National Indigenous Medicare needs major changes, say territorial health ministers

Territorial health ministers say major changes are needed to Canada’s aboriginal health care system.

Health Ministers Tracey-Anne McPhee of the Yukon, Julie Green of the Northwest Territories and John Main of Nunavut joined a federal committee Tuesday to explain how Canada could improve its Non-Insured Health Benefits (NIHB) program for eligible Indigenous people in their communities.

The NIHB Program covers certain health insurance costs – such as dental care, vision care and out-of-territory medical travel – for those who can prove their status and do not already have healthcare coverage at their place of work.

“I’m concerned that what we have in place is not culturally appropriate,” Green told the committee.

The federal government program covers certain medical travel costs, such as meals and lodging, for health services that patients cannot obtain where they live.

Green said the plan does not cover several health needs unique to Indigenous peoples, such as travel costs for patient family members.

“People come from small communities. They’re not used to going to places even the size of Yellowknife,” Green said. “They would like people to accompany them.”

Government ‘pre-clearing’ who travels with patients according to a list of criteria, including whether they can travel alone and whether they are minors. In some cases, a doctor must support the patient’s application for insurance to cover the travel expenses of his companion.

Nunavut Health Minister John Main says the policy needs to reconsider how it determines the number of people allowed to travel with a patient outside the territory on a medical trip. (Steve Silva/CBC)

Nunavut Health Minister John Main said that policy doesn’t work when some patients need more than one caregiver to accompany them.

the Politics considers the need for more than one escort an “exceptional circumstance”, where the patient would be expected to provide more private health information to substantiate their claims.

On the committee, Main gave the example of a child undergoing chemotherapy treatments, who would need medical support with his parents to go to appointments in the provinces.

“Nunavut may approve this cost for compassionate reasons,” he said.

But, as Yukon Health Minister Tracey-Anne McPhee has pointed out, it’s not always clear when the territories should absorb medical travel costs and when they’re covered by the NIHB program. .

Education Minister Tracy-Anne McPhee answers questions from reporters after Question Period on March 18. (Jane Sponagle/CBC)

“First Nations governments and our government are saying, ‘OK, where do I fit into this program…are we going to qualify, that kind of stuff? ‘” McPhee said.

The review of the insurance plan is one of the health strategy, published in 2020. The report states that the federal insurance program and the territorial program, which provides similar benefits to other Yukon citizens, “are not harmonized or… well coordinated.”

“This means that family members living in the same residence could have different benefits and different means of access,” the report continues.

The Standing Committee on Indigenous and Northern Affairs is taking feedback on the NIHB program until May 3.