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Canada’s healthcare system is segregated in a way that disproportionately and negatively affects Indigenous life. Don’t believe me? Read this thread. (1/n)
To begin, when comparing Indigenous versus non-Indigenous health outcomes, Canada ranks even worse than the United States. The average life expectancy for an Indigenous person in Canada is 10 years lower than the national average. Read more: https://thevarsity.ca/2019/09/15/why-do-canadas-indigenous-people-face-worse-health-outcomes-than-non-indigenous-people/
(2/n)
(2/n)
Contributing to these disparities is the lack of a national Indigenous health policy.
The Canada Health Act of 1984 makes no provision for Indigenous peoples.
In fact, Indigenous health care still falls under the Indian Act, or federal jurisdiction. (3/n)
The Canada Health Act of 1984 makes no provision for Indigenous peoples.
In fact, Indigenous health care still falls under the Indian Act, or federal jurisdiction. (3/n)
Those with recognized Indigenous ancestry in Canada can access medical services using the federally-run Non-Insured Health Benefits (NIHB) program. In 2016, over 800 000 First Nations, Métis and Inuit accessed care using NIHB. (4/n)
While many recognize that the NIHB program covers items such as dental and vision care, it is less well-known that the NIHB also provides critical funding for medical transportation, essential supplies such as bandages and respirators, as well as pharmaceuticals. (5/n)
Accessing pharmaceuticals using the NIHB is a bureaucratic mess.
Numerous pharmacists have already sounded the alarm regarding the NIHB’s extreme lack of clarity regarding drug access, culminating in a letter from the Canadian Pharmacists Association published in 2014. (6/n)
Numerous pharmacists have already sounded the alarm regarding the NIHB’s extreme lack of clarity regarding drug access, culminating in a letter from the Canadian Pharmacists Association published in 2014. (6/n)
Furthermore, payments for drugs ordered using the NIHB are processed using Express Scripts. Express Scripts is a well-known pharmacy benefit manager (PBM) from the USA known to prevent patients from accessing essential pharmaceuticals while simultaneously inflating prices. (7/n)
Most worrisome, in 2016, twenty-two physicians from Sioux lookout wrote a letter to Health Canada stating that the medical transportation approval process for Status Indians was completely inaccessible.
Denial of transportation in remote communities is denial of care. (8/n)
Denial of transportation in remote communities is denial of care. (8/n)
To add insult to injury, Health Canada has yet to address physicians and pharmacists’ concerns surrounding the NIHB.
They completed an audit of the program in 2017… but take this in:
The audit didn’t include any Indigenous patient perspectives. At all. (9/n)
They completed an audit of the program in 2017… but take this in:
The audit didn’t include any Indigenous patient perspectives. At all. (9/n)
In these silent, insidious ways, the NIHB invisibly reproduces a racial hierarchy between Canadian settlers and Indigenous peoples, contributing to the dramatic health outcome disparities between Indigenous and non-Indigenous folks we see today. (10/n)
This is what structural racism and neocolonialism looks like in Canada, and my tweets barely scratch this issue's surface. To read more, please visit https://skyknowledgeinstitute.org/medicine and click on the working document. You’ll see all of the sources I’ve used there. @SkyKnowledgeIn
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