Thank you, Mr. Yakeleya. The honourable Minister responsible for Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. I agree that there’s a lot of information that has been going out and there’s a lot that people need to know. I am willing to answer any specific questions that the Member’s constituents may have about what supplementary health benefits are and what we’re trying to change, what is covered right now and how that is different from NIHB and other supplementary health benefits policies across the country.
Will the program the Minister is proposing resolve the new costs for this government while you’re trying to manage the changes within the existing program budget?
The fact of the matter is, we have a supplementary benefits program. The changes we are proposing are not cost-cutting measures. At the same time, we need to make sure that the costs are affordable and reasonable. What we are trying to do is we are realigning the Supplementary Health Benefits Program for non-aboriginal people. What we have now is we cover those who are over 60, and those who have a chronic condition, and those who make under $30,000. We have a group of people among non-aboriginal people who are excluded. The changes we are proposing are to bring them on stream.
I want to ask the Minister, for example, what are the implications or consequences of requirements for new funding for residents in small communities if we were to not go ahead with the proposed program?
The answer to that has to do with what I keep saying about insured services versus non-insured services. Insured services are what people know as our health care. That’s our doctor service, hospital service, nursing service, surgeries, hip replacements, having a baby. Those are what we know to be a health care that everybody is entitled to and everybody will get. Nothing changes from that.
What we are talking about is uninsured services. Things like the cost of drugs, glasses, dental, and equipment. Right now the aboriginal people get those covered through NIHB and Metis health benefits. For non-aboriginal people, we have a group that are excluded. We are trying to make that fair and equitable. The more we spend on that, we will be spending money on other things. We are willing to pay to support those who need it the most and we are saying we will determine the access by looking at people’s income, because that is the fairest way of looking at one’s ability to pay.
Thank you, Ms. Lee. Final supplementary, Mr. Yakeleya.
Thank you, Mr. Speaker. I want to ask the Minister how the new program will affect young working mothers who make enough that they will be expected to cover their own extended health care and might have to decide to either buy food or buy medicine.
Right now, as the program exists, we have a real working mother on Facebook every day. I got on Facebook six months ago. This lady posts every day. She says she’s a single mother with two kids. I need a job with a dental plan. I need a job with a dental plan. And I go, there’s a lady with two kids and she is struggling to pay for our dental care. Under the existing system it is totally possible for somebody making $500,000 a year -- and there are people who make $500,000 a year, good on them -- $200,000, $300,000 with no expenses and they get 100 percent coverage. To me, that is not fair.
Thank you, Ms. Lee. The honourable Member for Yellowknife Centre, Mr. Hawkins.
Thank you, Mr. Speaker. In the House I talked during my Member’s statement about our Territory needing a transplant policy that is clear, that can help northern families keep the family unit strong and united during those darker periods of life that no one certainly wishes upon them. My question to the Minister of Health and Social Services in the past is, would you look at this and it has been an outright no, feeling that we don’t have the money or whether the existing plan doesn’t really allow it or whatnot. That’s not so important as the question today, which is simply if the Minister of Health and Social Services will reconsider this request of mine, to examine the possibility of what it would cost to develop a policy to ensure that families who have loved ones out of the Territory for care do get a chance to respite. And certainly have a section in there in case something happens where it’s required to unite the whole family for one particular circumstance. Would the Minister be willing to at least investigate that possibility and see what it would cost the government if we were to go down that path?
Thank you, Mr. Hawkins. The honourable Minister responsible for Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. As the Member knows, we have investigated this. I have responded to the answer to this. We are not in support of designing a separate program based on different medical conditions.
When somebody needs to go away for medical treatment, their needs are similar, whether an elder or somebody having brain surgery. We have mothers who need to be medevaced out or babies who need to be medevaced out. We have elders who need to be taken elsewhere. We provide all kinds of medical services where the family needs to be there. We provide that service. We have a Medical Travel Policy that allows for an escort. We believe that having one policy that applies to all is fair.
I’m not sure that’s necessarily right. The reason I say that is because one policy is great when the questions are simple. But in this particular case and other cases that have been presented by this House, our questions aren’t typically black and white. They require a lot of melding and forming to and fro. The Health Minister is correct, we do have a Medical Travel Policy, but people have been refused even with doctors’ notes. That’s why I’m suggesting that could an analysis of this particular situation, which has not been done, be considered at this time and we could examine what the true costs would be through an analysis and then make the type of decision could this government afford health care support in this regard.
I believe the Member is speaking about two different things. One is somebody who can be denied medical travel even if someone has a doctor’s note. Yes, that is possible. If a doctor prescribes uninsured service, they will not get medical travel.
The second thing is, the original point that he was suggesting is because of the situation of a family who has had a child needing a transplant is different, we should set up a different policy for that situation.
Mr. Speaker, as dire as the situation is, we get… I’m only aware of one situation, and to set up a whole new policy just for one situation, Mr. Speaker... I’m not saying all family situations are the same. I’m not saying all medical situations are the same. Yes, there are many unique situations. But the fact of the matter is, we require our residents going away for service for all kinds of different reasons. We get asked every day from families who would like government support to be with them and sometimes it’s for months. What we are saying is government policy is that we pay for one person. Yes, we could do more and we don’t even need to do the cost analysis. It just means that we have to pay more. We are doing what we can do with the resources we have. Thank you.
Mr. Speaker, this isn’t about one family, and I want to make sure that that’s absolutely clear. You know, it may be about one family to the Minister, but as I proposed it, and the Minister has discussed with me that there are other families that this could apply to, so you can’t say it’s one family only.
I’m talking about when your loved one dies in Edmonton and we have to leave their family here in Yellowknife or we have to leave them in Inuvik, we have to leave them in Fort Smith, we have to leave them wherever, that we don’t unite the family. We don’t have any kind of policy. And that does happen here. They only come one way and it’s not the right way.
So, Mr. Speaker, I’m asking the Minister to do that type of analysis about what it would take to unite families for that sort of opportunity. I think it’s more than just one family. It’s about good territorial policy that puts the importance of health care above everything else, and this is one of the issues. Would the Minister, once again I ask, reconsider this opportunity to look at this situation? Thank you.
I believe I answered that question. I really feel we have one policy that looks after our families and I don’t know what else to say. Thank you.
Your final supplementary, Mr. Hawkins.
Thank you, Mr. Speaker. Mr. Speaker, at one time there was a Compassionate Travel Policy and it was stopped. It could well be suited for particular cases like this. Would the Minister reinvestigate it from that point of view, from a compassionate point of view? I mean, all I’m asking her to do, and I want to be absolutely clear, Mr. Speaker, is I’d like her to do an analysis and we could cost it out and take it from a compassionate point of view when these situations are very dire, as the old Compassionate Travel Policy allowed. Would the Minister reconsider this under that circumstance? Thank you.
Mr. Speaker, I don’t believe there was ever a compassionate policy. I am aware that there is a Medical Travel Policy. If you need a medical escort, you get one. The elders would have an escort. Somebody with a language issue will get an escort. Mr. Speaker, the Member is asking me to do a compassionate analysis. Maybe the Member could tell me how do we decide what is more dire: a family who needs to be near a child who has had a transplant, a 90-year-old elder from Fort McPherson who’s dying of cancer who we don’t know how long it will take, somebody who’s had a brain… I’m just thinking of this thing. Somebody who needs to be in long-term care for three to six months in southern jurisdictions and I get asked for the whole entire community to come and stay with the family. Maybe the Member could tell me what is the indicator we use to do what is compassionate. We have people in small communities who need to be near a doctor. In Inuvik we have somebody from Fort McPherson. We have somebody from Ulukhaktok who needs to be in Inuvik or in Yellowknife. They need housing and they need their families to come in.
Mr. Speaker, this is not about cost. In health care when somebody needs medical care, they get their care. When they need an escort, they get an escort. And under the rule, we allow one person. Thank you.
The honourable Member for Hay River South, Mrs. Groenewegen.
Thank you, Mr. Speaker. My questions are for the Minister of Health and Social Services. Mr. Speaker, I asked the Minister yesterday if she was aware of any complaints or inquiries into the conduct of any physicians. I’m going to sort of move away from that today because she didn’t really directly answer my question and I still don’t really even know if she knows. But it raises an interesting point. To be the agency which approves the licences of people to practise medicine is a huge responsibility. It’s also a huge liability, because if a complaint is laid and an investigation is undertaken and it is elevated to the point of going to a board of inquiry or going to the College of Physicians and Surgeons, then it would be really good if the Minister of Health and Social Services was aware of that happening and was also aware of her options with respect to suspending a licence to practise for a period of time.
So I’d like to ask the Minister what is the protocol currently in place for when a complaint is laid and how she would become informed of that complaint and the process that would ensue. Thank you.
The honourable Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. I have the access to information when the complaints come forward. The Medical Profession Act allows that when there are sufficient complaints, a licence can be suspended or even while the investigation is going on and the medical legislation committee would make a recommendation to the Minister to revoke a licence. So all those powers are available under the current system. Thank you.
So the Minister is saying that she would not just maybe be informed, but she would most definitely be informed of a complaint and the process that would follow. And this is not about the number of complaints. This could be one complaint. One complaint could be enough to launch some type of an investigation or disciplinary action.
Mr. Speaker, how involved is the Minister or our government or the act, how involved is it in laying out the process for an inquiry that would ensure the integrity of that inquiry and of that process? Because there are certain laws that are part of inquiries, public inquiries and inquiries in general, there are certain laws that pertain to the complainant, to the defendant, and there are certain laws of natural justice, and there’s a standard to be upheld in that process. How much would the Minister, in her role, be involved in ensuring the integrity of that process as it unfolded? Thank you.
The legislation sets out a very clear process on the steps that a complaint would go through. A board of inquiry would obviously follow the administrative rules which speak to apprehension of bias, making sure there is no apprehension of bias and natural justice and all that. Mr. Speaker, my role in that regard is to appoint the Members into that board of inquiry, and the Medical Profession Act states clearly how that inquiry will take place and then they will make recommendations. Thank you.
Mr. Speaker, is the Minister satisfied that the process as it exists now has sufficient teeth in it or, well, let’s just say in the case of an uncooperative defendant, somebody who has been complained of and just chooses not to cooperate with the process. What kind of teeth are there in the process that would compel somebody to even participate to respond to a complaint or appear at a hearing or participate? Is she satisfied that the process is sufficient to do that? Because what I’m hearing is to the contrary. Thank you.
Mr. Speaker, there are teeth in the legislation to take actions, including suspending the licence while the investigation is going on. The key part in this is that anybody who has a concern about any physician should come forward and lodge their complaint. If they have some concern about criminal conduct, they should go to the RCMP. The most important thing is the evidence that the complainant brings forward in this process, because without the evidence, the process may not have the impact that some people might be looking for or the Member would like to see. Thank you.
Your final question, Mrs. Groenewegen.
Thank you, Mr. Speaker. If we as a government fail to deal with these types of complaints in a very serious way, I think we are putting ourselves at great risk and great liability. It’s one thing for a patient who has filed a complaint, to want to pursue a remedy with respect to the doctor, but we are throwing this wide open for this government to become the party that would be pursued for negligence if these processes are not intact.
Mr. Speaker, in the case that I am referring to, the complainant filed a complaint. The response from the defendant was not even shared with the complainant nor could it be without the defendant’s permission. This speaks to me of a real flawed process.
Mr. Speaker, how can I as an MLA or a private citizen challenge this process? How can I get access to this? It is all shrouded within this privacy of the people that are being complained of. How can a regular citizen, or even I as an MLA, or anybody gain access to know about what is going on within the confines of these processes? I don’t think the process is as good as the Minister thinks. Thank you.
Mr. Speaker, I agree with the Member that government has a responsibility, the Minister has a responsibility and we have a responsibility to respond to the people that bring forward serious allegations. So far, even talking to the Member, I do not have any specific information about what the situations are. That is why I am asking anybody out there who has concerns about a physician, they should follow this complaint process.
Mr. Speaker, so far what we are hearing is what we heard from somebody else. Mr. Speaker, the legislation states the board of inquiry, for example, could be open to the public. The conduct and the process and the outcome depends on evidence being put forward. I would just encourage. I have to state that anybody who has any information should come forward with that information so that it can be assessed and the individual in question could go through the process with the evidence before them. Thank you.
Next I have the honourable Member for Great Slave, Mr. Abernethy.
Thank you, Mr. Speaker. Originally, I was going to ask questions to the Premier on supplementary health, but now I am going to ask the Minister of Health and Social Services some questions on supplementary health. In responding to Ms. Bisaro, the Minister of Health said that this new policy excludes nobody. Can the Minister please confirm for me that this new policy that is going to be proposed is not going to exclude anybody? Thank you, Mr. Speaker.
Minister of Health and Social Services, Ms. Lee.
Mr. Speaker, this supplementary health excludes nobody for the non-aboriginal people. Thank you.
Mr. Speaker, I find that response kind of funny, because when I look at the Minister’s numbers in the presentations that were provided, I see 1,232 people that are being excluded from this policy. Pretty much anybody that has insurance is excluded. If you have insurance, you are excluded. Therefore, not everybody is covered by this policy. My biggest concern is not all 1,232, although I do have a concern for all of them, my biggest concern is for the 532 people that have insurance that are currently receiving specified medical condition support under supplemental health. By cutting those people off, we are putting a huge financial burden on people who are really sick, people who have specified conditions; Crohn’s, other conditions, cancer, all those types of things. I am wondering, how can we exclude those 532 people? My question is to the Minister. Why would we want to exclude those 532 people with specified conditions, catastrophic conditions, who have incredibly high costs? Thank you, Mr. Speaker.
Mr. Speaker, we have presented in our presentation on the website and in our public presentation, the profile of those who use our program under supplementary health and such. Mr. Speaker, we have designed a program to make sure that supplementary health benefits or extended health benefits are available to everybody in the Northwest Territories. You get them either by NHIB, NHB or third-party insurance. If you don’t have those, you fall under supplementary health benefits.
I know this is a point that people disagree with, but I am just trying to explain and I am being straightforward here. Our supplementary health benefits I said is a non-insured health benefits program. Government is saying we want to be the safety net for those who don’t have access elsewhere, so that nobody is excluded from having an extended health benefits program. But if you have insurance, yes, you have to have that insurance program and you have to rely on that insurance program. If you don’t have an insurance program, we will help you and we will give you access by your income. I know people may not agree with that, but that is the fact of the program. I keep repeating that. Thank you, Mr. Speaker.
Mr. Speaker, I think it is a far bigger problem than the Minister is giving it any credit for. I met a young man yesterday. He has a chronic condition. It costs him $10,000 a month. If that individual, who just graduated from university goes and works for the GNWT, he gets 80 percent coverage under his insurance. Therefore, he is only going to be spending $2,000 a month out of pocket. He is probably going to start at about $50,000, so if he chose to say, okay, I don’t want to work for the GNWT, I am going to go somewhere where they don’t give me insurance, he is going to get all the money covered, which is $10,000 a month; 12 months, $120,000. It is going to cost us more money.
Our best interest and the best interest of everything is to get as many people on insurance as possible. If people are covered by insurance and then we provide some top-ups, it is going to save us a lot of money in the long run. That is consistent with the policy that came out on September 30, 2007, yet the Minister’s plan is going to be a disincentive for anybody to get insurance. Everybody is going to dump their insurance. Anybody making under $50,000 or $60,000 is going to dump their insurance. My question to the Minister is: where is the incentive for people to get insurance? What is the incentive to help us save some money so that we can provide some of our services? The only thing we are doing is increasing our costs and hurting our people.
Mr. Speaker, I am not going to disagree with the Member for what he is saying, so I hope he understands that I don’t reject everything he says, as he suggests, Mr. Speaker. That is a serious issue. That is a challenge for any insurance.
What we have right now is that under seniors policy where anybody who is over 60, you are covered 100 percent on everything. So people do drop insurance already. We are going to, on their policy, encourage people to get insurance. If we know they have a job that has insurance, we are going to encourage them to keep those insurance. We are going to ask them to go to their first insurance first, before they come here. The question we have to ask is we have a people right now who have no insurance at all. We have a system right now with the insurance who is dropping out of the insurance. I don’t know why that would be a factor that prevents us from looking at coming up with a program. Thank you, Mr. Speaker.
Final supplementary, Mr. Abernethy.
Thank you, Mr. Speaker. I think the Minister hit it on the head. Let’s do something to find a solution for those people who don’t have insurance. That is our problem. Right now they are already covered for drugs, under supplemental or specified medical condition, so we need to find a way to get them dental and eye care. So let’s do that. But what she is doing is creating a program that is going to be a disincentive, she says. I don’t know how she is going to do it, but the Minister says we are going to encourage people to keep their insurance. People aren’t stupid, Mr. Speaker. If they look at the program and they go, oh, I’m going to get 100 percent coverage if I had no insurance but I am going to have to pay $2,000 a month if I have insurance, who is going to get insurance? Nobody. Therefore, our costs are going to go up. This is going to do nothing but increase our costs. The Minister didn’t address that. I would like the Minister to address how we are going to stop our costs from going up, because we created a program that is going to destroy insurance. How are we supporting insurance, Mr. Speaker?
Mr. Speaker, first of all, we are talking extreme examples in saying that somebody will pay $10,000 a month in insurance. The second thing, Mr. Speaker, is, yes, somebody could get their company insurance to pay for it or the government insurance to pay for it under our program. At the end of the day, there is individual responsibility to that. Thank you, Mr. Speaker.
The honourable Member for Nahendeh, Mr. Menicoche.
Thank you, Mr. Speaker. I would like to follow up on my Member’s statement when I was speaking about the John Tsetso Memorial Library in Fort Simpson and I would also like to ask a question to the Minister of Education, Culture and Employment.
I was very pleased that he did have an opportunity to view the facilities in Fort Simpson and he saw the state and condition of the library, which is now a resource centre, and also in meeting with the leadership they have indicated that they would like to move forward, they would like to do something to the library, get it repaired or get a new one built for Fort Simpson. I’d like to ask the Minister at this time what plans has the department been looking at since his visit to Fort Simpson last month, Mr. Speaker. Thank you.
The honourable Minister of Education, Culture and Employment, Jackson Lafferty.
Mahsi, Mr. Speaker. Since our last visit to Simpson, looking at the library and the situation it’s in and that the books are stored away, I did instruct my departmental staff to visit the community and look at those options that were put forward by the Dehcho Education Council back in March 2010. They’ve identified four different options and we were waiting for the community to come back to provide us with the options. Now we have those options and my department is going to the community to meet with -- I believe the MLA is arranging that meeting -- the superintendents and the board as well. Mahsi.
