Arctic leaders embrace Romanow report

Arctic leaders agree that Roy Romanow’s ideas could help Inuit and northern residents get better access to nurses and doctors, and improve the abysmal state of health care in northern Canada.

But they’re also worried — because the report doesn’t talk about long-standing federal funding practices that have bled cash out of northern governments for nearly 15 years and doesn’t acknowledge Ottawa’s obligations to Inuit.

Roy Romanow, a former premier of Saskatchewan, presented the nation last week with the results of his 18-month, $15-million royal commission inquiry into the future of Canada’s health-care system.

Among its 47 recommendations are proposals urging the federal government to spend $1.5 billion over two years on rural and remote health care in Canada, and to give the provinces and territories at least $6.5 billion more per year for health care by 2006.

Romanow says in his report that part of the $1.5 billion rural and remote fund should be spent on hiring more doctors and nurses, and that part of it should be spent on telehealth.

“Telehealth” is the term used to describe long-distance methods of examining patients and communicating diagnostic information — using tools such as videoconferencing and the electronic transmission of X-ray images and test results.

Northern leaders like those ideas — but not if Ottawa uses its old per capita, or per person, method for dividing the new money among provinces and territories.

Per-person funding rarely provides Nunavut enough money to cover the high costs of operating in the Arctic.

“We are happy that Nunavut is prominent in the section on rural and remote issues, recognizing that we have taken a leadership role in a lot of areas that we have tackled, in terms of the challenges that we have faced,” Nunavut Premier Paul Okalik told reporters last week.

“I think we would like to see how that money would be dealt with, we would like to see more details on that. As you know we have an ongoing issue with per capita arrangements and we’re hoping for base funding for Nunavut.”

Nunavut’s health minister, Ed Picco, who today is at a meeting of provincial-territorial health ministers held to talk about the Romanow report, says the same thing.

“If it’s based on a per capita or per population amount, then it’s going to fall short of the needs of the government of Nunavut,” Picco said.

In September 2001, the federal government agreed to give the provinces and territories an extra $4.2 billion a year to help them pay for medical care.

But because of the territory’s small population, Nunavut’s share of that immense amount of money turned out to be a pittance.

“When I extrapolated the number as minister of health for Nunavut, that gave us an additional $3 million in resources. That’s not acceptable,” Picco said.

Canada’s other two northern territories have the same problem.

“We were clear to Mr. Romanow that federal funding based solely on population size does not recognize the NWT’s unique health and social conditions or the challenges we face in providing full access and service delivery,” Stephen Kakfwi, the premier of the Northwest Territories, said last week.

Cathy Towtongie, the president of Nunavut Tunngavik Inc., said that NTI welcomes Romanow’s call for a rural and remote health fund.

But she says Romanow’s report doesn’t address the reality of Nunavut.

“In fact, the unique circumstances of Nunavut Inuit are overlooked in the commission’s recommendations for aboriginal health, which focus on the needs of First Nations, especially treaty Indians living on reserves,” Towtongie said in a press release last week.

Right now, Nunavut Inuit get hospital insurance and basic medical services in their capacity as residents of Nunavut, and not as aboriginal people.

However, Ottawa’s Non-Insured Health Benefits Program, or “NIHB,” gives Inuit extra aboriginal health-care benefits — worth about $60 million a year — that the GN’s hospital insurance system does not make available to non-Inuit. But that’s only a relatively small proportion of the $160 million a year that the GN spends on health.

One of the biggest NIHB benefits is medical travel — but right now it’s worth only $250 per flight and doesn’t cover the cost of transporting patient escorts.

Picco said in the legislature this week that the GN has been attempting to negotiate an increase in this amount for two and a half years.

Regardless of how much money the NIHB contributes to the expense of providing health care to Nunavut Inuit, NTI says both governments have not respected Article 32 of the Nunavut land claims agreement, which gives Inuit the right to participate in the development of health programs in Nunavut.

“The governments have not yet involved Inuit in a meaningful way in these processes, and as a consequence, many health programs do not adequately reflect the needs of Nunavut Inuit,” Towtongie said.

NTI is therefore suggesting that it should have a right to “sign-off” on all Inuit-designated health-care dollars used by the government of Nunavut and receive an accounting of how they are spent.

Jose Kusugak, the president of Inuit Tapiriit Kanatami, agrees that the remote and rural access fund will help Inuit.

“It’s evident that the messages Inuit presented were heard by the Romanow Commission,” Kusugak said.

But like all the others, he says Inuit will continue to suffer unless health money is allocated on the basis of need, rather than per capita.

“Our ambulance ride is 2,000 kilometres long,” Kusugak said in an ITK press release. “It’s an airplane, not a vehicle. It takes a day, not an hour to get to the hospital. It’s called a medivac, not an ambulance. It costs $5,000 not $500.”