Thank you. The fact of the matter is we are, and the Members know that I have made a presentation to the planning committee. We have a process in place where we work on policies like this together. Mr. Speaker, I don’t know if there is any forum more public than the Legislative Assembly. This is a work in progress and I have a proposal before the Members and I look forward to hearing what Members have to say. Thank you.
The honourable Member for Kam Lake, Mr. Ramsay.
Thank you, Mr. Speaker. I’ve got some questions for the Minister of Health and Social Services, as well, pertaining to the proposed changes to supplementary health. I guess, first of all, in listening to some of the comments the Minister has made back to some of my colleagues here on how this is working and how Cabinet is dealing with this issue, I have to take issue with the fact that she said Cabinet takes public opinion very seriously. Then the first question I’d have, Mr. Speaker, if Cabinet takes public opinion seriously and the Minister is serious about public opinion, why are you still intent on implementing this asinine program shift and change by September 1st of this year? Thank you.
The honourable Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. The fact of the matter is we are trying to develop a program that addresses some of the deficiencies in the existing program, as I have laid out in response to MLA Groenewegen’s question. We have gone out and consulted. We have done analysis. I do understand that there are very differing views out there about how we should provide this program, to what extent, to whom and who should pay for that. So who should pay for that and how we should pay for that and such. So we have listened to those and we have analysed them and we have shared that with the committee. I understand that none of that information is ever satisfactory to some of them, and I understand that this is very, very difficult, but, Mr. Speaker, the Cabinet listens to what the Members have to say and what the public has to say. Thank you.
Thank you. I thank the Minister for that. The Minister states quite clearly that Cabinet listens to what the public has to say and listens to what Regular Members have to say. Then the obvious question is: will the Minister take another look at the proposed changes and defer the implementation date on these program changes? Thank you.
Thank you. As the Member knows, this has been consulted, and studied, and analysed. We have the final proposal out here, Mr. Speaker. My preference is to work with the Members and see how to make this workable. There was a question about the fact that MLA Abernethy raised, and I think MLA Groenewegen raised it too, we don’t want to have a system where everybody dumps their insurance. The program as it exists now, because we cover universally to anybody who is over 60 or with a chronic condition, we have a system where everybody drops their health insurance. We have one of the lowest rates of personal insurance holders in the country. The fact is, you know, we do income tax for all other essential programs in this government. Not housing perhaps, but we have income support, we have rental subsidies, fuel subsidies, we test the income on seniors’ fuel, Mr. Speaker, there are a lot of essential programs in this government already that we income test because resources are limited.
The fact of the matter is, we have a program where we are encouraging people not to insure. The last thing is this is the only thing where people could actually go elsewhere to get help before they come to the government, which you can’t say about lots of government programs that the government has to offer. Thank you.
Thank you. I heard the Minister say earlier during the proceedings that she’d be tabling a document called What We Heard from the Public and I think that’s all fine and good, but what the Minister should be tabling in this House is what the government intends to do with what they heard, and I don’t hear her saying that. It’s fine and dandy to put what we heard, but what exactly is the government going to do with what they heard? I think that’s the important thing here.
We talk about sustainability. The Minister says these proposed changes are to lend sustainability to the supplementary health benefits going forward and the health system in general. How could this be possible, Mr. Speaker, when we know the people are going to dump their third-party coverage? It’s going to cost the Government of the Northwest Territories more money, in addition to that in the area of administration of the program. How can the Minister stand up in this House, in front of the Regular Members and say the proposed changes are going to add sustainability to our health care system going forward? Thank you.
Thank you. Obviously government and the House hears the people and we make decisions and take actions according to what we heard and in the interest of all the people that we serve. I think we’ve had much discussion about that already. I need to answer MLA Ramsay’s question...and I just lost my thought. Sorry, Mr. Speaker.
Final supplementary, Mr. Ramsay.
Thank you, Mr. Speaker. Given the divisiveness of this subject and the fact that it’s dominated the discussion here in the House, obviously we’ve had members of the public in the gallery the few days we’ve been back, the Minister has received numerous letters, we as Members have received numerous letters. Again, I’m going to ask the Minister, will she park the implementation of the changes until after the next territorial election and let the public decide? I suggested this to the Minister the other day, if she thinks she can get re-elected campaigning for these changes, go door-to-door in your riding and see if you get re-elected. That’s the true test of whether or not the public wants to accept these changes, Mr. Speaker. Thank you.
Yes, Ms. Lee, sit down. I will disallow that question as I did the last time. I don’t think it’s appropriate to have those types of suggestions put to the floor of the House. Next on oral questions I have Ms. Bisaro.
Thank you, Mr. Speaker. I have a few more questions, as well, for the Minister of Health and Social Services. I’d like to follow up on the questions that I’d asked previously. One of the town hall meetings was held here in Yellowknife and during that town hall meeting -- actually, no, that’s not true, it was at a meeting that was held at the Baker Centre -- one of the attendees at that meeting stated in reference to the proposed program that’s put forward that the government can do better than this. Somebody else then suggested that this is probably the best that this government can do, that they are maxed out on creativity and capacity. I, unfortunately, somewhat have to agree with that statement.
The Minister several times has said we are doing what we have to do. She’s also said we are looking at it, we’re looking at who should pay for that and how we should pay for that. It suggests to me if you say we are looking at it, that there is a possibility for change. And we ask the questions whether or not change could be made and the Minister has consistently said no. So I guess I would like to then ask the Minister if there is no possibility of changing this policy, why does the Minister and Cabinet feel that we have to do these changes in the way that they are proposed? Thank you.
Thank you. The honourable Minister of Health and Social Services, Ms. Lee.
Given the contentious and difficult issue we are dealing with, I don’t think we could have everybody agree to the proposals being put forward and it can’t be about coming up with a program that everybody is happy with, especially if you are realigning programs. At the end of the day, government has to make some choices and we have to make decisions together about how do we make sure that we have this program that includes the people that are currently excluded, minimizes the impact as much as possible and to see how we make this program not eat up other programs unreasonably, because as Member Yakeleya and others have suggested, we have an obligation to provide core services to our people, Mr. Speaker. We will and I am committed to continue to work with Members to see how we improve the proposal that we have before us.
I think I heard the Minister commit that she’s going to work with Members and that’s the first positive thing I may have heard. I would hope that the next thing that she’s going to do in committing to work with Members is to take some of the suggestions from Members and change the policy and change the proposed plan. The Minister has stated as well across the country that we have the best plan of any across the country and these changes are going to make us equal to other plans across the country. I guess I have to ask the Minister, why are we aiming low? Why are we not aiming to keep the plan that we have and not reduce it to something else? Thank you.
Because, Mr. Speaker, we are far from aiming at anything low. I am going to table this Slave River Journal article written by a small newspaper agency in Fort Smith. They took their time to do a cross-country survey on what is available. Even the Yukon has a program for seniors that are over 65. Every program is income tested. Every program has deductibles. Why do we have to compare with the rest of Canada?
The fact of the matter is, Mr. Speaker, health care is important. We need to be able to fund it. We need to focus our energy on core health. When we are talking about delivering programs in small communities and across the Territories, things are more expensive and challenging here than anywhere else. We need to look at a broad spectrum of programs that we need to provide for health care for all our communities, for all our people. Thank you.
I guess I don’t really have a response to that and I’ll just leave it at that. I think we could argue the philosophy in that article, on the comparisons in the article, for quite some time.
I need to ask the Minister, again, I think I’ve asked this before but there are any number of different ways that this coverage of people who are not currently covered could get funded. I want to know from the Minister why that hard work and that analysis was not done. There was hard work required to find the different way to do it that didn’t marginalize certain people and I don’t believe that’s been done. So I ask the Minister why they couldn’t do the intensive analysis, the intensive search for savings within the government and find a way that would allow us to cover the people at the lower end and not disenfranchise or marginalize some of the people who will have excessive costs. Thank you.
Because, Mr. Speaker, this is the non-insured program and the non-insured program is not where everybody gets service, regardless of their ability to pay. That’s insured service. Mr. Speaker, we are looking at including people who are excluded and asking those on top of the income threshold to make a contribution.
Mr. Speaker, the Member is concerned about high cost of drug expenditures and we know that there are some outliers and there are some people on the border that will be hard hit. So we are working on and those things are addressed by a cap. So that’s something that we need to address with the Members on the other side and which I’m willing to discuss. Thank you.
Your final question, Ms. Bisaro.
Thank you, Mr. Speaker. Mr. Speaker, I’d like to mention that I believe later on today we’re going to receive a number of petitions protesting the changes to the Supplementary Health Benefit Program. My understanding is that the names on these petitions total about 3,000 people. That’s some 7 or 8 percent of our population and that’s a significant number.
So I’d like to ask the Minister: in hearing that there are 3,000 people who have concerns about this program, what does that say to the Minister? And I would ask her to comment on this information and will that have any impact on her determination to proceed forward with these changes? Thank you.
I’m sure if I read all of those 3,000, which I will, I probably know almost all of them. This is not impersonal to me. This is not just an issue that we’re talking about. This is very near and dear to me, as well. I talked to the people. I know who was at those meetings. I know people who are writing me. I’ve known them for all of my life here. I understand that this is a very, very pressing issue and dear issue, Mr. Speaker.
So we will continue to work on this package. We have done everything we can to… We have done a lot of work. The Department of Health and Social Services spent a majority of their time for the last three years working to make sure that we come up with as generous a program as possible. This is a consensus government and I am looking forward to working with Members on the latest proposal we have to see how we could improve that. Thank you.
The honourable Member for Weledeh, Mr. Bromley.
Thank you, Mr. Speaker. My questions today are for the Minister of Health and Social Services. I’d like to start by asking the Minister what is the cost of administering the current supplementary health system and what’s the anticipated cost of the new system under the Minister’s current proposal? Can she compare and contrast those costs for me? Thank you.
The honourable Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. I don’t have the number in front of me, but we have a number of staff that run the Supplementary Health Benefits Program. We believe that the new program would cost $200,000 to $300,000 to administer. Thank you.
I have other beliefs on what the cost of the system will be and I think the Minister is aware of those. The current system provides equal coverage, full coverage to both Metis, seniors and non-aboriginal seniors. Under the new proposals, I’ve heard from the Minister that will no longer be so. In fact, we will no longer give full coverage to non-aboriginal seniors. Can the Minister explain to me how that can possibly be seen as not being divisive, a racially divisive policy? Thank you.
I don’t believe there is anything I can say that would make people change their mind on that issue. The fact of the matter is we do have an NIHB program in this country and in Canada that the federal government funds. The GNWT funds Metis health benefits that is on par with NIHB. The changes we are trying to make are because we have a non-aboriginal program that excludes a whole bunch of non-aboriginal people that need us, and that’s where my focus is. We are coming up with a program that is as generous and as fair as possible to cover all non-aboriginal people into that program. Thank you.
Mr. Speaker, I’ll just remind the Minister that our Elders Parliament was clear on that question and I refer her to their sage insights on that issue. I’d like to ask what input from the Minister’s stakeholder panel did she include in the current proposals. Thank you.
Last the Joint Leadership Council met with all of the health chairs we did an in-depth briefing on this supplementary health benefits and we talked about the pros and cons of this in our health care system. The department staff met and wrote to NGOs, the seniors’ societies, the seniors’ groups and other groups such as the Centre for Northern Families or Persons with Disabilities. So we had a group of NGOs that looked at the proposal, they gave their feedback and we have incorporated those. Thank you.
Your final question, Mr. Bromley.
Thank you, Mr. Speaker. I do have a final question, and I just want to preface by saying I think the Minister and Cabinet must surely be aware that the answers we’re hearing are totally inadequate and the main point behind all of this discussion today is that we’re not there yet. We need to go back to the drawing board on this. The Members are speaking and the public has spoken.
Mr. Speaker, can the Minister tell me, given the complexity and administrative challenges we can expect with the current proposals, given that people that are covered by third-party insurance may very well drop it under the current proposals, and given that we’re likely to cause financial and economically independent families to move to income support, how does the Minister expect this will contribute to sustainability of the supplementary health program and our government? Thank you.
Mr. Speaker, we have a proposal before us and we have an opportunity to work on that. I believe, as I’ve stated already, this is a difficult issue and it does take some courage and resolve on our part to make changes, Mr. Speaker. We cannot say that cover the working poor, cover those 2,200 people, find the money to do it, raise taxes, go without. We can’t continue to say that, Mr. Speaker. The Members here have an obligation to listen to everybody as well. I keep being told that I need to listen to everybody. Yes, we are listening to everybody and we have to make decisions. We are here to make decisions and sometimes it’s the hard decisions, sometimes they are really tough for the short term but it might have a better long-term effect. The fact of the matter is, Mr. Speaker, we need to be mindful of the fact that we have low income families who are having to decide about getting their next set of glasses for their kids, going to a dental appointment for their kids, and we have no means of accommodating those. And the fact of the matter is, right now as the supplementary program exists, it encourages people who can afford insurance to opt out of them because we put no responsibility on those people to go to the private insurance and we top up people who have insurance who have high income while we are ignoring the poor.
Now, Mr. Speaker, surely we could do something; work together in the short term so that we can address this and not say study this thing for another four years, seven years, 10 years, and let the world go by. The fact of the matter is, there are lot of things that we do for seniors. We cover home care in our seniors program, which is not covered elsewhere. So I think we have a good package to work with. I’m looking forward to working with the Members to see how we can improve this. We need to balance what the people’s needs are. Thank you.
The honourable Member for Great Slave, Mr. Abernethy.
Thank you, Mr. Speaker. I asked a question earlier about the generous and equitable nature of this new program and the Minister didn’t give me a response. Yesterday I talked about three scenarios. Sorry, I’ll just go back for a second.
There’s an individual, a young man who has a chronic condition that costs about $10,000 a month. In the current system, if he was working for the GNWT he would have 80 percent coverage by insurance, which means the insurance company would cover about $96,000, and he could apply for a top-up under the current system, which would pay for about $24,000. Under the new system proposed by Minister Lee, this individual will have insurance that will cover $96,000, but that individual will be on the hook for the $24,000 that he could apply for top-up now. It is in that person’s best interest to not work for a company that has insurance. It is in that person’s best interest to take a job at $50,000, dump his insurance and have the Government of the Northwest Territories pay $120,000 rather than $24,000. You can buy an awful lot of glasses and pay for an awful lot of dental appointments for $120,000, or in this case $94,000.
I think we are missing the boat here. We need to fix the problem. Also, I am really happy to hear that the Minister is going to table that Slave River Journal report, because I was going to do the same thing. When I read it, I agree. Yes, a lot of different jurisdictions are doing co-payments and premiums, but in no jurisdiction, not one, in fact in many of the jurisdictions, every one of them has a program that offers some sort of specified condition program and not one of them discriminates because people don’t have insurance. I want you to tell me, or rather, Mr. Speaker, I want the Minister to tell me how all these other jurisdictions don’t discriminate because somebody has insurance for people with specified conditions we are going to. Thank you, Mr. Speaker.
Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. If you think that Supplementary Health Benefits Program is a safety net program and to say that to access it is either you have to have insurance and if you don’t, the government will help you and to say that if you have an insurance program, you can’t access the program and to say that that is a discrimination, that is kind of a strange way of looking at that. What we are saying is that the government will be there for you. If you have other insurance, access that first and if you don’t, we will help you.
Like I said yesterday, Mr. Speaker, the Member has a point. Any insurance program like this has a built-in incentive for people to dump their insurance because government picks them up. Right now, we have that in the system. Anybody who is over 60, they have no incentive to keep their insurance. In fact, a lot of government employees have a pension health plan and they are told don’t get that because the GNWT will cover for that. If you have a chronic condition, there is no incentive to do that.
What I am saying is, with all the resources we have or not enough resources we have, if we have a program where people that access those elsewhere, we need to build that in. The fact of the matter is, yes, for those new people we are bringing in in the lower income, yes, there is a possibility that people could drop that, so I am willing to work with the Member to see how we can prevent that.
The fact of the matter is, over the years now, next 10 or 20 years, employers and everybody else would ask the government to take this on. They would expect the government to be the last resort of an insurance, which is more reason why we need to define who is going to have access to this program and we have to say we are going to cover the poor first. We are going to cover the poor and the lower income, youth, women, seniors and men, and for those of you on top of the income threshold, if you could get insurance elsewhere, I am sorry to tell you, you have to go and get that first and get that second and because we need to spend health care on other things, that is called core services.
Mr. Speaker, this is a value question. It is a huge public policy question. I am sympathetic. I am willing to listen to the Members on the other side, but you can’t say, okay, we don’t like this. We have people who don’t like it. They want you to cover everybody. Do universal, raise taxes. Unless you are going to do that, delay for another 10 years. I hope that we can work out a solution. Thank you.
I will just remind the House that we have quite a few people on the list. I think that we are starting to burn up a lot of time here, so if you can be direct in regards to your responses and also direct in regards to your oral question and keep to the specific question that you are asking. Again, I will just remind the House it is your time, so I would like to be fair to the other Members waiting on the list. Let’s keep moving. Mr. Abernethy, supplementary.
Thank you, Mr. Speaker. I think I finally heard what the real problem is. The Minister has been dodging this one for a long time I think. The problem is we as a government have been supporting ourselves to have people dump insurance. We have people telling people that are retiring, don’t get insurance because we will cover it. I know there are other employers that are out there saying, don’t get that insurance or don’t take our government insurance because if you don’t you can get full coverage by the GNWT. We have actually supported an environment where we are encouraging people to dump insurance. The Minister has admitted that today, but we don’t fix it by putting in a program that convinces even more people to dump their insurance. We need everybody to work with us. We need people who have insurance to keep that insurance because it helps us save costs so that we can provide top-ups to all of our residents. That is what we need. What they are doing is exactly the opposite. They are actually creating more incentive for people to dump their insurance. It is a self-fulfilling prophecy. Sooner or later, the prices on this whole program are going to go up. I am curious if the Minister can talk to me a little bit more about that. Why would we want to create a program that actually encourages everybody to dump their insurance? It makes no sense.
Mr. Speaker, yesterday the Member said people are not stupid. They are not going to... Why get an insurance or work on a job if you are on the threshold? If you make $51,000, you have to pay a whole bunch of money. If you are $49,000, you are not going to. Of course, people are going to drop those as it is happening right now. We have lots of people that are dropping it. It isn’t only because when you are retiring, the government and HR employees say, well, you don’t have to keep that. People are not stupid. I’m sorry. People do what works for them. So that is why we are suggesting in this plan that for people on certain income levels, we are going to cover less than what the insurance will cover. That is the built-in incentive for people to go and get the insurance.
Now, insurance is dealing with those people who would, of course, if it is going to cost you more because your income is high to get it from the government, then you will get it from the insurance, because most insurance companies will cover 80 percent and that is a built-in incentive for people to get insurance.
The second thing is, yes, we have to work on improving how to ask people to get a third-party insurance first. The Member asked already how this is done in Nova Scotia. If you go to the government office to get a supplementary health benefit, they will ask you, do you have access under NIHB? Do you have access under Veteran Insurance Program? Do you have your employer pension plan? Do you have private insurance? If you say no to all of that, the government program comes in and we could look into that. I think that is a fine idea. Thank you, Mr. Speaker.
Mr. Speaker, the Minister has already acknowledged that we, when people are retiring, have encouraged people not to take our insurance. I am curious what the Minister plans to do for those people that have taken our information in good faith and have declined the insurance provided by the GNWT because they were under the impression that they were going to get coverage as seniors basically for the rest of their lives in the Northwest Territories and today we turn around and we say we know we told you not to take the insurance, but tough luck. What are we going to do with those people, Mr. Speaker? Those people exist because we have told people to dump their insurance and now we are taking away a program that they relied on to make the decision to actually accept the government’s decision to decline the insurance. Thank you, Mr. Speaker.
Mr. Speaker, I am happy to tell the Member I have an answer for that. They have 90 days to reinstate the insurance at any time from any time. They could reinstate it, but right now we have a program that they don’t have to. They could ask for it now. They could reinstate it now and it will be...
Excuse me. Again, the debate is going between Members. We run questions through the Chair and allow for responses and also good questions and good answers so that we can all hear it and to be fair to the Member. Ms. Lee.
Thank you, Mr. Speaker. Anybody who declines to take on that extension, they could renew it at any time. Within 90 days of application, it will be reinstated. Second thing is, Mr. Speaker, I have unfairly attributed that HR staff tells people that; it is a hearsay. People said that they were given the option of not renewing and they told us to do that because we have a built-in incentive in our Supplementary Health Program to drop these insurance programs. Thank you.
Final supplementary, Mr. Abernethy.
That is not horrible news. It still doesn’t mean that what we are doing is the right thing. It is my understanding that, if they jump back in, it is based on age, so now they are going to spend a lot more money than they would have if they jumped in when they were originally encouraged not to. I understand what the Minister is saying is for GNWT staff. What about all the other staff? What about all the other staff? What about all the other staff from other employers who were encouraged to don’t bother taking the health insurance because don’t worry, the GNWT has got this great seniors’ program and you’ll be covered? You know, we treat people well in the Northwest Territories. Well, we used to. So I guess my question is: what are we going to do for all those other people who turned down their insurance because their employers said not to who aren’t the GNWT? So we’re helping some, but once again, we’re turning our backs on a bunch. Thank you, Mr. Speaker.
