Responsibility for aboriginal health care is a complicated and contentious issue. All levels of government play a role, but debates exist about who is responsible for what and to what extent.
The dispute arises from a clause in a 19th-century treaty — Treaty 6 of the so-called “Numbered Treaties.” Aboriginal groups claim this “medicine chest clause” obliges the federal government to provide all forms of health care on an ongoing basis.
Aboriginal communities experience a lower quality of health than the general population, according to government data. First Nations and Inuit peoples tend to have higher rates of infant mortality, injury, suicide, and chronic and communicable diseases.
Because of that disparity and the unique culture of Canada’s Aboriginal Peoples, there exist many specific programs and benefits aimed at improving aboriginal health.
Provincial, territorial, and federal governments all share a measure of responsibility for aboriginal health care. Provinces and territories provide and pay for insured doctor and hospital treatments, while the federal government is responsible for public health services and non-insured health benefits through Health Canada’s Medical Services Branch.
Health Canada also has a First Nations and Inuit Health Branch (FNIHB) with a specific focus on aboriginal communities. Its primary aims are to provide:
- Community-based health programs on reserve and in Inuit communities;
- Drug, dental and other benefits to First Nations and Inuit regardless of residence;
- Primary care services on reserves or isolated areas where provincial facilities are not easily accessible.
Those eligible are also covered by the Non-Insured Health Benefits Program that provides coverage for some services not covered in other plans, such as dental or vision care, medical transportation or short-term crisis counselling.
Like all Canadians, Aboriginal Peoples also have a right to refuse any medical treatment and also retain the right to use traditional medicine in lieu of physician-recommended treatments.
Jordan's Principle provides that where a government service is available to all other children, but a jurisdictional dispute regarding services to a First Nations child arises between Canada, a province, a territory, or between government departments, the government department of first contact pays for the service and can seek reimbursement from the other government or department after the child has received the service. It is a child-first principle meant to prevent First Nations children from being denied essential public services or experiencing delays in receiving them.
Jordan’s Principle applies to all aboriginal children whether they live on or off reserve. It ensures that there are no gaps in government service to them, including (but not limited to) mental health, special education, dental, physical therapy, speech therapy, medical equipment and physiotherapy.
The Principle is named for Jordan River Anderson, an aboriginal child who died at the age of 5. Jordan spent two years in hospital while the federal government and the Manitoba government disputed which one would pay for his home care.
What health care coverage is available?
Fact sheet — First Nations and Inuit Health Branch