National Indigenous health insurance plan needs major changes, say territorial health ministers

Territorial health ministers say major changes are needed to Canada's Indigenous healthcare insurance plan. 

Health ministers Tracy-Anne McPhee from the Yukon, Julie Green from the N.W.T. and Nunavut's John Main joined a federal committee Tuesday to explain how Canada could improve its Non-Insured Health Benefits (NIHB) program for eligible Indigenous peoples in their communities. 

NIHB covers some medicare costs — like dental, vision and out-of-territory medical travel — for those who can prove their status and who don't already get health-care coverage through their place of work. 

"I'm concerned that what we have in place isn't culturally appropriate," Green told the committee. 

The federal government's program covers some medical travel costs, like meals and accommodations, for health services that patients cannot get where they live. 

Green said the plan does not cover several unique healthcare needs for Indigenous people, like travel costs for the patient's family members. 

"People come from small communities. They are not accustomed to travelling to places even the size of Yellowknife," Green said. "They would like people to accompany them." 

The government "pre-authorizes" who travels with patients according to a list of criteria, including whether they can travel alone and if they are a minor. In some cases, a doctor has to support the patient's request for insurance to cover their caretaker's travel costs. 

Nunavut Health Minister John Main said this policy does not work when some patients require more than one caretaker to come with them. 

The policy considers the need for more than one escort an "exceptional circumstance," where the patient would have to provide more private health information to justify their claims. 

Main gave an example in the committee of a child undergoing chemotherapy treatments, who would need medical support along with their parents to travel to appointments in the provinces. 

"Nunavut could approve that cost on compassionate grounds," he said. 

But, as Yukon Health Minister Tracy-Anne McPhee noted, it's not always clear when the territories should be absorbing medical travel costs, and when they are covered by the NIHB program. 

"First Nations governments and our government are saying, 'OK, where do I fit into this program … will we qualify, these kinds of things?'" McPhee said. 

Reviewing the insurance plan is part of the Yukon's healthcare strategy, released in 2020. The report says the federal insurance program and the territorial program, which provides similar benefits to other Yukon citizens, "are not aligned or ... well-coordinated." 

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

The standing committee on Indigenous and North Affairs is taking comments on the NIHB program until May 3.