Strengthening Policy for First Nations Self-Determination in Health: An Analysis of Problems, Politics, and Policy Related to Medical Travel in Northwest Territories

Medical travel, where a patient travels to a larger centre for services not available in their home community, is a critical element of the Northwest Territories (NT) health care system. For residents with a valid NT health care card who do not have other coverage for medical travel, the territorial...

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Main Authors: Crystal Milligan, Stephanie Irlbacher-Fox, Mark J. Dobrow
Format: Article
Language:English
Published: McMaster University Library Press 2023-01-01
Series:Health Reform Observer - Observatoire des Réformes de Santé
Subjects:
Online Access:https://mulpress.mcmaster.ca/hro-ors/article/view/5223/4362
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author Crystal Milligan
Stephanie Irlbacher-Fox
Mark J. Dobrow
author_facet Crystal Milligan
Stephanie Irlbacher-Fox
Mark J. Dobrow
author_sort Crystal Milligan
collection DOAJ
description Medical travel, where a patient travels to a larger centre for services not available in their home community, is a critical element of the Northwest Territories (NT) health care system. For residents with a valid NT health care card who do not have other coverage for medical travel, the territorial government administers some travel benefits through the NT Medical Travel Program as well as the federally funded non-insured health benefits program. The Gwich'in Tribal Council (GTC) recognizes that medical travel constitutes a major burden and presents extraordinary challenges for Gwich'in living in small remote communities in NT. In 2020, the GTC conducted research that suggests current policy and programs provide only partial access to care. Informed by Gwich'in medical travel stories and drawing from literature on the concepts of health care access, knowledge, power, and Indigenous rights, this article reframes prevailing understandings of the problems, politics, and policy associated with medical travel in NT. The authors contend that relevant and equitable medical travel in NT depends on policy-making that engages First Nations as equal partners with different levels of government and describe key considerations relevant to policymakers in NT and throughout Canada.
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spelling doaj.art-1928e76b345e4eaa9774f59c1becdc642023-01-16T12:41:11ZengMcMaster University Library PressHealth Reform Observer - Observatoire des Réformes de Santé2291-63692023-01-0110310.13162/hro-ors.v10i3.5223Strengthening Policy for First Nations Self-Determination in Health: An Analysis of Problems, Politics, and Policy Related to Medical Travel in Northwest TerritoriesCrystal Milligan0https://orcid.org/0000-0001-5413-3800Stephanie Irlbacher-Fox1Mark J. Dobrow2https://orcid.org/0000-0003-1105-1658University of TorontoHotıì ts'eeda Northwest Territories SPOR Support UnitUniversity of TorontoMedical travel, where a patient travels to a larger centre for services not available in their home community, is a critical element of the Northwest Territories (NT) health care system. For residents with a valid NT health care card who do not have other coverage for medical travel, the territorial government administers some travel benefits through the NT Medical Travel Program as well as the federally funded non-insured health benefits program. The Gwich'in Tribal Council (GTC) recognizes that medical travel constitutes a major burden and presents extraordinary challenges for Gwich'in living in small remote communities in NT. In 2020, the GTC conducted research that suggests current policy and programs provide only partial access to care. Informed by Gwich'in medical travel stories and drawing from literature on the concepts of health care access, knowledge, power, and Indigenous rights, this article reframes prevailing understandings of the problems, politics, and policy associated with medical travel in NT. The authors contend that relevant and equitable medical travel in NT depends on policy-making that engages First Nations as equal partners with different levels of government and describe key considerations relevant to policymakers in NT and throughout Canada.https://mulpress.mcmaster.ca/hro-ors/article/view/5223/4362knowledgepolicygwich'infirst nationsself-determinationmedical travelhealth care access
spellingShingle Crystal Milligan
Stephanie Irlbacher-Fox
Mark J. Dobrow
Strengthening Policy for First Nations Self-Determination in Health: An Analysis of Problems, Politics, and Policy Related to Medical Travel in Northwest Territories
Health Reform Observer - Observatoire des Réformes de Santé
knowledge
policy
gwich'in
first nations
self-determination
medical travel
health care access
title Strengthening Policy for First Nations Self-Determination in Health: An Analysis of Problems, Politics, and Policy Related to Medical Travel in Northwest Territories
title_full Strengthening Policy for First Nations Self-Determination in Health: An Analysis of Problems, Politics, and Policy Related to Medical Travel in Northwest Territories
title_fullStr Strengthening Policy for First Nations Self-Determination in Health: An Analysis of Problems, Politics, and Policy Related to Medical Travel in Northwest Territories
title_full_unstemmed Strengthening Policy for First Nations Self-Determination in Health: An Analysis of Problems, Politics, and Policy Related to Medical Travel in Northwest Territories
title_short Strengthening Policy for First Nations Self-Determination in Health: An Analysis of Problems, Politics, and Policy Related to Medical Travel in Northwest Territories
title_sort strengthening policy for first nations self determination in health an analysis of problems politics and policy related to medical travel in northwest territories
topic knowledge
policy
gwich'in
first nations
self-determination
medical travel
health care access
url https://mulpress.mcmaster.ca/hro-ors/article/view/5223/4362
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AT stephanieirlbacherfox strengtheningpolicyforfirstnationsselfdeterminationinhealthananalysisofproblemspoliticsandpolicyrelatedtomedicaltravelinnorthwestterritories
AT markjdobrow strengtheningpolicyforfirstnationsselfdeterminationinhealthananalysisofproblemspoliticsandpolicyrelatedtomedicaltravelinnorthwestterritories