AFN tackling the dwindling benefits of NIHB

The Assembly of First Nations has stepped up its efforts to bring about changes to the Non-Insured Health Benefit program.

“I don’t know how many resolutions we’ve had at the AFN chiefs assemblies calling for improvement of access for non-insured but looking at  statistics, looking at our results, the gap is getting wider between First Nations people that depend on non-insured and the dominant society,” said AFN Ontario Regional Chief Stan Beardy, who holds the health portfolio and chairs the Chiefs Committee on Health.

The AFN has mobilized at the regional level with roundtables to take place over the next couple of months.

“We need to identify what works and what does not work. We need to demonstrate to the government that the national policy is not working for First Nations people,” said Beardy.

Among the issues is drug coverage, which has seen drugs delisted and more non-generic drugs covered, and lack of support for Elders, who live in remote fly-in communities.
The AFN will also continue to work in partnership with medical organizations.

“NIHB is an issue that we deal with consistently,” said Dr. Peter Doig, president of the Canadian Dental Association.

The CDA and AFN have been working together for a number of years to bring about changes to the NIHB. Doig says that the CDA and NIHB have an NIHB technical working group committee. CDA was adamant that representatives from both the AFN and the Inuit Tapiriit Kanatami be part of that working group. The NIHB regulates benefits for both First Nations and Inuit peoples.

Doig said CDA conducts a ‘Days on the Hill’ every spring and issues in regard to NIHB always make the agenda for talks with MPs, senators, government ministers and key advisors. The last few years, the CDA has included representatives from the AFN at those meetings.

“The NIHB program places challenges on the provision of dental services to First Nations people in Canada,” said Doig. “There are dental services the rest of the population will get as part of routine oral health care that are restricted under the NIHB program.”

The NIHB program covers 86 per cent to 88 per cent of treatment costs, although there are a handful of preventive procedures that are covered fully. The shortfall in funding leaves the dentist with a number of options: turn down a patient; bill the patient for the additional cost, whether personal or through other health insurance; or conduct business at a loss.

Doig said there are dentists who choose not to provide treatment if the patient is covered only by NIHB. He also notes that treating someone through NIHB places undue administrative strain on dentists.

There have been improvements in the NIHB program over the years – including a recently announced five per cent annual escalator for funding – but the still existing “raft of restrictions,” said Doig, need to be addressed.

Doig said other medical professions, such as optometrists and pharmacists, also have concerns with the program.

Beardy believes that the more other medical organizations learn about NIHB coverage, the more they will “begin to understand there is injustice here and (they) will be compelled to do whatever they can in their field to assist us.”

The roundtables will serve a number of purposes. Not only will they put forward solutions to the NIHB crisis and options on how to implement the solutions, but they will also educate First Nations members.

“What’s most important here is that our people understand what their basic human rights are in terms of health care,” said Beardy.
“When they go to a clinic somewhere and they’re denied basic human rights, they’re able to speak up and say, ‘This is a human right. This is my right. I’m entitled to health care.’”

In spring, AFN will develop an action plan which will include mobilization at the political, legal and technical levels.

“We’ve been struggling with the system for many, many years … and now is as good a time as any to attempt to advocate for those changes,” said Doig, who adds that his organization promotes “optimal health for Canadians and that means all Canadians not just segments of Canadians.”

“To be well is universal. We see health as a basic human right,” said Beardy. “We expect the same type of service that everybody else in Canada takes for granted.”