Thank you, Chair.
Good evening, everyone. My name is Céleste Thériault and I'm the executive director of the National Indigenous Diabetes Association, located on Treaty No. 1 lands in Winnipeg, Manitoba. It's an honour and a real privilege to be speaking about this bill in front of you as it relates to indigenous people in Canada.
I'll talk a bit about the National Indigenous Diabetes Association. We refer to ourselves as NIDA, and we're a charitable, non-profit, member-led organization established in 1995 as a grassroots initiative by women on the side of Lake Winnipeg who were advocating because diabetes was taking too much from their people. That was almost 30 years ago. It is inclusive of first nations, Inuit and Métis in Canada.
This bill really provides the beginnings of a comprehensive pharmacare program for all Canadians and represents a significant step towards addressing social health inequities across Canada, including within indigenous populations.
I may refer to indigenous people—first nations, Métis and Inuit—with a pan-indigenous term to represent them, but they are distinct nations with distinct interests. They suffer disproportionately from socio-economic constraints and illnesses, but they stand to benefit substantially from the provision of much-needed diabetes care, especially Métis individuals who are not covered under NHIB, the current non-insured health benefits program, and so the current government of the day is really commended for this first step and for including diabetes medication in that first step.
That said, we should be continuing to do this in a good way. What does that mean?
It means talking with indigenous nations, political leaders and individuals with lived experience to make sure that no one gets left behind. We know changes that affect indigenous people in Canada should be done with us—“nothing about us without us”, and I would like to mention that because of the short period for big decisions between the tabling of the bill and this consultation, we didn't have adequate time to consult all of our members of interest on the implications of the bill. Our organization by no means can talk on behalf of all indigenous nations across Canada, so there should be continuous and ongoing meaningful dialogue with many indigenous people and nations, especially with our political leaders. The Minister of Health talked about not only provincial and territorial governments but also our indigenous governments, which have some sovereign right to having their voices heard on this legislation.
It's vital that we roll out this new program very carefully and really consider the context of the existing benefits, particularly through NIHB, the non-insured health benefits, which presently are the right of status first nations and Inuit beneficiaries in Canada and provide for medications for the treatment of diabetes and for other pharmacological care. However, it's not all of them, and that is to the detriment of the individual.
It also remains unclear whether the NIHB and the new pan-Canadian pharmacare program will be responsible for providing medication coverage to these individuals. However, the minister said earlier today, all the programs would kind of remain in place, so we believe that would be helpful.
The coverage of medications for first nations and Inuit can be bureaucratically burdensome, and we know this. Individuals and health care providers on reserve are already administratively overwhelmed, so we need to ensure that the policy is reducing those burdens and that our providers can directly impact patients and deliver patient care in a good way. We don't need to burden them with getting their patients' medications covered.
We also want to make sure there's a comprehensive list of medications, allowing both the prescriber and the patient to be advocates in the health care journey of diabetes management. Of course, we want to steer away from a two-tiered health care system, where the best and strongest medications are only available to those with deep pockets, privilege, and secure employment with strong health benefits.
Similarly, we want to ensure that no indigenous person is left behind, because Métis individuals are not included in the NIHB. This bill means that Métis will have much greater access to care through this bill. We have to remember that when we walk forward in this legislation. We need to be at the bare minimum of equal or better than current coverage for all indigenous people in Canada.
We must make sure that we are working together to ensure that there is equal access to brand name medications for diabetes care when the generics are not available, again supporting timely access and ease of use for indigenous people so that those living with diabetes can keep their healthy blood flowing now and several generations from now.
As an indigenous woman, I would be remiss if I missed the opportunity to also comment on the contraceptives. As someone who had to use three IUDs to get my last one successfully put in, I know IUDs are quite expensive, and that would be not have been possible for me had I not had some support in place to be able to do that and make that a reality. All indigenous people need to be able to access whatever form of contraception need and to to determine what is best for their own person, and the funding should be provided for each of those types, without exceptions, just as it should be with diabetes care, as it is an extremely personal journey.
We look forward to a Canada where first nations, Métis and Inuit have equitable access to life-saving medications, although more consultation is required to move forward in a good way. We invite further collaboration on this vital project to ensure that no one is left behind. We want to ensure that everyone, from our indigenous elders to our youth to our lived-experience people in indigenous nations to governments and politicians, is adequately involved in the decision-making process of this bill, not just, as I said, our provinces and territories.
Let's continue to work together in a good way to ensure that we are raising health outcomes for all indigenous people in Canada and representing a significant step forward in addressing social health inequities across Canada—
