Thank you.
[Witness spoke in Ojibwa as follows:]
Aah boozhoo dinawemaagidok ogimaamako nidishinkaaz Gaagonishchi’ag doonjii
[Ojibwa text translated as follows:]
Hello to all my relatives and my leader. My name is Boss of the Bear. I come from Gaagonishchi’ag.
[English]
I would like to begin by acknowledging that I'm joining you from Winnipeg on Treaty 1 territory, also the unceded lands of the Dakota.
I want to take a moment to acknowledge our elders, who are the keepers of our knowledge and culture and who faced significant barriers when attempting to access non-insured health benefits.
I want to thank the standing committee for the invitation to appear today.
Right now, there is a documented 11-year gap in life expectancy between first nations people and all others living in Manitoba, and that gap is growing.
I want to remind the standing committee that Canada has a responsibility to provide equitable health services to first nations citizens. According to article 24.2 of the United Nations Declaration on the Rights of Indigenous Peoples, indigenous peoples “have an equal right to the enjoyment of the highest attainable standard of physical and mental health. States shall take the necessary steps with a view [of] achieving progressively the full realization of [that] right.”
First nations also have inherent aboriginal and treaty rights under section 35 of the Constitution Act of 1982, including the right to health and self-determination over health systems. Treaties have affirmed first nations jurisdiction over our health systems and established a Crown obligation to provide medicines and protection.
Due to the existing crisis in health care for first nations, the Southern Chiefs' Organization is actively leading a health care transformation process following the signing of an MOU with Canada in June 2020. Our community engagement process has included input on non-insured health benefit programs and services. The NIHB program has been identified as one of the most significant concerns in its aspects, as it impacts every first nations citizen, from our children and youth through to our elders, both on and off reserves.
The current NIHB services are some of the biggest barriers to positive health outcomes of first nations citizens. The administration of the program and the inconsistent application of the program policy result in citizens receiving substandard services or being denied care outright.
I cannot state strongly enough that our citizens told us that no component of the NIHB program meets their needs. For instance, 61% of southern first nations citizens have a drive time of between one and three hours to get from their nation to the nearest hospital pharmacy. The biggest barrier in getting to the hospital pharmacy is the denial of services by NIHB for medical transportation.
Let's stop and think for a moment about having to seek permission every time you need to get to the hospital or a pharmacy. Even when transportation is approved, NIHB medical transportation rates, including mileage and meals, sit well below the rates provided in other areas and by other programs like Veterans Affairs, for example. The current NIHB medical transportation private vehicle mileage reimbursement rate in Manitoba is 21.5 cents per kilometre. Veterans Affairs is almost double the rate, at 49.5 cents per kilometre.
The current NIHB meal allowance rate for our citizens is set at $48 per day, where Veterans Affairs is $93.50. When travelling to larger urban areas for medical appointments that are not available on reserves, the commercial accommodation rates are not high enough to ensure the safety and comfort of our citizens. Accommodations in Manitoba are at a maximum of $120 per night, whereas with Veterans Affairs it's $157 to $169.
For essential life-saving treatment like dialysis, many are forced to relocate to large urban centres like Winnipeg, because there is no treatment available closer to home, yet no medical transportation is available to our citizens who live in urban centres, even if those citizens are elders.
We could talk about other program inadequacies and fundamental inequities with dental, vision, mental health, prescriptions and other medical supplies, and here are a few examples.
Our citizens face long wait times in backlogged services from the NIHB vision department. Providers, even those on the approved list, are charging additional fees, but these monies cannot be reimbursed as they are above the approved rates. Providers should be required to make clients aware of this, as clients assume that if they are on the approved list, they shouldn't be directly billed, so they're taking on those additional costs.
In order for us to secure long-term, positive outcomes for our citizens and nations, these inadequate NIHB programs and services must be dismantled. I understand that the federal government acknowledges the gaps and the devastating results, but despite identifying this as a problem since at least 2016, there have been almost no improvements in seven years.
In conclusion, these are just some of the reasons that the Southern Chiefs' Organization is building a new first nations health system that will provide better service and close the health gap between Anishinabe and Dakota peoples and the rest of Canada.
I thank you for your time and interest today and look forward to any questions.