Inter Press Service - December 5, 2002
Mark Bourrie

The report by former provincial premier Roy Romanow is expected to be used as a blueprint to fix the country's ailing medicare system. In it, the author acknowledges native health concerns but stops short of endorsing the view of aboriginal leaders that they need more control over their health services.

The report, released last week after Romanow toured the country collecting opinions and information for 18 months, says it's time to fix the "appalling" state of native health care, and that federal and provincial governments should co-operate to develop new ways to deliver health care to aboriginal people.

Canada's provinces are responsible for health care services but aboriginal people fall under federal jurisdiction.

Life expectancy for native people in Canada is shorter by about seven years for men and five years for women. HIV/AIDS cases have exploded, especially among injection drug users, rates of tuberculosis are up to 10 times the national average, infant mortality rates are higher, and aboriginals on remote reserves are up to three times as likely to kill themselves.

Romanow cited rampant poverty, housing shortages and other factors that contribute to poor health.

But he also blamed a "confusing mix" of federal, provincial, territorial and native-run health care.

Benefits vary among regions. Federal services for native people are sometimes more generous than provincial ones for non-natives living in remote regions, stirring animosity between the groups.

Native leaders say they control 350 million dollars (224 million U.S. dollars) of the 950 million that Ottawa's Health Canada spent on native programmes last year. They had urged the commission to recommend giving them more control, along with more money.

The Romanow report calls for Ottawa to inject an additional 15 billion dollars into the health system over the next three years. Canada already spends more than 100 billion dollars on health care annually.

"If it's done with us it will work," said Matthew Coon Come, national chief of the Assembly of First Nations, whose organisation represents one-half of Canada's 1.4 million aboriginals.

The group's health spokesman, Ontario vice-chief Charles Fox, said aboriginals have struggled in the past to cooperate with government officials.

"Historically, the paternalism that we run into at that level makes it problematic."

Aboriginal people, especially in the North, face problems with access to health care. Diseases such as tuberculosis can spread because they do not get diagnosed early enough. Aboriginal leaders say they need Native-operated clinics in small, remote communities, rather than fly-in visits by doctors based in larger centres.

A group representing 26 First Nations in western Manitoba province also demanded more native control of health care.

The provincial and federal governments should give native communities money and let aboriginals run their own health care systems, said Francis Flett, president of Manitoba Keewatinowi Okimakinak, which represents Algonkian-speaking aboriginals.

The 365-page report recognises the need to improve rural and aboriginal health care, but it he argues for provincial control of services to far-flung communities.

"The current fragmented approach does not allow either aboriginal peoples or government to get the maximum benefit," says the report. "Studies suggest that the problem is not the level of funding," it adds, "but rather the fragmentation".

Romanow seems convinced that turf wars can be overcome to at last improve aboriginal health.

"The situation is simply unacceptable and must be addressed," he says.

"There are deep and continuing disparities between aboriginal and non-aboriginal Canadians both in their overall health and their ability to access health services."
021205
IP021216

Always watch for outdated information. This article first appeared in 2002. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2002. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .