Joy SpearChief-Morris has been awarded the prestigious 2025 CJF-CBC Indigenous Journalism Fellowship, which aims to amplify Indigenous voices and enhance the understanding of Indigenous issues across Canadian media platforms. Patricia McCartney, a caregiver from Six Nations of the Grand River in southern Ontario, faced challenges in securing coverage for her mother’s medical supplies through the federal Non-Insured Health Benefits (NIHB) program. Despite her mother’s eligibility for NIHB benefits, including coverage for various medical supplies and equipment, McCartney encountered numerous barriers that affected her mother’s quality of life.
With over 983,000 eligible First Nations and Inuit clients, the NIHB program has been a significant financial commitment for the federal government, averaging $1.87 billion annually over the past five years. McCartney detailed the extensive paperwork and administrative hurdles she navigated for months to obtain coverage for her mother’s incontinence supplies, highlighting the burdensome nature of the process. As a registered pharmacy technician, McCartney emphasized the considerable effort required to access NIHB services, equating it to a full-time job.
Amy Lamb, the Executive Director of Indigenous Pharmacy Professionals of Canada, shed light on the ethical dilemmas faced by pharmacists when dealing with NIHB and expressed concerns about low reimbursement rates and administrative complexities within the program. Lamb emphasized the challenges posed by NIHB’s position as the payer of last resort, leading to delays in care delivery and underfunding issues. The program’s shortcomings have also affected the adoption of newer drugs and technologies, impacting the level of care available to Indigenous clients.
Suggestions for program improvement, including recognizing traditional healers and enhancing the approvals process, were outlined in a report presented by Members of Parliament in 2022. Despite these recommendations, the federal government has not disclosed any actions taken to address the identified issues. Concerns regarding administrative burdens and delays were met with responses from Indigenous Services Canada, emphasizing the electronic submission of claims and the absence of backlogs in claim processing.
Caroline Lidstone-Jones, CEO of the Indigenous Primary Healthcare Council, highlighted the challenges faced by remote communities in accessing online services like Express Scripts due to internet limitations. The Assembly of First Nations, in collaboration with the federal government, has been engaged in a joint review process to enhance the NIHB program since 2015. Urgent calls for modernization and a rights-based approach to the program have been made by AFN National Chief Cindy Woodhouse Nepinak, stressing the need for a culturally safe system that aligns with reconciliation efforts.
McCartney’s struggles with delayed coverage and out-of-pocket expenses for her mother’s medical supplies underscore the tangible impacts of administrative inefficiencies on individuals. The financial strain of purchasing essential supplies has hindered McCartney’s ability to allocate resources towards additional care services, emphasizing the critical need for streamlined and equitable access to healthcare support within the NIHB program.
