrant refugee health as a key priority in regional organisation activity and planning.

This includes collecting information about migrant and refugee groups, including residency status, women’s preferred language, requirements for an interpreter of a bilingual worker and collaborating with migrant organisations with the expertise and knowledge in this field.

3) Provide ongoing investment to support and develop a bilingual, bicultural health workforce that is professionally recognised and appropriately remunerated.

The health workforce needs to represent, reflect and respond to the needs of our current and growing multicultural Australian population.

Dr Regina Torres Quizaon is the National Program Manager at the Multicultural Centre for Women’s Health (MCWH), and at the time of this speech was Acting Executive Director.

Regina has a PhD in Cultural Studies and over 20 years’ experience working in gender and diversity as a project manager, researcher and educator. She has significant expertise in the theory and practice of intersectionality.

Since joining MCWH in 2009, she has led the development and delivery of several health equity projects including the coordination of a multilingual COVID-19 vaccination health education workforce across Australia.

She migrated with her family from the Philippines in the early 70’s. Regina speaks English and conversational Tagalog.

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MSI Australia is the leading, accredited, national provider for abortion, contraception and vasectomy.