Thank you. The point is that we have a program that is for extended health benefits; it’s not for core health. It is one where people can get access elsewhere, which is not what you can say about lots of programs. People can’t get education elsewhere, public school or lots of things the government must offer. I know it’s hard to accept, but Extended Health Benefits is an extended health benefit and we are having to ask people who can get that access, who can afford it to do that. Those who have decided not to have insurance, we could go and buy insurance at any time. Of course, government will be there if somebody can’t get insurance because of their existing condition, or because they have a family history or whatever for whatever reason if they can’t get the insurance, if they have a very, very high cost of drug costs or whatever, the government is there to support them. This program is trying to address expanding services to those who are excluded and putting some responsibility on this Extended Health Care Benefits. But, Mr. Speaker, we can ask that anybody who comes into the Supp Health Program that they need to try to get their insurance first, or if they have another NIHB or whatever else, then they need to obviously get that first. Thank you.
The honourable Member for Hay River South, Mrs. Groenewegen.
Thank you, Mr. Speaker. I want to sort of change the tack of the questions here a little bit for the Minister of Health and Social Services. Mr. Speaker, we have a process issue here. If the policy to change the supplementary health benefits was adopted in the previous government, and if it is now being implemented in this government, what opportunity do we have to represent the views and concerns of our constituents to stop this from being implemented in its current format?
Mr. Speaker, we have about another five days of this Legislature sitting, this is due to be implemented before we come back here to sit again, but there’s nothing coming forward from this side of the House that gives us an opportunity to have a vote, and even if we were having a vote, the Minister has said today she can’t even answer us to tell us how much this is going to cost. Like, normally if we vote on things in this House it’s based on the principle of the service or the program or the infrastructure, and there’s a dollar amount attached to it. So we’ve said how much does the current Supplementary Health Program cost? How much will the revised Supplementary Health Program cost? We can’t even get those kind of numbers. We don’t even have a vote. This really is putting consensus government at risk here, I would suggest.
Consensus government doesn’t work if we, representing the numbers of people that we represent on this side of the House, are bringing the voice of our constituents to this table and there’s nothing to even vote on. So what do we have at our disposal? What can we do to stop this before the implementation date? Thank you.
The honourable Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. The expected cost to the government over the next four years is $8,539,702 next year, $8,824,108 the year after, $9,341,402 the year after, and about $9,893,970 for the year of 2013-14, understanding that when you’re talking about health care costs, you’re talking about estimates because it’s demand driven, it’s whoever walks in the door. But, Mr. Speaker, we expect that the new program would cost around $8.5 to $9.8 million every year.
Thank you. Okay, and thank you for those numbers. That’s the first time I’ve personally heard those numbers. Mr. Speaker, do those numbers take into account the opportunities that we have discussed here for people who are in the $50,000 or lower to opt out of third-party insurance programs? Does that take that into consideration? Because it’s fine to say, well, we’ll look at that after the fact, but I would suggest that’s like looking at it after, you know, closing the door after the horses are out of the barn here. These are the kinds of things that need to be considered before, before you implement a policy and not afterwards, and this is why we’re saying we need to take the time to make sure we get this right, before we run with it. I don’t know why the Minister doesn’t agree to defer this until we have something that we can agree to. This is consensus government.
Thank you. We do have time to agree on things. Requiring people to get third-party, we could make that as part of the program and we can do that right now and you don’t have to study that for a year or two months.
Mr. Speaker, the Member asked does this take into consideration those who will drop out of third-party. Not in specific dollars, but neither does it include people now because their income is higher or because they have other third-party options that they could use that and the savings that the government would get if that had happened. So, Mr. Speaker, no, it doesn’t, and when you are budgeting health programs you can’t be right down to the dollars because we do know and Members have been talking about drugs or equipment or anything. So this is the best estimate we have for the cost. Thank you.
Thank you. The Minister has clearly said this is not about cost savings and the numbers that she had put forward with an escalation value on them, and yet why are we mixing this up with core health services? I get the impression that Members on this side of the House are trying to lobby Members on this side, somehow leading to believe that there’s some question between our ability to deliver core health services to Colville Lake or any of these other communities where, you know, they need nurses and front-line workers, are trying to connect this to the supplementary health benefits. It is absolutely a red herring.
This government, you want to talk about priorities, this government should make core health in those communities a priority, quite irrelevant from what’s happening with supplementary health benefits, and if they don’t, they need to go back and look at some of the things they’ve got on the books that they think are a priority, because I think some of them are unnecessary expenditures. Let me say it that way to be kind and polite.
Mr. Speaker, why is the Minister, let me ask her, why is the Minister trying to tie the delivery of core health services in our communities to this issue of supplementary health, given those numbers that she just read out to me?
It is absolutely an essential part of discussions to discuss how does this relate to core health service. Mr. Speaker, maybe the Members think $8.5 million is a small amount of money. I would like to hear from the other side about how do we find that. Eight and a half million dollars every year is not a small amount of money. That would be lots of core services, Mr. Speaker.
The fact of the matter is the health care issue now is a number one issue for Canadians; all jurisdictions in Canada. Ontario is projecting that it will spend 55 percent of their budget on health services in the next two years. Quebec is projecting they’ll spend 60 percent of their dollars. Yes, we could cover all the core health, we could have nurses and doctors or whatever in every community, we could spend on medical travel, everything, all the things that we need to do we could spend 50 percent of our budget on health care. But, Mr. Speaker, the fact is in government, in the Northwest Territories, our people rely on government more than probably in Ontario. They need us for lots of different things. Yes, there might be a waste here and there, but the fact of the matter is, I don’t know why I keep saying that, but our Health and Social Services budget is, like, $370 million. In the last 10 years our budget doubled by 500 percent. Health and Social Services budget went up by 98 percent, but our population only grew by 6 percent. Thank you.
Final supplementary, Mrs. Groenewegen.
Thank you, Mr. Speaker. The Minister states the obvious. The costs of health care are going up proportionately across the board. So why would we want to take supplementary health benefits and make that the target and say that’s not priority of this government? It’s going up across the board, whether you’re talking about front-line services, supplementary health benefits, pharmaceuticals, diagnostic procedures, new medical science, it’s going up, that’s the way it is. We can’t really stop that train. People are living longer, thankfully, and there are more ways to be treated in the medical system, thankfully. So when we talk about the priorities of this government, why do you want take supplementary health benefits and pick on that particular one thing?
Mr. Miltenberger, I read in the media, wants to build a $2.5 million liquor store in Hay River. Is that a priority of the people of the Northwest Territories, Mr. Speaker? Anyway, I’d like to ask the Minister of Health and Social Services why is the supplementary health benefits going to be the target of this government’s restraint measures when she’s just said everything is proportionally going up and only targeting a certain group of people? Thank you.
Mr. Speaker, we are not targeting this and we have said this is not a cost-cutting measure. It is a sustainability issue, Mr. Speaker. Each department has a certain amount of money and we have a situation where we have a program that is mandated, that’s not legislated, it’s not core service. We do want to help people. We do want to help the seniors. We do want to help the low income people. We do want to help those with high costs of drugs. But we are asking -- and we have a very, very generous program -- we are asking for those people who can access insurance elsewhere or who have an income that should justify, that they pay something and nobody’s going to be without this access. Even at the highest income level they will get 45 percent covered. And if they have insurance, yes, access that insurance, because why shouldn’t we do that as a government, Mr. Speaker?
The honourable Member for Sahtu, Mr. Yakeleya.
Thank you, Mr. Speaker. Mr. Speaker, I want to ask some questions. I work with the Minister of Health and Social Services on the questions. The Minister has indicated, in terms of the health benefits to some people who are going to be affected. I want to ask the Minister is there a percentage of numbers, in terms of who these supplementary health benefits will be affected, the ones who are protesting, the ones who are in the gallery, people left to be being broke in terms of... What’s the percentage, in terms of the proposal that you have put before us? What is the percentage of people that are going to be affected by this new proposal?
The honourable Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. As the Member is aware, when we went to public consultation on this in April we just wanted to talk about the idea of it. Then people asked for specific options for income threshold and we offered $30,000 threshold to start and then $50,000. Assuming that the income threshold is at $50,000 for single and moving up progressively, we believe that this program will still provide 80 percent of the people a very good coverage of extended health. Thank you.
Mr. Speaker, the Minister indicated that for, for example, an income of $50,000 and up is a threshold. Is there a cap on the percentage about 50 percent?
We are suggesting a cap that we are discussing with the committee. Thank you.
Mr. Speaker, again, I go back to the basic principle of the real issue is the 2,300 people without coverage right now. Is there a possibility, when you’re having the discussion amongst other things with the committee, in terms of can we put this program in place for the 2,300 people who are in need right now, as we speak? Each day that we deliberate and debate this issue here these 2,300 people do not have the coverage that other people enjoy. That we can have some discussions on the other issues that are very controversial in this House here. That’s what I’d like to ask the Minister.
One of the reasons why we want to make this change is to bring in those people who are excluded. Yes, the option is there to bring them in without making any changes to anything else. Then we have to put in extra money. We believe it will cost two to three million dollars to bring them back in. But the thing is, as the Member for Hay River South mentioned already, the health care budget has been going up at about 8 to 10 percent every year even if we change nothing. The cost of delivering, the cost of human resources, the cost of health care is going up by 8 percent. Our budget has doubled but our population has remained the same; actually, really, almost no growth in the last 10 years NWT-wide. I mean, Yellowknife has seen growth, but NWT-wide. So, Mr. Speaker, it is a challenge for us to add new people and expand services without having to look at how do we realign the program.
As I have said already, this is a program where people can get service elsewhere if they buy the insurance. We need to consider that and we need to continue to work on that. Thank you.
Your final question, Mr. Yakeleya.
Thank you, Mr. Speaker. What I’m hearing from the Minister is if we do not go with the proposed plan, somewhere down the line we’re going to have a sustainability issue in regard to health care and that we have to find somewhere $8.5 million. That definitely is very concerning to me and my people in the region in looking at other issues regarding health. Also, that we’re going to be under siege. We really have a problem here, Mr. Speaker, in terms of this issue here.
Is this the best that the Cabinet can put before us? If we do keep the existing program, I believe that we’re going to be dealing with this issue in the next year or so. Is this what the Cabinet can put before us with our limited budget and our needs in my region and other small communities, in terms of health care services and services that we desperately need, as I spoke of earlier? That’s the question that I want to ask the Minister.
As I indicated earlier, suggestions such as how do we minimize the opportunity for our people to dump their insurance, I think we should put our heads together to see how we could do that and we should look into that, Mr. Speaker. We are going to work through this because we know that there’s a time limit to this and I’m willing to work with the Members about how to improve this. There is a challenge to expanding the program to those who need it, without making some changes within. Thank you.
I’d just like to recognize the clock. The time for oral questions has expired. Item 9, written questions. Mr. Hawkins.
Thank you, Mr. Speaker. I seek unanimous consent to return to item 8 on our agenda, oral questions. Thank you.
---Unanimous consent denied.
Thank you, Mr. Speaker. My questions are for the Minister of Health and Social Services.
The items listed below are suggestions gathered from Members and NWT residents for efficiencies or alternate funding of the proposed changes to the Supplementary Health Benefits Program
Will the Minister provide me with a list which shows the pros and cons of each suggestion and that provides the ranking given to each option by the Department of Health and Social Services or the Cabinet?
increase income tax;
devise a form of government-assisted, third-party insurance for low income families;
use graduating deductible for coverage, for example, starting at $200;
grandfather people currently using the existing program and implement changes for new clients;
seek input from pharmacists and other front-line service providers in devising the program;
consult with Blue Cross in devising the program;
seek input from established stakeholder groups;
avoid administrative complexity in the new system;
levy a prescription fee for everyone;
increase seniors’ benefit to age to 65;
require employers to provide private insurance and individuals to obtain private insurance coverage only if they provide proof of uninsurability;
do thorough assessment of potential costs of top-ups for people with third-party insurance under the proposed program;
make small, targeted adjustments to deal with specific deficiencies in the existing program;
revise the drug formulary.
Thank you.
Thank you, Ms. Bisaro. The honourable Member for Sahtu, Mr. Yakeleya.
Thank you, Mr. Speaker. My questions are for the Minister of Health and Social Services.
Can the Minister provide to me the Medical Travel Policy for elders leaving to hospitals outside their communities?
Can the Minister provide the policy where elders must have or shall have escorts regardless of their medical condition and that our health centres must abide by this policy?
Will the Minister provide to me an explanation as to what is the rational to not have escorts travel with elders who must go to hospitals and who makes the final decision to approve medical escorts?
Can the Minister provide to me what is the department going to do to ensure that our Medical Travel Policy respect the aboriginal cultures and beliefs towards taking care of our elders?
Can the Minister provide a detailed (diagram) protocol of the approval process between our Sahtu health centres, our Sahtu Health Authority Board and the Territorial Medical Office?
Thank you, Mr. Speaker. I would like to table a petition today signed by 319 citizens of Hay River and 104 citizens of Fort Smith. The petition is that all seniors be eligible for supplementary health care benefits regardless of income. Thank you, Mr. Speaker.
Thank you. The honourable Member for Great Slave, Mr. Abernethy.
Thank you, Mr. Speaker. Mr. Speaker, I would like to present a petition dealing with the matter of supplementary health benefits. Mr. Speaker, the petition contains 495 signatures of NWT residents and, Mr. Speaker, the petitioners request that access to supplementary health benefits be expanded and that incremental costs to support the expansion be funded through graduated territorial income tax. Thank you, Mr. Speaker.
Thank you. The honourable Member for Great Slave, Mr. Abernethy.
Thank you, Mr. Speaker. Mr. Speaker, I would like to present a petition dealing with the matter of the Supplementary Health Benefits Program. Mr. Speaker, the petition contains 1, 944 signatures of Yellowknife residents and, Mr. Speaker, the petition requests that access to supplementary health benefits be expanded and that Extended Health Benefits Program for seniors remains unchanged. The petitioners also request that existing revenue from territorial income tax be used to fund the expansion. Thank you, Mr. Speaker.
Thank you. The honourable Member for Nahendeh, Mr. Menicoche.
Thank you, Mr. Speaker. I would like to present a petition dealing with the matter of supplementary health benefits. Mr. Speaker, the petition contains 89 signatures of Fort Simpson residents and, Mr. Speaker, the petitioners request that current benefits provided under the Supplementary Health Benefits Program remain unchanged. Mahsi cho.
Mahsi, Mr. Speaker. Mr. Speaker, I wish to table the following document entitled Annual Report on the Activities of the Rental Office, January 1st to December 31st, 2009. Mahsi, Mr. Speaker.
Thank you. The honourable Minister of Human Resources, Mr. Bob McLeod.
