The Minister has indicated that she’s going to follow up on this incident and she’s going to have a discussion with her department and certainly the Sahtu Health Board in terms of what happened. In this discussion, I want to ask the Minister, when you look at this issue and examine what happened, are there policies that you need to implement right away within the Sahtu Health Board in terms of our health centres and handling our medical records when they’re being asked to be sent to another health centre or community for medical reasons, that there’s strong policies in place, relook at the policies that they have now and that they could be implemented in the Sahtu in the interim, because I’m not sure how long this investigation will take in regard to this matter.
It is important for everyone to know that there is a policy already in place to protect privacy. Every health centre has that, every authority has that. We already have policies and procedures to protect privacy and medical information and confidential information. This is not a case of breach of that procedure. It is a situation where one out of 10 numbers that they pressed was switched and it just happened to be the other number was CBC.
Mr. Speaker, we understand accidents do happen. We will look to see what other measures we need to take to make sure that this doesn’t happen again, and we will take actions to make sure that we do everything humanly possible to make sure that that doesn’t happen. Thank you.
Final supplementary, Mr. Yakeleya.
Mr. Speaker, in the CBC report it’s reported that Privacy Commissioner Elaine Keenan-Bengts says what apparently happened within the Sahtu Health Centre wasn’t good enough in terms of them checking the information as to where the fax was going and confirming that it’s going to a location, it also confirmed that it’s been received at that location. That wasn’t done. This simple oversight hasn’t been looked at. So, again, that’s why I asked Minister about this issue. I know it’s going to take a while to get the report done. Can something like this, what the Privacy Commissioner is saying, can something like this be implemented right away at all the health centres in the Sahtu, where medical records are going be looked at with the utmost respect and confidentiality? Thank you.
We are working with the Privacy Commissioner. We are providing and the Sahtu Health Authority has reported to her in writing, or will report to her in writing, about what happened and what steps are being taken to prevent this from happening again. Understandably, the Sahtu Health Authority is quite upset about what happened. We are very sorry to the individuals involved and we’re doing everything we can to make sure that this doesn’t happen again. We are working closely with the Privacy Commissioner. Thank you.
The honourable Member for Frame Lake, Ms. Bisaro.
Thank you, Mr. Speaker. My questions today are addressed to the Minister for Health and Social Services. As other Members have said today and as the general public may be aware, recently the Minister published the policy titled Supplementary Health Benefits Policy, dated September of 2007. It’s become crystal clear that the implementation of any changes to the Extended Health Benefits Program as the Minister is proposing can only be done through means testing, something which was not crystal clear before. I feel the Minister has led us down, and the public down, the garden path for about a year and a half. She has studiously avoided telling us that the motion that was passed a year ago or so would have no effect, there would be no blank slate, no adequate consideration of alternatives. So I’d like to ask the Minister why did she not communicate the content or the intent of this policy to the Standing Committee on Social Programs and to the general public last February or March when the motion was debated. Thank you.
The honourable Minister of Health, Ms. Lee.
Thank you, Mr. Speaker. First of all, my understanding was that Cabinet documents were not to be made public. I have learned since that this policy was already signed. It is not a paper under discussion in Cabinet, so it was able to be released. Secondly, I’m hearing here, and Members outside, that somehow, I just have to say that, Mr. Speaker, we have been open-minded about this policy. I had this policy in front of me, I wanted to look at whether or not what is being proposed is fair and equitable and we believe that the newest changes that we are suggesting would be generous. It would cover a vast majority of people. Mr. Speaker, the income test is one that was included in the policy and we looked at that to see how fair and equitable that is and on the basis of analysis and the review we have done, we believe under the circumstances for non-insured health benefits -- remember this is not an insured service, this is not a universal service, this is not a legislative service -- for a program of supplementary health benefits we believe that this is the fairest way to implement this policy. Thank you.
I find it hard to believe that after three years in Cabinet the Minister didn’t realize that policies could be publicized. But there we are. It is what it is. I did note that the Minister mentioned fair and equitable two or three times in her response. I’d like to mention to the Minister that on March 24th of this year the Minister stated in a statement that the existing program is exclusive, unfair and inequitable. I’d like to know from the Minister how she considers that the proposed changes, which will put financial hardship on only some of our NWT residents, is going to make the new program inclusive, fair and equitable.
The existing program is exclusive, unfair, and it does not address the needs of vulnerable people because we have no provision under the Supplementary Health Benefits to provide for those whose income is too high to qualify under indigent supplementary health benefits programs but too low to be able to buy some of the health benefits that they require, and they’re not old enough to qualify under seniors benefits. The new proposed package is much more fair and equitable because it opens access to supplementary health to everyone, 100 percent of non-aboriginal people.
The Member says somebody is going to suffer financial hardship. Our income threshold is so high that it would be... Everyone, even at $200,000-plus, you would still get 45 percent coverage. I have to tell you, there is no other program in the country that will provide supplementary health benefits to those with an income over $200,000. In any other jurisdiction if your income is $200,000, you cannot access anything like that with the government. That’s why our program is fair.
I’d like to thank the Minister for a lesson on information that I already know. I’d like to also state that we’re not in other parts of the country. We’re in the NWT and we have a policy which currently works in most cases. I agree totally that we need to cover the people who are not currently covered, but what we are doing is solving one problem and creating another. I need to discuss with the Minister some of the examples that my constituents have given to me of how they are going to be in financial hardship based on the information that we currently have. I don’t gather that it’s changing very much.
I’d like to quote again from a document which the department had on their website. It was entitled “A Conversation with Northerners” and on page 15 of that document, 8(a) states that all families should have fair and equal access. From that statement I’d like to suggest that the department and the Minister carefully omitted to say all aboriginal families will have fair and equal access. This is a very divisive policy and it’s been stated by some of my colleagues earlier.
I’d like to ask the Minister how having these changes only apply to non-aboriginal peoples will make this new program fair and provide equal access.
I am going to do my best to answer questions, but I hope she won’t tell me I’m telling her something she already knows. As I stated already, the supplementary health program right now excludes a segment of the population that needs help from the government. Those are the low income working families who need help and work in jobs that don’t have employer insurance or whatever. It is, I believe, our government’s responsibility to provide assistance for that. I hear from others, cover them anyway, bring extra money, do it by universal health care, just spend the money.
The point is this is not a part of Canada health care. This is not a legislated health care. In the rest of the country it is something that you have to pay out of your own pocket. We are suggesting that we make this program available to everybody, everyone has access, no one will be without. But your condition of access will not be determined by your age or your medical condition or anything. It will be dependent on your ability to pay. I do not know of anything else that’s more fair than to look at one’s ability to pay to get extra help.
The Member objects to the fact that this is going to be available to all non-aboriginals. That’s why it’s fair. Before that it was not available to all non-aboriginals. There were a whole bunch of non-aboriginals who need it the most who were excluded from it. I believe that is a fair thing to do.
Final supplementary, Ms. Bisaro.
Thank you, Mr. Speaker. To the Minister I agree with that philosophy and I said that. But there are other alternatives. There are other alternatives which are out there that are not being considered. That’s because the policy is not being opened to change. That’s what’s required.
As to the fairness if what is being implemented applies to all residents of the NWT, this policy implementation will not be inclusive, it will not be fair, it will not be equitable, because it does not apply to all of our residents. It applies to a portion of our residents.
I want to ask the Minister why she is not willing to consider revisions to the policy to make it fair and equitable.
My position is that it is fair and equitable because it gives access to all non-aboriginal people. It uses a criteria being used all around the world and all across the country, in determining a government social program. This is to be a safety net. We are going to give benefits to seniors. We’re going to give benefits to those with chronic conditions. We’ll be able to expand services to single moms, young university students. We’re going to be opening the program to everybody.
The program that we have now is not a program... We already have a separate program for Metis and NIHB for the treaty people. The program we have now excludes a bunch of non-aboriginal people. The government feels it is important that we bring them on and we bring it in a most fair way.
The Member and everybody else says there are other alternatives. I’m interested in hearing them. I’ve already said universality is not usually the criteria used for supplementary health programs.
The honourable Member for Weledeh, Mr. Bromley.
Thank you, Mr. Speaker. There are so many places to start here. I want to follow up on my colleagues’ questions to the Minister of Health and Social Services. I’d like to start with the last theme there. Groups and many of my constituents were opposed to the supplementary health benefits proposal. They’ve raised the issue of whether the changes will pass the test of a human rights complaint. The changes being proposed are unwise, in my mind, but implementation and administrative costs and the lost service to the sick would be a further waste if we go ahead without legal advice when indeed it was needed. Has the Minister received legal advice on whether the changes she proposes can legally stand?
Thank you, Mr. Bromley. The honourable Minister responsible for Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. Using income threshold and looking at one’s ability to pay to determine whether you have access to a program or not is used in many places. We have those in lots of government programs, including the seniors’ fuel subsidy. This is a very commonly accepted way of doing it. We’re expanding the program to those on the basis of income, whereas before it was on the basis of age. I believe that this is the right thing to do.
I was more interested in the Minister’s perspectives on the divisive, racially divisive, culturally divisive proposals that she has coming forward. I would welcome any further comments she might have on that.
It was noted at a recent public meeting that the representatives of the NWT Pharmaceutical Association have repeatedly offered to meet with the Minister and her department to share their knowledge and experience in any considerations of changes to the supp health program. The department was also invited to attend the annual general meeting of this association. In both cases the department and the Minister failed to take up those offers. Can the Minister explain why the department would not respond to these offers and how they can design a program without the wisdom and advice of important front-line providers such as these? Thank you.
The fact of the matter is, as a part of our consultation process we did write to the pharmacy association and the NWT Medical Association. The pharmacy association did not respond. We had written in March. We did get an email from Mr. Dolynny, who was not a president of the pharmacy association. He invited our staff to come. We had five days’ notice. Our staff was not going to be available for that time. It was five days’ notice. We had offered to meet with them at another time when it was more convenient, Mr. Speaker. So it is entirely inaccurate for anybody to suggest and it’s without evidence of a basis to say that we did not listen to them. We had written to them and the pharmacy association did not respond.
Secondly, Mr. Speaker, this supplementary policy is something that’s used everywhere in the country. Everywhere in the country this is how the pharmacy program is… A lot of programs across the country are income tested, so I’m sure that the pharmacists in the Territories will be able to adjust to this policy.
I guess the word should be put out that if you’re not president of an association, don’t bother contacting the Minister on an opportunity for input
---Applause
Last year when the Minister was directed to go back to the drawing board on supp health, she promised to go back to the beginning and carry out consultations with no preconceptions such as a means test. Yet at her departmental community meetings, Mr. Dana Heide said he was directed to base the proposals on an income threshold model. Can the Minister explain how this could be a fulfilment of her promise, please?
When the motion was passed we had a big debate about whether or not income test is a good option. We should look at things from the blank slate. We did review those. I directed the staff to look at the user profile, look at who’s using it, how much it’s costing, what does it mean, how can we expand the programs to those who are excluded. We looked at all of that, Mr. Speaker, and I know that there are those who choose not to accept some of the information that they received. But the fact of the matter is we have done the research and the research shows that, in terms of income profile of our people, that we have low income, middle income, high income, in all peoples in their ages and background. I believe fundamentally that government’s role is to provide support to those who need it the most, and we will do that. We will provide for seniors. We will provide for working families. We will provide support to those who need assistance from us. Thank you.
Your final question, Mr. Bromley.
Thank you, Mr. Speaker. Mr. Speaker, my last question for the Minister is really about the really good suggestions and incredible amount of thinking and thoughtful drafting of options to be pursued by the Minister. Certainly the progressive taxation was one of them. I think there was some mention of fees. I assume that the Minister has developed a perspective on those in response to the overwhelming comments from the public on those suggestions. Thank you.
Yes, Mr. Speaker, we have referred those suggestions and we have reviewed them and looked at the implications of progressive taxation, taxation to pay a program like this, which is not an insurer service, and we have reviewed the suggestions made in the Minister of Finance’s roundtable on revenue options. There was a suggestion for progressive taxation by Alternatives North. I believe that the program that we are proposing under supp health is a progressive taxation within the program in that we are supporting those who need it the most and we are asking those on a higher income to make a contribution to a supplementary health care cost, where in any other province they would be required to pay 100 percent unless they had insurance. Thank you.
The honourable Member for Hay River South, Mrs. Groenewegen.
Thank you, Mr. Speaker. Mr. Speaker, in my Member’s statement I attempted to describe what I think is a process that is in place that would allow a panel of peers of physicians to receive complaints and deal with complaints about the conduct of physicians who practice in the Northwest Territories. I would like to ask the Minister: could she please describe for me what the process is? What is in place currently in the Northwest Territories? Thank you.
The Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. There is a very specified procedure for filing complaints under the Medical Profession Act. Anyone who has a concern with a physician or any other medical practitioner could write… Well, they could first talk to the chief executive officer and the people in their authority. Then there is what’s called a complaints officer under the Medical Profession Act, and the complaints officer would review the complaints. Complaints could go into alternative dispute resolution or any other ways of sorting it out, or the matter could go into a board of inquiry where a board made up of appointed people would look at those complaints. Thank you.
Mr. Speaker, the board of inquiry, who sits on that board? How do they get on that board? What is the Minister’s relationship with that board? Thank you.
Mr. Speaker, the Minister of Health and Social Services appoints members to this… It’s not a panel that exists throughout the year. It’s formed when a complaint is moved to that board of inquiry and a panel is selected from individuals appointed by the Minister. The panel will include at least one doctor who is licensed to practice in the NWT, one doctor who is licensed to practice in a province, and one member of the public who is not a doctor. So it’s usually made up of three members on that board. Thank you.
Mr. Speaker, during this Minister’s tenure as Minister of Health and Social Services, has she ever made appointments to a board of inquiry to look into a matter of a complaint about conduct of a physician practicing in the Northwest Territories, or is she aware of any time in the recent past when a board of inquiry has been appointed? Thank you.
No, Mr. Speaker, I have not appointed a board of inquiry during my time as Minister. Thank you.
Final supplementary, Mrs. Groenewegen.
Mr. Speaker, is the Minister aware of any board of inquiry that was appointed to deal with a complaint where that complaint, to this day, has not been concluded or disposed of? Are there outstanding complaints that have been raised against any medical professionals that have not yet been concluded? Thank you.
I think I would have to undertake to get more information on that. I am aware that there are a couple of cases, but these things have a way of taking a long time. I can’t tell you exactly when it started or where it is. I don’t have all that information in front of me, so I will undertake to get back to the Member on where -- I can’t remember exactly what she asked -- but I will have to undertake to get back to the Member. Thank you.
Thank you, Ms. Lee. The honourable Member for Great Slave, Mr. Abernethy.
Thank you, Mr. Speaker. My questions today are for the Minister of Health and Social Services and are on the supplemental health program.
Before I start, I would like to thank the Minister for acknowledging what we all feared was true, that the changes are actually taxed on the sick and the elderly. The Minister has talked about doing things in the fairest way and opening up the system to everybody. She has also indicated that it is not available to all non-aboriginals. The Minister is a master of doublespeak, because, in fact, it is available to everybody right now. Specified medical conditions coverage under Extended Health Benefits is available to everybody in the Northwest Territories regardless of whether they are a senior or not. Anybody can apply for coverage on drugs. I have obtained a list of conditions that are covered under this program from pharmacists. Basically it includes almost every condition you can possibly imagine, so for all those low income people that the Minister is talking about who don’t have coverage right now, they can fill out the paperwork and they can get coverage for the vast majority of the drugs they are receiving.
I am curious if the Minister can tell me how, in fact, we are changing anything other than adding some dental and some vision coverage, because we are already covering the dental. We are already covering the medical under the specified medical conditions. Thank you, Mr. Speaker.
The Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. I absolutely did not say and I would ask the Member to correct that I said that this was a tax on sick and the elderly. Mr. Speaker, that is misleading. That phrase is offensive because, Mr. Speaker, the fact of the matter is our health care system is entirely based on taking care of the sick and the elderly. We take care of the sick and the elderly.
Supplementary health benefits is a completely different thing. The Member says that there are actually people not excluded. Obviously, then, he is not paying attention to the low income families who need help from us.
Mr. Speaker, the fact of the matter is, the program as we have it now allows people in our communities whose income is $200,000, and there are seniors or anybody else who makes $200,000 and good on them, that is great. I hope that I make $200,000 when I retire. We could have somebody who makes $200,000 and they have a government pension insurance. They get insurance coverage but we top them up for the rest of the 20 percent. That is what we have. Then we have a family down the street in downtown Yellowknife who may be a single mother with four kids. She makes $50,000 a year. She doesn’t work for an employer who has health insurance. For them, it is a decision about whether they are going to go to a movie or buy the next set of glasses or get a dental appointment.
When I was a university student at 25, I didn’t have parents who had an employer health insurance. I had to fork out $150 to go to a dentist.
Mr. Speaker, this program is trying to say, we are going to expand the coverage to all the people and we will determine the access not by age, not by your condition, by your income. At the same time, we are coming up with an income threshold that is more generous than any seen anywhere, to the effect that we will provide to 80 percent of people as good a benefits package as you would get if you work for the government.
Mr. Speaker, the Members here who care about low income people, fairness, inclusiveness, poverty, anti-poverty strategy, everybody should get up and applaud for the good work and the benefits that this package has to offer. Thank you.
Mr. Speaker, it sure sounded like that is what she said on this side of the House. If Hansard proves that she didn’t in fact say that it is going to be a tax on the sick and the elderly, I do apologize for that. But I didn’t hear a response to my question. Basically, if you look at the list of conditions that are covered under the extended benefits, it covers pretty much every condition. I think the only one that I could figure out that is missing on here is high cholesterol, so these low income families that she is talking about, if they want coverage for drugs, they can get it. They can get it today if they just apply for the specified medical conditions. So what she is saying, that they are not covered, it is not completely true. It is doublespeak. She is saying one thing when really she is trying to say another, which concerns me. This is an important issue. Quite frankly, to suggest that we on this side of the House don’t care about the poor and the low income families is frankly quite insulting, because we all do and want that to happen. We want those people to be covered but we don’t want them to be covered at the expense of everybody else. We want to find a way to cover everybody universally. That is what we are talking about.
Mr. Speaker, to me the entire revision of the Extended Health Benefits Program seems to lack common sense. For example, the discussion paper lacks any projections which would help the reasonable person to make a reasonable decision. The department has not identified any alternative scenarios or made any potential outcomes available for discussion.
Mr. Speaker, could the Minister of Health and Social Services please tell me why no analysis was done outlining the effects of these proposed changes on the people that the changes affect, people affected both in a positive way because yes there are a couple of them, thank God, but also tell me how these changes are going to affect those people that are going to be affected negatively, like people with catastrophic conditions who have an insurance provider but are now going to be expected to come out of pocket $700 or $800 where today they are covered. Those people with catastrophic conditions who have insurance are the people that are going to be the most damaged by what you are proposing. What you are proposing for those people clearly is not fair. I would like the Minister to answer some of those questions. Thank you, Mr. Speaker.
Mr. Speaker, the effect and the picture, the impact that we are drawing here is that for 80 percent of the non-aboriginal NWT population, they will have as good or better Supplementary Health Benefits Program than what they would have if they work for the Government of the Northwest Territories. That is a good program. That is a generous program. That is a fair program. For the rest of that population, 20 percent, they will still be covered. We are still generous. We are asking that they will start paying a premium starting at 20 percent, but no one will pay more than 45 percent. Anybody in that income bracket, I would think, would look to get an insurance program which will then cover them 80 percent.
Mr. Speaker, catastrophic drugs, what Members are talking about, when we are talking about catastrophic drugs nationally, we are talking about drug costs that the government is asked to pay that costs hundreds of thousands of dollars. That is a program that we will be introducing. We are working on it. But for the benefit of this program, yes, we are asking our people to start having to pay for some of their supplementary health costs out of their own pocket. In the rest of the country, you would pay 100 percent on this if you had employment health insurance. If you don’t have employment health insurance, if you wanted to get assistance from government, your income threshold would have to be much lower than what we offer.
Mr. Speaker, the Department of Health and Social Services has reviewed this for three years. We have worked hard to come up with a comprehensive, fair and equitable plan. Mr. Speaker, we stand by this. Thank you.
Mr. Speaker, they have researched their option for three years; they haven’t considered options or alternatives we have asked them to. I would like to ask her again, why didn’t they?
Coming back to my original question, what about those individuals who have insurance from their employer now but have a significant condition that has high costs? If you have a cost that is $10,000 a month -- and there are some of those individuals -- and you have insurance that covers, say, 80 percent of your cost, you are still going to be out of pocket $2,000 a month. But because you have insurance, you are not eligible for anything under your proposed plan. Today, you could apply for a top-up so that you don’t have to come completely out of pocket. You have mentioned any top-up for anybody with insurance. If you have insurance, you are out of luck. Forget it. Don’t have insurance and don’t have a catastrophic condition, because if you do, you are out of luck. That is what I am asking. What are you going to do to help those people, Minister Lee?
Mr. Speaker, we made it always clear that what we are trying to do in Supplementary Health Benefits is to offer an insurance program for those who don’t have it. We are not going to be topping anybody. What we have now is we exclude a whole bunch of people who have limited supplementary health benefits and then we top up people just because of their age. What we are saying is we will look after the seniors, we will look after the youth, we will look after the working families. Everybody would have equivalent to 80 percent. For certain people under certain income thresholds, we will cover 100 percent. At a certain threshold, you are going to start paying for your supplementary health benefits. Nobody will pay more than 45 percent of their supplementary health benefits, but on average, yes, nobody would get a top-off, unless you’re below the income threshold, and that’s a fair policy. Thank you.
