Debates of February 8, 2011 (day 35)

My door is open, we can talk about it anytime. We do and we have and we will continue to talk about this. Thank you.

Next on my list, on page 8-25, is Ms. Bisaro.

Wendy Bisaro

Frame Lake

Thank you, Mr. Chair. I just have one question. I wanted to follow up to the questions and answers from Mr. Bromley earlier relative to the possible changes to the Extended Health Benefits Program and the concern I think that all Members have with those who are not currently covered. I don’t think there was any argument during the debate on the changes to the Supplementary Health Program that we did not want to cover those people who aren’t covered, and if I understood the Minister correctly, I heard her say that there will not be any consideration of how to cover those people until the 17th Assembly. If that’s the case, I really am somewhat stumped. I don’t understand, if we have to develop a policy I understand that, but I don’t understand why we have to wait another 10 months before we start to develop a policy or if we develop a policy and take it to Cabinet. We still have time left in this Assembly. I think it’s an area of policy that ought to be looked at. As I mentioned earlier, it’s a specific area, a specific core of our residents who are not currently covered by extended health benefits and they should be. So I would like to ask the Minister why we can’t start the process to look at those people, that core group of people now. Why do we have to put it off until the 17th Assembly?

Thank you, Ms. Bisaro. Ms. Lee.

Wow. Let me just be brief. I guess just one reason, as I stated earlier, is that given the discussions we’ve had over the last two or three years, we were told clearly that the Supplementary Health Benefits Policy that was approved, but not in effect yet, should be rescinded. We did that. A core part of that policy was an income threshold which, in turn, determined a group of people that we considered to be working poor. We were told, in no uncertain terms, that our public does not want us to determine health benefits by income. So that’s where we are.

As I stated earlier, we are following and we have been reviewing the recommendations from the Joint Working Group report to see what we can adapt within the short time frame that we have. We know that the process requires that whenever we are establishing a new policy or are making major changes to a policy, we have to follow that consultation process. That would have to be done on this policy.

It makes it difficult. As just a practical point of view, how do we determine working poor if we have done away with income testing? Is there another way to determine working poor? Secondly, if we are going to not determine working poor, that means just universal coverage on all supplementary health benefits and that would require a policy change, and I think that’s something that we need to talk about.

We, as a society, have to say, okay, do we want to cover everybody for supplementary health benefits? I think there are many who might think that we should and I think there will be many who will say not. That’s a major, major public policy to date and that will have to be done as a process. It’s not something that I think that I could do within the direction I got out of Joint Working Group.

Wendy Bisaro

Frame Lake

I didn’t want to go anywhere near income testing. That wasn’t the question I asked. I simply asked why we couldn’t start to consider coverage for that group of people who currently have no supplementary health benefit coverage. I didn’t really hear an answer. I heard the Minister say that it’s a big policy decision and there has to be some consultation on it. Absolutely. But why can’t we start?

I need the Member to tell me how we determine the working poor if we don’t talk about income. Who are they? It’s everybody who’s not covered, right? So if we’re going to cover working poor without determining income, that means we are covering everybody. Everybody. I agree that might be something that everybody wants to do, some people might want to do. But we’re no longer then talking about working poor. We’re talking about having universal supplementary health benefits for everybody who lives in the Northwest Territories. That is a good public policy debate to have. We don’t have working poor defined anymore because without talking about income and need, who are they?

The Joint Working Group review have asked us to look at encouraging people to get third-party insurance, NHIB parity, lots of different things that we could look at within the existing framework. With all due respect, we need to have an honest, frank discussion about what we’re talking about. When we rejected the Supplementary Health Benefits Policy, people made it clear that we don’t want you to test income as eligibility criteria. With that went out the door the ability to determine working poor. Other than covering everybody, we have to put some kind of eligibility. That has to have a bigger debate and we can’t do that within the framework of what we were told in the Joint Working Group.

Wendy Bisaro

Frame Lake

I’ll have to go and check Hansard tomorrow, but I don’t believe in either of my questions I mentioned the words “working poor.” I’ll leave it at that.

Thank you, Ms. Bisaro. I have nobody else on the list for page 8-25, Health and Social Services. Mr. Bromley.

Bob Bromley

Weledeh

Thank you, Mr. Chairman. I just can’t leave it hanging like that. I think this is too big a question. I think, you know, I’m not disagreeing with anything that I heard from the Minister. I think there was solid agreement amongst everybody that we figure out a way to cover people who were not covered now, be that a universal plan or defining the working poor. That came through in the Joint Working Group principles. I guess I would just say we need to have that debate and we need to decide which way we’re going to go on that one.

I just want to say in response to the Minister’s remarks that if that’s what it takes, then we’re not done yet. I know it’s been a long haul on this one but that was sort of... I’m sure we all agreed that we wanted to get that done some way. I recognize that’s not within the immediate actions that we are working on within the existing policy. It’s an unresolved issue but it’s one that all of us want resolved. Let’s commit to continue working on that and making sure that everybody does come in somehow under coverage. Just a comment.

Thank you, Mr. Bromley. Just a comment. To Ms. Lee for response.

Thank you, Mr. Chairman. I appreciate the Member’s comment. I don’t think anything he says precludes the debate that I said that was required.

Thank you, Ms. Lee. I have nobody else on page 8-25, Health and Social Services, activity summary, supplementary health programs, operations expenditure summary, $26.218 million.

Speaker: SOME HON. MEMBERS

Agreed.

Okay. We’ll move along to page 8-26, Health and Social Services, activity summary, supplementary health programs, grants and contributions, contributions, $15.747 million.

Speaker: SOME HON. MEMBERS

Agreed.

Okay. We’ll move along to our next page, which is page 8-29, Health and Social Services, activity summary, community health programs, operations expenditure summary. Mr. Beaulieu.

Tom Beaulieu

Tu Nedhe-Wiilideh

Thank you, Mr. Chairman. This is an area that is of great interest to me in the health field; the whole area of treatment and counselling and so on and so forth. Speaking to local health workers, the cost of other health, the cost of people being sick and hospitalized and whatnot, a lot of that is attributed to, I guess, not necessarily all addictions but attributed to alcohol. The health workers seem to think that alcohol is a big, huge contributing factor in small communities for the health of the folks. The communities also seem to have a solution. I’d like to see the department working with the communities on that solution. The solution that seems to come up most often, whether we were in the Gwich’in or down further south in the small communities, the solution seems to be that the people thought that the local counsellors working with individuals on the land seemed to be the best way to help people heal from alcohol addiction. I believe that. I heard it many times and I also believe that is the case. I’d like to ask the Minister, my first question is: is the department going to do anything to head in the area of on-the-land treatment at the community level for alcohol addictions?

Thank you, Mr. Beaulieu. Ms. Lee.

Thank you, Mr. Chairman. We do do that. We do on-the-land treatment programs and it is part of our programming. I do admit that we have a bit of a patchwork funding, because it depends on the money we have in the department as well as some funding sources that we could find with the federal government. We approve those on an application-by-application basis. I agree with the Member that on-the-land addiction programs are a desirable way to go and one that I would support getting more of. I agree with the Member that we don’t have a comprehensive, across-the-board, all across the NWT programming for that.

Tom Beaulieu

Tu Nedhe-Wiilideh

Another area that seems to have many long-term benefits and it’s kind of the area that today in my Member’s statement I talked a little bit about which is in the review of the Child and Family Services Act. It’s not just that. It’s the overall prevention in the area of health. Again, the addictions, apprehensions, the whole thing seems to have real long-term benefits. This is an area where I’d like to see the department step up more in the prevention. I’m talking about starting at a very low-grade level in the schools, promoting some good, healthy habits in the schools and so on. I think that’s essential and I believe that if all the departments are working together and we’re trying to get kids into preschool, kids into daycare, working with the Department of Education and that being two real key areas where you get the students started off on the right foot and get them into daycare and into preschool, it gives them a little bit of an advantage in kindergarten that the things they gain from that when they get into kindergarten are something that they retain always. They’re always up to speed at their grade levels as they go through school.

I think prevention going in, health professionals going in and talking to kids and so on and spending the money that it takes to bring in people, models and so on from even other jurisdictions or other communities to talk to kids and talk about the benefits of healthy living, I think that’s something the department should also do. I guess I’d just like to ask the Minister if they would look at that at this time again.

I believe by and large we do a lot of that already. Healthy Choices Framework, the Strategic Initiatives committee money. There are a number of examples we could give the Member where Education, Culture and Employment and their schools, and MACA, and Health and Social Services work together, especially working with children in our communities. I know of many, many examples where our community health reps and health staff go to schools. As the Member knows, in Fort Resolution, for example, the school there is just a beautiful example of where the teachers and the health care professionals are involved in working with the children. We see that in the Sahtu and we see that in many different communities, so that work is being done already, no question.

We need to reinforce it and enhance it and that, of course, depends on the resources available. I don’t know how much work that would require, but I can see if we can put that together for the standing committee. Maybe we should talk about what we are doing now and what we could do, how we can improve it going forward, but what the Member is saying, is, I think, the basic principal that our government works on. Thank you.

Tom Beaulieu

Tu Nedhe-Wiilideh

The last, there are a few smaller items in here, too, but with the time allotted, the last key item again has long-term benefits in cost and is trying to provide for care for elders in the home. Right now the overall government policy doesn’t make it really easy for individuals to care for their elders. If we have an elder -- and we have that situation occurring a few times in both communities that I represent, in Lutselk’e and Fort Resolution -- where younger family members are either living with their elderly parents or their elderly grandparents. Without those members supporting the elderly, those people would be in long-term care. Long-term care is very expensive and it is lonely for the elders and it displaces them and the only long-term care, really, is outside of those types of small communities that I represent. I think the government should put things in place, whether it be housing, income support or various health programs, to accommodate those individuals for living with their elderly parents or grandparents, because the long-term benefit, and even the immediate benefit, is there.

I don’t know what the exact cost of putting someone in long-term care is, but I know it is fairly high. It is fairly significant. There is staff, there is nursing, there are all of those things that these guys are actually taking care of, these guys that can deal with the medications, other needs, shopping, driving the elderly around, taking care of any maintenance that is needed in the house and so on. The government needs to respond to those people and support them so that when they are there... Sometimes it is a little bit of a sacrifice to do this, for a young person to be given the responsibility in the family to be the one that takes care of the elder in the family. There are some sacrifices that go along with that and the government doesn’t make it real easy. It is not necessarily health, I am just talking in general, but this is an area where I think health could right the model and followed by other departments, they would be able to say that if an individual is taking care of the elderly, these are the benefits to doing that and right now it is the opposite, there are more deterrents than benefits. I would just like to see if the Minister would look at something like that working with other departments. Thank you, Mr. Chairman.

As the Member stated, this is an issue that involves housing and income security and other sorts of government network programs that might create barriers in terms of benefits that one might get. That is something that I would be willing to look at.

Going forward, though, it is something that future governments have to consider, because we do, in our Foundation for Change action plan, I believe it is the approach of any other government to encourage family members and communities to partake in taking care of our elderly and persons with needs as much as possible, and it’s something that we need to expand on and it’s something we are trying to do in communities in the Territories. I believe this is something that my department has to flag as something that the next government has to continue to work on.

Lastly, I think we have to have a national campaign about how we look after each other because our population is aging and it’s not just going to be about money. It’s going to be about not having enough womenpower/manpower to physically look after all those who are going to need to be looked after and a general shortage of young people who are going to be able to pay taxes or look after us. I anticipate that I’m going to be elderly soon, too, and I think we need a national campaign on how we look after each other over the next 20 years. I don’t think it’s just about money. I think families and individuals have to look after each other. Government has a role to play, but I don’t think government can do it alone.

Thanks, Minister Lee. Next on my list is Mrs. Groenewegen.

Jane Groenewegen

Hay River South

Thank you, Mr. Chairman. I move that we report progress.

---Carried

Report of Committee of the Whole

Speaker: MR. SPEAKER

Can I have the report of Committee of the Whole, please, Mr. Abernethy.