Debates of May 11, 2010 (day 8)

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Statements

QUESTION 98-16(5): PROPOSED CHANGES TO SUPPLEMENTARY HEALTH BENEFITS PROGRAM

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.

Speaker: 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.

Speaker: MR. SPEAKER

Final supplementary, Mr. Abernethy.

In the policy that Cabinet put out they indicate that the territorial Supplemental Health Benefits Program should be designed in a manner that does not cause employers to reduce supplementary health benefits programs to their employees; i.e., insurance. Everything the Minister just said pretty much encourages everybody to dump their insurance. It doesn’t make any sense at all. Even people who are making a lot of money who have insurance, if they have a catastrophic condition, it’s in their best interest not to have insurance from their provider. So right there on that fact they’re going against the policy that they put in place. I’m curious if the Minister can explain to me how they can put a program in place that clearly contradicts the policy that they put in place in the first place. Thank you.

To a certain extent that’s happening under the existing program. That is not new. We have learned that a lot of government employees who could extend their extended health benefits after their retirement for $25 a month have opted out of that because the GNWT covers 100 percent with no questions asked after they turn 60.

Mr. Speaker, the fact of the matter is there are a lot of people who make less than $50,000 who don’t have insurance coverage that covers basic dental and vision in the first place. So we are looking to cover them. Yes, Mr. Speaker, everybody says extend the coverage, but don’t take it away from anybody even if they could afford it and just expand, expand and do universal. The point is this is not an insured service. We are hard pressed to pay for the insured services, nurses and doctors in our communities. Mr. Speaker, the opt out happens anyway to a certain extent where we are looking at covering those on a low income. Thank you.

Speaker: MR. SPEAKER

Thank you, Ms. Lee. The honourable Member for Yellowknife Centre, Mr. Hawkins.