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Concerns raised over Non-Insured Health Benefits program

Thursday January 23, 2014

Regional Chief Stan Beardy is calling for changes to the Non-Insured Health Benefits (NIHB) program due to a widening gap in health outcomes.

“The outcomes gap between First Nations and non-First Nations health continues to widen,” Beardy stated in a Dec. 19 special bulletin posted on the Assembly of First Nations website. “First Nations are being denied high quality, equitable access to the health products and services that non‐Indigenous Canadians take for granted.”

The bulletin stated that regional roundtables will be held across the country during January and February to obtain regional input about First Nation challenges with the NIHB. The Ontario roundtable is scheduled for Feb. 25-27 during the Chiefs of Ontario Annual Health Forum at the Intercontinental Hotel in Toronto.

“We encourage all First Nations and those who believe in fairness to join the AFN over the next several months to raise the profile of the NIHB file with policy-makers, politicians, mainstream Canadians, the media and other allied health organizations,” Beardy said. “Further, rather than just identify the problems we will work to create solutions. I commend the AFN Chiefs Committee on Health for their dedication and efforts to advance this important cause with First Nations and all Canadians.”

Kitchenuhmaykoosib Inninuwug Chief Donny Morris said his community has had problems with NIHB over a number of travel issues, including patients being required to pay for their flight if they missed an earlier appointment.

“Especially now with the weather delays and then you miss your appointment, and right away they expect you to pay for it,” Morris said. “They just don’t see the fact that when the plane is delayed, they should have somebody there to make the changes automatically, not just say no, it’s over and done with, you move on.”

Morris said eye and dental issues are also a problem in his community.

“If you’re in a remote community and your glasses break or your lens comes out, you’re out of luck,” Morris said. “Eye, dental and even other professionals should come frequently to the communities and (NIHB) should be looking after those things.”

Eagle Lake health director Bernadette Wabange said her community has problems with prescription drugs that are not covered by NIHB.

“They take (their prescription) to the pharmacy to get their prescription filled and then the pharmacist says that is not covered under NIHB — you will have to pay for the drug,” Wabange said. “A lot of (community members) will say: ‘I don’t have money to pay for it so I will just do without the drug then.’”

Prescription drugs that require prior approval from NIHB are also a problem for community members.

“Sometimes that will take up to a week, and then by that time they don’t even need the medication,” Wabange said.

Wabange said another problem with NIHB is the lack of coverage for the use of a new optical examination tool for diabetic patients.

“These are mostly Elders who are getting billed, it’s $40, for this test to be done,” Wabange said. “The cost to run the test is being covered; it’s just the cost for using this specific tool that is not covered.”

Wabange said community members’ dental bills are also not being fully paid by NIHB, which is leaving them at risk of having the unpaid portion sent to collection agencies.

“A lot of the dentists are now getting to the point of saying you have to pay so much, like 50 per cent or 30 per cent up front because they don’t get the full reimbursement from NIHB,” Wabange said. “(Our community members) rely solely on NIHB. We don’t have other private health plans. Our people would really like to trust the federal government in fulfilling the treaty obligations. First Nations and Inuit Health Branch of Health Canada (needs) to provide for the health care of First Nations people.”

Wabange said prostrate screening for men is also not covered by NIHB.

A Health Canada and Public Health Agency of Canada spokeswoman said the government of Canada recognizes the importance of helping First Nations people and Inuit in reaching an overall health status that is comparable with other Canadians.

“Budget 2013 provides the Non Insured Health Benefits Program with a stable funding for the next five years,” said Sylwia Krzyszton, senior advisor, media relations with Health Canada and the Public Health Agency of Canada, in an e-mail reply. “This paves the way for greater sustainability and certainty for NIHB.”

Krzyszton said where NIHB provides medically necessary health-related goods and services in areas such as prescription drugs, vision and dental care, and medical supplies and equipment, the program has processes in place to ensure benefits support the medical and safety needs of clients.

“Work will continue to focus on actions needed to ensure sound management and efficiency in each of the benefit areas, in alignment with the First Nations and Inuit Health Branch strategic plan,” Krzyszton said. “The management of NIHB has a long history of collaboration with the AFN and other stakeholders.

“Health Canada understands that the AFN discussions are expected to focus on tangible options for positive changes. The department looks forward to hearing the results from the upcoming regional and national level discussions on the NIHB Program.”

Once the regional roundtables are held, a two-day National Policy Forum on NIHB will be held in Ottawa in March, with registration open to regional roundtables participants, leadership, Elders, First Nations health directors and medical practitioners serving First Nations communities.


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Haven't we learned yet that

Haven't we learned yet that we can spend tons of money trying to find solutions to present to the government but in the end, they will only do what they want to do. Things happen from the inside out, not the outside in, and I mean no disrespect to our local, provincial and national leadership.

I don't think the AFN has much of a leg to stand on right now either given recent events concerning the FN Education Act. They will most likely accept a low-ball effort from the feds concerning health care as well.

People in the marginalized communities don't feel supported at all. They don't feel supported by any level of the health care system. There are the NIHB workers, the ones on the front-line who deal directly with travel only; the clinic or hospital support staff; the doctors; the managers; the CEO's and Board members. A lot of things are dysfunctional within those working perimeters because there is too much distance between the different departments and hierarchy. Now if that disconnect lies within the organization, imagine how disconnected the patient feels from it, and how that impacts their health care? Adding to it the historical legacy of how people were treated.

We believe that the solutions will come from leadership - at these higher levels. Well if our leadership doesn't really recognize what the problems are, then how will they ever find solutions?

Start talking to the people. All the people.

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