If Canada is a G7 country, then why does healthcare in the Arctic regions more closely resemble Third World conditions? Life expectancy in Nunavut, the largely Inuit territory formed in 1999, is ten years below the national average, a sign of what Nunavut premier Paul Okalik has called “a legacy of neglect” on the part of the federal government.
Critics say it is disturbing that the three northern territories have both the largest percentages of Aboriginal Canadians and the worst healthcare in the country. Nunavut has an 85% Aboriginal population, while the Northwest Territories stands at 48%, and the Yukon is 20% aboriginal. A shortage of medical professionals, the extremely high costs of delivering care in such remote, large regions, a small tax base, and what critics call a lack of federal political will, have all produced what is, by many accounts, a dire situation.
However, a recent meeting between Prime Minister Jean Chrétien and the premiers of Canada’s three territories has led to an agreement to provide a $60 million (Cdn.) minimum level of spending in addition to regular healthcare funds. The additional funds set aside for the Arctic are a useful precedent, Premier Okalik has said.
At stake is the federal government’s traditional per-capita funding scheme, in which federal healthcare dollars are allocated to provinces and territories strictly in accordance with the size of the population. Though the scheme works in the southern provinces, the tremendous distances and harsh climate conditions in the northern territories make such funding woefully inadequate.
The president of Nunavut organization Inuit Tapiriit Kanatami noted in a press release that “our ambulance ride is 2,000 kilometres long … 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.” Northern leaders have long warned that per-capita funding will never meet the needs of Arctic residents, ensuring that the disturbing discrepancies between southern and northern health will continue.
The three territorial premiers’ intense lobbying had little effect on a February 5 five-year healthcare deal between the provincial ministers and the federal government that gave the territories a pittance compared to their funding requests. The premiers then symbolically walked out of a news conference announcing the $27 billion plan. The success of their private meeting with the Prime Minister was therefore a pleasant surprise.
Canada is in the midst of publicly debating its healthcare system in the wake of a November 2002 report. Roy Romanow, head of the Royal Commission on Healthcare in Canada, produced a report analyzing the Canadian healthcare system and suggesting improvements. Now, Romanow has expressed dismay that many elements of his plan have gone unfunded, though he says that the federal government is generally on the right track.
Arctic leaders were mostly enthusiastic about Romanow’s recommendations for additional funds for “telehealth” and recruiting more healthcare professionals to work in the north. Telehealth is the term for the use of telecommunications and computer equipment to virtually connect patients and doctors who may be hundreds or thousands of miles away. Northern leaders were disappointed, however, that Romanow failed to address the per-capita funding problem in the report.
Though the additional funds are quite welcome, no one pretends that there isn’t far more work ahead in order to bring health standards and healthcare quality in the north closer to the level enjoyed in the southern provinces. Federal Health Minister Anne McLellan will meet with northern leaders in the spring to discuss further steps to address the situation.
