Thank you, Mr. Speaker. At the beginning of this process when this side of the House and the champions in our communities came forward to say that this was completely wrong, this approach, there was a promise of a clean slate, the removal of an income means test as the philosophy, and yet that did not come forward. The Minister continues to say that the saving grace of this Supplementary Health Benefits Plan is to take from Peter to pay Paul.
What is stopping the Minister from doing a thorough analysis when we constantly hear about how much data and work they’ve done today? The one thing that can be the true factor for all of the basis of this discussion is the analysis of what it would cost to include this additional group called our working poor. No one wants that to happen. Why does the Minister keep defending every other topic under the moon, under the sun, under the heavens, other than dealing with that one question of why don’t we do that analysis and get it before this House so that we can have a true and thorough debate? Thank you.
Mr. Speaker, all the information is there for the Member to say whether he supports an approach that would make the program more fair and equitable and extend the coverage to those who need it the most. This is not a situation of taking money out of Peter and paying Paul. This is a situation where we are trying to increase Peters. We are trying to make more Peters; we’re not trying to take money from Peter to pay Paul. We want to expand the number of Peters. Thank you, Mr. Speaker.
Thank you, Ms. Lee. The honourable Member for Hay River South, Mrs. Groenewegen.
Mr. Speaker, I would like to ask questions to the Minister of Health and Social Services primarily from the point of view of the concerns of my constituents in Hay River who are senior citizens.
Now, I first of all want to say that we have a remarkable package of services and support under our health and social services system for the seniors in the Northwest Territories. We have chosen, we have paid for that, we have done that. I need to know what analysis has been done about the impacts or the potential impacts of now pulling that back and not having that. We hear about the cost of living in the communities. We hear about seniors on fixed incomes, and no doubt there are folks who are receiving these benefits who are in a higher income bracket, but this is what they have become accustomed to. They have a higher income bracket, but they also probably have higher expenses than most seniors who might live down south and we don’t want to lose...(inaudible)... Has the analysis been done on the impact if we were to lose seniors out of the Northwest Territories as a result of these changes? Thank you.
Thank you, Mrs. Groenewegen. The honourable Minister responsible for Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. I also received the letter that the Member is talking about and we are aware of the concerns that the seniors have. The important thing to know is that our information shows that this will benefit seniors on fixed incomes and low income in the same way as it would benefit every citizen who’s on a lower income. Our information has shown that there are people over 60 who have high incomes, just as there is for any other age group. So, Mr. Speaker, the fact is, even with these changes, this Extended Health Benefits Program will be very robust. So there will not be another program, even for the seniors, that’s going to be much better that it would encourage them to move.
So, Mr. Speaker, I think we should look at this chart that shows exactly what the income level is and what the threshold is and who would continue to get 100 percent coverage, and at which income level they would start contributing to the cost of extended health benefits, and you will find that even for those who are making $190,000 of income, no matter what age, that they would still get support from this government. I have to tell you, in no other jurisdiction would you still get extended health benefits at $190,000 net income, of any age. Thank you.
Mr. Speaker, because the seniors who are currently receiving the benefit of this program regardless of income who are over 60 years of age in the Northwest Territories have planned that they would have this coverage, have become accustomed to this coverage, has the Department of Health and Social Services given any thought to grandfathering those folks who are already covered by this and phasing in a change to supplementary health benefits so that younger people like myself, for example, could begin at an earlier age to start to plan for the fact that they may need to think about insurance or putting money aside for sickness or so on? Has any thought been given to that? Because I’m just very afraid of the outcome of pulling this back from people who are already receiving it. Thank you.
We are interested in listening to our public about transitional measures or the option of grandfathering. That was discussed with the stakeholder groups. Some have said no. We are getting feedback on that on the website; people are divided on yes or no. But definitely that is a legitimate issue for discussion and I’d be happy to receive input from the Members and others out there. Thank you.
Mr. Speaker, to be clear, what is driving this change to our policy on supplementary health benefits? From what I understand is the projected costs going forward and the sustainability of those costs and also the people who are not currently receiving coverage, there’s a group, there’s a gap, there’s a group that are left out. If it is the cost that is driving this review, I think that the issue of cost, which Ms. Lee has indicated, is not something easy to quantify. It is difficult to have a fulsome debate on this when we don’t know what those costs would be. Because those are the kinds of decisions that government and policymakers can make, that they say it’s going to cost us this much, even on a projected basis. Well, we choose and we say that is a good expenditure of public funds and we want to do that. So, I mean, are there any costs that are part of this equation in this consideration? Thank you.
The Member knows and everybody here knows projecting to the last dollar what our health care expenditures are going to be, whether how much it will cost to run Stanton tomorrow or Extended Health Benefits Program, what’s it going to be at Hay River, whatever, that is, I mean, there are lots of formulas to do that, but at the end of the day, it’s a projection.
Mr. Speaker, sustainability of health care programs is a national issue. It’s an issue for every government. We know that on the whole that we will continue to see increases and we budget accordingly. So sustainability is an issue that we need to consider, but the thrust of this policy is not to reduce costs or to decrease costs, but it is to see how do we fix this program so that it works better. Because we know that it’s not working as well as it should. The program criteria that it has is not backed up by evidence, because we know that people of all ages have all different incomes and ability to pay and different medical needs. We are, right now, under the existing policy, excluding a whole bunch of groups of people, and we are trying to find a way to see if we can bring them on, and to ask those who can afford to pay something, to contribute to their health care costs. Thank you.
Thank you, Ms. Lee. Your final supplementary, Mrs. Groenewegen.
Thank you, Mr. Speaker. So it is about the redistribution of resources. It is taking resources which are now expended on behalf of those seniors who are in a certain income bracket and re-profiling those resources to a group of people who are not receiving them. So it is a redistribution of the resources this government has. But if we were given a number and we were told, Members of the Legislature, if we would commit to expend this much money, we could take care of the folks who aren’t being looked after plus we could leave the Seniors Supplementary Health Benefits the way they are. But how can we make that decision in a vacuum, in the absence of any kind of financial projections? That’s the kind of information I’m saying that we need in order to make a decision like that. Is there any effort on the Department of Health and Social Services, even on a projection basis, to estimate what it would cost to include those people who are not covered now, while at the same time not taking anything away from those people who are covered? Thank you.
I know that any debate about health benefits is difficult, it’s emotional, and it’s a difficult thing to do. In answering the Member‘s question, it is a little bit about redistributing resources, but most importantly, Mr. Speaker, it’s about fairness.
I hope you don’t mind if I use this example, but it just keeps coming at me. In this Assembly there is myself, MLA Bisaro, the Member herself, Member Ramsay, Member Bromley, Member Abernethy and Member Hawkins who would belong to this program. Right now, when some of us hit 60 years old, they will get so many dollars for glasses and $1,000 dental benefits. We have very nice third-party coverage through our employer. I don’t know why anybody here among us that I just named, when they turn 60, they automatically get dental benefits and eyeglasses when I don’t -- I guess I will when I hit 60 -- when we could get that coverage by our employer insurance and especially when there are people out there who do not get benefit of that dental benefit and eyeglasses even if they can afford it because they are not 60 and we do not look at their ability to pay. I submit to you, Mr. Speaker, all six of us could afford to pay our own dental benefits. This is not just about redistribution of resources; it is about what is fair and what is equitable. Thank you.
Thank you, Ms. Lee. The honourable Member for Great Slave, Mr. Abernethy.
Thank you, Mr. Speaker. The Minister is right; this is about what is fair, this is about what is right, this is about what is just. I also can’t agree that the intent behind what we are doing here is sound. We want to support the low income families, the low income earners who don’t currently have insurance now. The problem is how this Minister and this department happened to be going about the process.
The Minister said we need to have a debate about substance. Yes, please, let’s have a debate about substance. The problem is it would be difficult to have a debate about substance when the information the Minister agreed to get after we passed our motion didn’t come forward. They didn’t go out to talk to the stakeholders. They didn’t consider options. They didn’t research around other options. That is what the Minister said she was going to do. If the Minister had done that, we would have the information to have a debate about substance, a well-rounded, thorough debate about substance. We can’t have it now. Why didn’t the Minister go get the information that she said she was going to get after the debate, after the motion? We need that information to have this debate. We can’t have this debate. All this dancing around she is doing isn’t helping us do the right thing to the people of the Northwest Territories. Thank you, Mr. Speaker.
Thank you, Mr. Abernethy. The honourable Minister of Health and Social Services, Ms. Lee.
Mr. Speaker, I don’t understand why the Member thinks that he can’t put input into this process. Exactly what is the problem he has with the substance? What is it about the program as proposed that he doesn’t agree with or support?
Mr. Speaker, public meetings started this Monday. We are going to continue to have public meetings. In preparation for those public meetings and public consultations, we posted a conversation document a month ago. We are in the middle of the debate. Mr. Speaker, I would like to hear from the Member what in substance does he have a problem with. Thank you.
Mr. Speaker, it is nice that they are asking us questions for a change. Technically, I can’t say what I have wrong with the substance, because in order to make a fair and accurate assessment of whether this program that they are proposing is a right one, we need options to consider. We need alternatives to consider. Research should have been done on this. When we did the motion, Mr. Speaker, the motion included a discussion around the department going out and meeting with the potentially affected stakeholders to get that information, get those options and they were going to research it. The Minister said they would talk to the stakeholders and get that information. They should be coming back to us with all of that information. What the result might be is this might be the best program, but without all of these alternatives we will never know and never be able to make the decision that this is the best. I want that information. The Minister said she was going to give it. Why didn’t she provide us with that information that she said she was going to provide? It is simple. Thank you, Mr. Speaker.
Mr. Speaker, the direction of the House and the result of the last discussions were that people wanted to know more about who were using this program, how the income threshold would impact the residents who were covered and who would not be covered anymore. At that time we suffered from not having enough detailed information about exactly who was served by this program.
Mr. Speaker, as I stated already, there hasn’t been, I don’t think, a more thorough analysis of a program like we have presented as a result of doing this research for the last number of months and we are putting the information out there. But we understand that people may need more information to have a better discussion and we are willing to provide the information. So, Mr. Speaker, if the Member has more information he needs, I’d be happy to do everything I can to provide it. Thank you.
The Minister seems to remember the parts of the motion and the debate that support her case. What she’s not talking about here is that we are also asking for alternatives and options. I don’t see alternatives and options. Yes, they’ve done a lot of research, I’ve got to tell you. The product they are providing to us now has way more research. It’s a lot of research, it’s good information, it explains a lot to defend the model that they want to put forward. Where are the alternatives? Where are the options? Those options would have come from the stakeholders that she promised that she would consult with if they’d actually had consultations over a year ago. They didn’t. So I guess I’m going to ask: why didn’t the Minister ask -- and we all know she’s going to say they did -- but why didn’t the Minister not have the consultations that she said she was going to have to obtain these alternatives and options, the information that would help us make informed, reasonable and rational decisions in the best interest of the people? Thank you, Mr. Speaker.
The fact is there is a lot of information to make informed, rational, logical decisions about where we should go with this program on behalf of all the people who need our attention with this program. Mr. Speaker, I know the Member is referring to the public working group. In fact, they asked for more information about the program. Exactly who does it serve? What is the background of the people that access this program? What would it mean in many different ways? So they asked for more detailed information before they put any input in, so we presented that information to the group and the group responded to the material we presented. Thank you.
Thank you, Ms. Lee. Final, short supplementary, Mr. Abernethy.
Thank you, Mr. Speaker. Once again no references to alternatives and options, the thing that is important to make a healthy, rational and reasonable decision. Since I can’t get an answer there, I’m going to ask a different question.
In my Member’s statement from the quote that I read, the individual said the process that we’re going through now does not allow the GNWT to change its policy to accommodate the discussions and recommendations arrived at as a result of these consultations with the affected people and stakeholders prior to the stated implementation date. We’ve said since she announced the start date of this new policy, it’s not enough time to consider some alternatives and make changes. Sounds like they’ve already got their plan decided to implement what they want. Why can’t we push the date back a little bit so we have an opportunity to put in some of these alternatives or at least consider them reasonably? Thank you, Mr. Speaker.
The constituent that he mentioned, I have the copy of that e-mail too. That e-mail was written before we had all the details that we posted on the website just yesterday. That participant was part of the stakeholders group which did not have all of the income data and who would benefit or not. This is an evolving process, Mr. Speaker. The public hearings started today. That’s an opportunity for people to give us feedback into what we are presenting.
Mr. Speaker, the Member keeps saying where are the alternatives. I’d be happy to hear from him about what alternatives that he wants us to consider, because I believe the information we have gives a really good point for discussion. Thank you
Thank you, Ms. Lee. The honourable Member for Kam Lake, Mr. Ramsay.
Thank you, Mr. Speaker. Mr. Speaker, I, too, would like to follow up on some of my colleagues’ questions who have been questioning the Minister of Health and Social Services to the proposed changes to supplementary health. The interesting thing for me, I was at the briefing on Tuesday and the information provided was good information, but again, Mr. Speaker, with all the trouble that was caused last year, about a year ago, just over a year ago and the issue is back before us again, I don’t understand why it took that long to get that level of detailed information in front of the Standing Committee on Social Programs. That information, Mr. Speaker, should have been there a long time ago.
Mrs. Groenewegen was asking questions about what research the Department of Health and Social Services has done on the impact of these changes, what impact this proposed change would have on seniors here in our Territory and how many of them would actually pack their bags and leave the Northwest Territories as a direct result of these proposed changes to supplementary health benefits. Many of our residents are approaching retirement age as well and I’m not interested in grandfathering anybody. I think people who have paid taxes and raised families here in the Northwest Territories deserve and have every right to the same benefits that people enjoy today. I’d like to ask the Minister that question: what research was done?
Thank you, Mr. Ramsay. The honourable Minister responsible for Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. I know that question has come up: has the department looked at what impact this will have in terms of people wanting to leave. I have two direct answers to that. One is that we have no reason to believe that anything we are doing here would encourage anybody to leave the North because our program is as good, if not better, than what’s available anywhere else. So our supp health benefits are still a robust one and the fact is all across the country, except for Nunavut, all extended health benefits are income tested. Not only are they income tested, some of them are means tested, which means they look at more than just the income. In some places it’s asset tested, which we are not proposing to do at all. In Nova Scotia and Newfoundland and other jurisdictions, their income threshold is less than $25,000 gross. We’re talking about a program that you still have access to even if you make $200,000 a year. So we have no reason to believe that anybody would leave.
Now, why can’t you come up with a dollar? That’s the same question as if somebody could tell me if I’m going to get sick tomorrow. I do not know what my health care cost is going to be to my government because we cannot project people’s health expenses. To ask that, the Member has to know that’s an impossible thing to answer.
The Minister knows full well, she’s the chair of the Strategic Initiatives Committee on the Cost of Living. She knows full well that it’s not a fair comparison to compare the cost of living here in the Northwest Territories to that of southern jurisdictions where, I might add, many people choose to retire in the South. Somebody has to protect the social fabric of our communities and keep families together and keep seniors in the North. I’d like to again ask the Minister how come a survey hasn’t been conducted with the seniors in the Northwest Territories to ask them if proposed changes to the Supplementary Health Benefits Program would result in them leaving the Northwest Territories. Like I said, when they leave, that affects the social fabric of our communities. We need to keep families together.
I really think the Minister has to address that concern and the $22,000 that the government gets in transfer payments for every person we have on the ground here in the Northwest Territories. That would be gone with them as well.
Obviously I disagree with the Member’s position on that. The fact is the cost of living issue for everyone in the North is important to this government. It’s also important that we continue to provide a robust Extended Health Benefits Program to our residents. What we are trying to do is to expand the coverage to those who do not have it right now, who are experiencing cost of living issues, as well as anybody else. So we are proposing an income as a criterion to consider and we are open to listen to our residents through this public hearing process about what they think of this and what other information they would like us to consider. We are open to listen to our residents through this public hearing process about what they think of this and what other information they would like us to consider.
Thank you, Ms. Lee. The time for question period has expired; however, I will allow the Member a supplementary question. Mr. Ramsay.
Thank you, Mr. Speaker. We have to have some type of competitive advantage here in the Northwest Territories to maintain our population base, especially for senior citizens. I’d like to ask the Minister if she can explain to me how she feels that this proposed change to supplementary health is fair when it is a redistribution. She talks about it herself. She says there are going to be winners. Who are the losers?
Under this proposal, if you go to the information that we have on the website, you would have to make $400,000 net income, that’s line 236 in federal income tax, you would have to make $400,000 before you have to pay 100 percent of glasses, $1,000 dental benefits, and 100 percent of your prescription drugs. You would have to make $150,000 before you start making some contribution. That is being competitive. I would challenge any other government in the land who would pay for thousand dollar dental fees and glasses without a means test when you’re making $200,000-plus.
The Member should support this proposal where we are going to provide access to children and working families right now who do not have that. I would argue that somebody making $70,000 a year could benefit from a $1,000 dental benefit for each of their children before somebody who’s making $200,000 to $400,000 that they get dental benefits just because they’re of a certain age. I do believe that it’s really important for the seniors out there to know that their benefits will be covered. There are no losers here because we are just asking people who can afford to pay to start contributing.
Thank you, Ms. Lee. Final supplementary, Mr. Ramsay.
Thank you, Mr. Speaker. As a government we’re spending hundreds of thousands of dollars by the Minister of Industry, Tourism and Investment, and I thank him for the initiatives that the government’s started on trying to attract and retain people here in the Northwest Territories. The government knows how important it is to have people stay here in the Northwest Territories. Like I said earlier, it’s $22,000 per person.
I’d like to ask the Minister again, I didn’t really hear it, she said there are no losers. When there are winners there are losers. Can the Minister stand up in this House today and tell the people of the Northwest Territories who is going to lose under her proposed initiative?
As the Member for Hay River South and many here know, we know that we have a very good health care program in the Northwest Territories. I honestly don’t believe that somebody... Mr. Speaker, making a public decision and doing the right thing you have to look at things as a total package. We have 2,000 people who will benefit by having access to these programs. Remember, I think people should know, even for other seniors programs like the rental subsidy or fuel subsidy, the day care subsidy, a lot of other government programs are income tested. This is not the first program that would try to do that. Really it is a very fair and objective way to do it.
Mr. Speaker, I have a return to written question asked by Mr. Hawkins on March 4, 2010, regarding physiotherapy (PT) and occupational therapy (OT).
PT and OT services are provided to community clients through inpatient, travel and outpatient services. The Stanton Territorial Health Authority (STHA) is responsible for providing services through travelling clinics to the Tlicho, Deh Cho and Yellowknife health and social services authorities. The Beaufort-Delta Health and Social Services Authority (BDHSSA) is likewise responsible for the Beaufort-Delta and Sahtu communities. The Hay River and Fort Smith health and social services authorities each offer PT/OT services through their respective hospitals. Service to communities is also provided through PT/OT outpatient clinics within Stanton Territorial Hospital (STH).
Later today, at the appropriate time, I will table the following:
a list of visits to communities by the authorities in the 2008-2009 fiscal year;
a list of attendances to the outpatient clinic at STH by community for the same time frame; and
a list detailing the number of people on a waitlist for PT/OT services as of January 1, 2010.
Rehabilitation services are not an insured service under the Canada Health Act. PT/OT services are listed by a variety of factors that include: staffing shortages; difficulties coordinating schedules with community health centres; the frequency of missed appointments; weather delays and cancellations for staff travel; budget restrictions; and the amount of time taken for preparation and follow-up for clients. Where applicable, third-party insurers, such as the Workers’ Safety and Compensation Commission or the federal government’s Non-Insured Health Benefits, also dictate the frequency and type of services and/or equipment available.
STHA has an agreement in place with Nunavut. Between April 1, 2007, and August 2009, STHA billed Nunavut $146,000 for PT/OT services, of which there is still $34,881 outstanding. Thank you, Mr. Speaker.
Thank you, Mr. Speaker. I have three documents to table. List of visits to communities in 2008-2009 by physiotherapists and occupational therapists.
Thank you, Ms. Lee. The honourable Minister responsible for Municipal and Community Affairs, Mr. Robert McLeod.
