Thank you, Mr. Beaulieu. Next I have Mr. Dolynny.
Thank you, Madam Chair. The question I have for the Minister or deputy minister is: When was the last time that the department has done a full review of the Supplementary Health Care Program in terms of criteria and eligibility for payment for whether it’s appliances, prosthetics, drugs, medical expenses? Thank you, Madam Chair.
Thank you, Mr. Dolynny. Minister Beaulieu.
Thank you, Madam Chair. I don’t have that information on the date, but we think that review had occurred in 2007, but we can check to confirm that.
Thank you. Can the department indicate whether or not we’ve got systems in place to have formal reviews done in supplementary health programs on a frequent basis or is this basically an on-demand request from the department when need be? Thank you.
Thank you. The department does not have a regular cycle for reviewing supplementary health benefits.
Thank you. The purpose for my questions here is to show savings in design, and the Minister is fully aware that I have talked to him and I’ve talked to his department many times regarding the opportunities of savings within the framework of the Supplementary Health Care Benefits Program. It’s unfortunate that a lot of the recommendations and a lot of the opportunities for savings have yet to be looked at or implemented. Again, my question is: Is that savings in design, and if we have not looked at this since, as the Minister indicated, potentially 2007, would the department commit within the life of this Assembly to do a full audit or a full review of the Supplementary Health Care Program to find ways to save money? Thank you.
Thank you. We will attempt to get to that review when we’ve completed the other reviews that are in the books now. We’re hoping that we’re able to complete the essential reviews that we had talked about on the other items that we’ve discussed here today. So if we’ve completed those reviews, then we will begin this review. I’m not sure that I can commit to completing a review within the next two and a half years, but we will attempt to do that.
Thank you, Mr. Beaulieu. Next I have Mr. Hawkins.
Thank you, Madam Chair. On this particular section I’m just wondering, quite often the territorial government has been well known for providing more services than it covers and there’s always been a dispute between the feds about what billable services can be reimbursed. This is the right section, I assume, for that detail. and if it is, just in case, then how far is the gap or what are we in delay of payments, because it’s always been quite a known subject that we’ve been behind on NIHB return payments owed by the feds. So let’s start with that. Thank you.
Thank you, Mr. Hawkins. Minister Beaulieu.
Thank you, Madam Chair. There is no gap and no delay.
Thank you. So the Minister is saying that all our services that we pay under the NIHB program are completely paid up to date by the federal government and there has been no dispute on our funds and allocations of that? Thank you.
Madam Chair, through the regular time it takes to cycle through receivables and payables, that’s the only thing we wouldn’t consider a delay or a gap. It is just a normal time to do business.
Only a few short years ago, there were several million dollars outstanding in disputes and discrepancies between what the GNWT picked up the tab for under services we thought, or believed very strongly, were NIHB funds and, that said, were outstanding fees with the federal government. When was the last balloon payment they made to catch up to that disputed amount? Thank you.
Madam Chair, we don’t know when the last payment was made to resolve this dispute. We could go back and check to see when the last time this was an issue, and we can check the date on that. But I can say that it’s not an issue now.
Would the Minister be willing to provide that type of update and have it in a written form to me, and possibly other Members, as to the current status of this file? When was the last equalizing on the amount that we believe we were out?
I’m sure it was only a few years ago that it was tens of millions of dollars outstanding. I have to admit, I find it almost a bit of a shock to hear that the feds have either come forward and made up the difference, or maybe, rather, did we write down the difference on that particular amount and just walk away from it? It seemed to be a very bitter dispute between our government and the feds. We said they owed us money and they said they didn’t, so if they had actually paid this amount, I would be surprised, if not shocked, that the really old Health Minister didn’t inform all Members that they finally paid what was outstanding. I think it would be a cause for celebration.
I don’t want to make needless or useless work, but this is going to have to go back, obviously, a couple of years. It is that easy to find out? I’ll start with that, because I’m really interested in this information. I suspect maybe other Members are as well.
I can’t see it being too difficult. We can provide a briefing note to the Member.
On this section, I think that will be perfectly fine. Thank you.
Thank you, Mr. Hawkins. Next I have Mr. Bromley.
Thank you, Madam Chair. There was a federal Health Transfer Fund and I don’t know whether it has to do with supplementary health programs or not, but the annual increase to the transfer was 2 percent. As the Minister knows, our health costs are going up about 7 or 8 percent. Does the Minister know what I’m talking about here?
Thank you, Mr. Bromley. Minister Beaulieu.
Thank you, Madam Chair. I would like if the Member could repeat the question. Maybe it is something that we would require assistance from the Finance Minister to respond to.
Madam Chair, I didn’t mean any offence, but I don’t know the name of it. It was the intent of my question. I know that during the 16th Assembly, it was well recognized, and I wonder if this might be part of what my colleagues are referring to, that this federal transfer – I believe it was related to NIHB or indigenous residents – was only increased by an inflation of 2 percent per year. We were suffering a penalty of the difference between that and the actual inflation rate which was about 6, 7 or 8 percent.
Again, I don’t know whether it had to do with supplementary health or not, but I bring it up here because I thought it did. If the Minister is not able to identify that program for me, I’ll just hold off on that question. But before I move on to my next, can I leave it at that and see if the Minister can shed any light? Thank you.
Madam Chair, I will just get the deputy to go through this information for the Member.
Thank you, Mr. Beaulieu. Ms. DeLancey.
Thank you, Madam Chair. I believe the Member is referring to a long-standing grant agreement for hospital and physician services to status Indians and Inuit which was formerly signed with DIAND and is now, of course, signed with ANSI. There is a 2 percent annual inflationary adjustment to this agreement. It’s intended to provide funding for hospital services and physician services to a maximum limit of about $28 million per year, and then we are poised to sign the agreement for the next fiscal year and it does have a 2 percent escalator in it. Thank you, Madam Chair.
Thank you, Ms. DeLancey. Mr. Bromley.
Thank you, Madam Chair. Certainly, and I think the Minister would agree with this, this means we are shouldering more and more of the costs because of this differential in real inflation rate versus what we are compensated for by the Government of Canada. I guess, at some point, I would be interested maybe in seeing the Minister provide a briefing on this and what the costs are. Just so I’m not so awkward next time, is there a name for this program and could it be shared? Thank you.
Thank you, Mr. Bromley. Minister Beaulieu.
Thank you, Mr. Chairman. This is an agreement for hospital and physician services to status Indian and Inuit. We would be pleased to provide a briefing note to the Member or committee.
Mr. Chair, my next question has to do with the pharmaceutical costs. I know seniors are going up something like 8 or 9 percent a year in the Northwest Territories and we are known to use a lot of drugs, apparently. The costs are going up. I know the Minister has been working hard to try and find out what we can do in the area of pharmaceutical costs.
Is there anything yet achieved or where are we at in our work towards trying to achieve some cost efficiencies with bulk purchasing or whatever? I know there have been a couple of things happen with just a couple of drugs at a federal or national level that have gained us significant savings. Thank you.
Mr. Chairman, the cost, just to provide some information, has gradually increased from 2007, about $3.6 million, to in 2011-12 about $4.1 million. In addition to that, I’ll have the deputy minister provide some details on the work we’re doing in the Pharmaceutical Management Strategy.
Thank you, Minister Beaulieu. Ms. DeLancey.
Thank you, Mr. Chair. We did provide a briefing to the Standing Committee on Social Programs not long ago. We’re still in the early stages, although we have put a number of pieces in place. We did have an initial report done by Alberta Blue Cross on considerations for developing a pharmaceutical strategy. We have done some work with Alberta Blue Cross in terms of implementing changes to how our programs are administered, but we’re really at the early stages of putting together the components of a pharmaceutical strategy. Some of the things we know we need to look at are catastrophic drug coverage, expensive drugs, and the possible review of our formulary. Right now we use the NIHB formulary. We are working with other provinces and territories under the Council of the Federation initiative to look at generic drug pricing.
A key priority on our work plan this year is to do what the Member is talking about, which is looking at potential for cost savings. Part of that will come through common procurement and bulk purchasing, and I did talk earlier about how all of our authorities have agreed that moving to common procurement has to be a priority under our back office initiative, so we’re putting a work plan in place for that. We are also going to be working this year to do a more detailed analysis, drilling down into the potential for other cost-saving potential and how we acquire pharmaceuticals.
Thank you, Ms. DeLancey. Mr. Bromley.
I think this is a big topic, but there’s obviously a very rich area for ongoing work here and I think I’m going to leave it at that rather than drill down into this, and I’m sure we’ll be visiting in committee about this further. I will leave it at that. That’s all I have on this page.
Thank you, Mr. Bromley. Page 8-27, Health and Social Services, activity summary, supplementary health programs, operations expenditure, $26.730 million. Does committee agree?
Agreed.
Thank you. Page 8-28, Health and Social Services, activity summary. Mr. Hawkins.
Thank you, Mr. Chairman. If I was to look for a line on medical travel, is this the only funding source area that I would search out or is it listed in any other line somewhere within the government?
Thank you, Mr. Hawkins. For that we’ll go to Minister Beaulieu.
Thank you, Mr. Chairman. We have some details here that I would maybe have the deputy minister just read the cost detail for the other areas like the revenues that come in to pay for medical travel and also the THSSI, I suppose.
Thank you, Minister Beaulieu. Ms. DeLancey.
Thank you, Mr. Chair. This is the main line item in the budget for medical travel. There is another just over $500,000 under hospital services which also relates to medical travel. What’s important to note, though, is that this is not our full budget for medical travel. This is the full amount that we vote, but Stanton Hospital, that runs the Medical Travel Program, gets an additional $12.7 million in revenues so that their full budget for medical travel is about $29 million. There is a shortfall. They are predicting a shortfall in that amount of about $2.3 million for this year.
Thank you, Ms. DeLancey. Mr. Hawkins.
I appreciate that answer and, certainly, the forthrightness of it. Where does the additional money come out of? Can I get some help in the description of, sort of, connecting the dots? I mean, it must come from somewhere.
The additional funding comes from third parties, so for example, costs that we recover from the Non-Insured Health Benefits program, costs that we recover from third-party insurance providers through our EHB program, out-of-territory residents' recoveries, recoveries from the RCMP, WCB and other private sources.
Thank you for that. Just adding a little further, so is it safe to say that… Sorry. Would it be correct to say that medical travel, then, is on budget for core cost and should we be including third-party cost in its normal line budget? If the taxpayers of the Northwest Territories asked the simple question does normal medical travel under the cost of our programs we offer as a government service, are we on budget or are we within budget, is that a fair statement to make?
The other portion of the budget that’s realized through revenues is included in the main estimates on the revenues page. We do show anticipated revenues, and of course, that’s based on historical trends, so we do our best guess at estimating that. It’s fair to say that it is reflected in the budget under the revenues.
