Mr. Delorey.

How do you get an equivalent to a master's degree?

Minister of Health and Social Services.

Thank you, Mr. Chairman. Mr. Chairman, it may be a combination of experience and education.

Mr. Delorey.

Okay, thank you, Mr. Chairman. My final question then is this: would an alcohol and drug counsellor with the highest degree possible in that field be able to train somebody in the mental health field?

Minister of Health and Social Services, Mr. Miltenberger.

Mr. Chairman, that's truly a hypothetical question. If we had specifics, we could look at that. Is it possible? Right off the top, I suppose, hypothetically it may be. I can't give you a definitive answer just on the basis of that question.

General comments. Ms. Lee.

Thank you, Mr. Chairman. I have a few more questions on the $250 medical co-payment. First of all, I don't agree with the Minister's assertion that to deal with this issue without dealing with all the other ones will be nothing but tinkering and that's not what he wants to do. I think that's just a way of avoiding dealing with something that can be dealt with separately. There is no rational connection between medical co-payment questions, and whether or not certain diseases should be included, or certain services should be included as a health benefit under the NWT health care system. I think they are connected and they're put together because the Minister chose to do it that way. So I just don't think that that washes in a defense of inaction.

Mr. Chairman, I have a question on the possibility or the option of coming up with a rebate for those people who have to pay $250 and not have any other means to pay for it, other than out of their pocket because they're not insured by their company or any other extra medical insurance that they might have. I think that this issue is fundamentally different than the other issues of whether or not this is an extra health benefit or not for that reason, because it's fundamentally wrong for some people who live in Yellowknife because they have doctors down the street, but they don't have to pay $250 when every other community that might not have that service has to pay for it. Then to say that most of them get covered in one way or another, but those who are not fortunate enough to have insurance packages don't.

The Minister was asked a question about what's the percentage of people who do not have the benefit of third-party insurance, and the Minister took the question as notice. But I'm hoping that the Minister will provide that answer as quickly as possible. Given that he's been studying this thing for months and months and months, for 14 months, I'm sure that the Minister and the department have looked at this. I would like to know if the Minister has reviewed the option of providing a rebate, because we had a precedence for that not too long ago. There used to be a rebate for property taxes. There were a lot of residents in the Territories, or in Yellowknife and I'm assuming in other places, too, that they pay property taxes and they applied for a rebate and they got $200 or $300 back. I'm sure that that had to go through the scrutiny of whether or not it meets the standards that the Minister suggests it has to meet for any exceptions that he might make for this one. So I would like to know if the Minister and the department have reviewed the possibility of a rebate. Thank you.

Mr. Minister.

Thank you, Mr. Chairman. Mr. Chairman, supplementary health programs is a basket of benefits and different programs, and they are all under the title of supplementary health benefits and many of them are in fact linked. We have looked at some options. Are we prepared to consider looking at options? Yes, we are. I don't agree that it's as simple as the Member sees it in her mind at this point. But we're going to continue working to deal with the issue. Thank you.

Ms. Lee.

Thank you, Mr. Chairman. Mr. Chairman, can the Minister answer whether or not the Minister has reviewed the option of a rebate, and has he any documents pertaining to that? Has he looked at constitutional consequences or legal implications or logistics or financial implications of a rebate for those who are paying for this? With every indication, the Minister is not meaning to collect from, but that he hasn't been able to find a way to get them out of. So has he looked at the option of a rebate, and are there any documents he could show us as to the pros and cons of the possibility of a rebate?

The Minister of Health and Social Services, Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, there have been many discussions over what's the best way to proceed with supplementary health benefits. Do I have any specific discussion documents that I can put on the table that outline all of the many varied discussions? No, I don't. I can tell you that there is work on other options to the supplementary health benefits. Tomorrow when we do the briefing, we can share more detail with the Members on some of the issues. At the end of the day, this is a policy-driven set of programs. So it's policy and money driven. So we've created these programs over the years and reinstituted the $250 way back when, when we were trying to raise money. It has implications that now if you want to back out of it how you do that, and how much it will cost to do that. Thank you.

Ms. Lee.

Thank you, Mr. Chairman. Mr. Chairman, maybe I'm so simple minded that I'm not able to explain very well here. I like to think that I'm focused on this issue at the moment. Mr. Chairman, maybe I'm wrong, but in his answers earlier today, when I suggested that maybe if the Minister needs to collect the money -- and I'm assuming that he's having to collect it from those people without third-party insurance, because he doesn't know how to find a way to exempt them from that because he doesn't want to forgo the revenues that he's getting from the federal government by way of non-insured health benefits or from his NWT counterparts by way of government insurance or any other agencies that provide insurance for the people so they can pay for this. I thought it was a way of suggesting a solution, then why don't you come up with a rebate for those who can't afford it? And then he said that the federal government may object to that, because then they will be singled out for paying for this and they may not pay for it. So I just assumed, in my simple-minded way, that he looked at this option. Now I'm being told that, no, he doesn't have documents specifically on this thing. So maybe it's too premature for him to suggest that this is not workable. So now I have to ask, will the Minister consider the option of giving a rebate for those who don't qualify and don't have the luxury of third-party insurance? He should cost that out, like Mr. Delorey asked earlier. How many of those people who are paying this $250 because they don't have any third-party insurance, what is the percentage of that out of the millions that he's collecting? And what will be the cost of a rebate? And what is the legal implication of that? Does he have legal authority to do that? Do we have to pass a law to do that? I mean, he should have looked at all those by now, because we know that he's been studying this for 14 months. So if he hasn't done that, would the Minister commit to looking into that? Thank you.

Minister of Health and Social Services.

Thank you, Mr. Chairman. Mr. Chairman, of course, we're interested in solutions and not just trying to defend the position. We want to do it in the right way. We know that we want to come up with a way that's going to close the gap not just for medical co-payments, but for the other related services that this particular segment of the population does not have access to. So, yes, we're prepared to look at a rebate. We're prepared, once we have our discussions with the committee, to see if we can pull that one whole program area out of the overall supplementary review. I just think it would not be the most appropriate way to proceed in terms of any kind of planned comprehensive change. Thank you.

Thank you, Mr. Minister. General comments. Mr. Bell.

Thank you, Mr. Chairman. The Minister has raised an interesting point in response to a Member earlier. He has indicated, I think throughout the day, that he didn't want to deal with this issue of the co-payment. And remember, committee did make a very clear recommendation that we thought this co-payment should be scrapped because it was simply targeting a small segment of society, and in effect picking on these people when they're sick to boot, Mr. Chairman. He had indicated that it wasn't a matter of just being able to deal with that in a piecemeal fashion. He said supplementary health benefits are a basket, a basket of programs that are linked. There are programs in here that we can't look at in isolation. It has to be an overall comprehensive plan. It involves Metis health benefits, senior benefits, benefits for the indigent. He's talked much about the consultation discussion paper that he's put out there and said that there is this list of options and he wanted to have a response from committee on these options and get our feedback, before moving in a comprehensive manner, in a well thought-out, well planned, coordinated manner, and simply not deal with the co-payment issue in isolation. But then I believe, unless I misheard the Minister, Mr. Chairman, he indicated that as of April 1st he was raising the Metis health benefits to 100 percent from 80 percent. I don't understand how that's possible, if in fact we are dealing with this as a basket of benefits and not looking at these pieces in isolation. Option one in this discussion document speaks to creating a single policy to house all GNWT supplementary health benefits, except for Metis health benefits. I mean, there are things in here that involve... Really some of the options are precluded if the Minister has already decided that April 1st Metis health benefits are raised to 100 percent, and he is in fact dealing with it in a piecemeal fashion. Is that not the case?

Minister of Health and Social Services, Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, if we accept the fact that in the Canadian Constitution the Metis people are recognized along with First Nations people, and that First Nations people and Inuit and Inuvialuit have non-insured health benefits, we've had them I think initially I believe at 60 percent, the Metis people; recognizing that they are one of the aboriginal governments of the land and should be on the same par as the other First Nations and Inuvialuit. We've kept it at 60 percent, then 80, and we've moved it to 100 percent. I see that as a separate issue, Mr. Chairman.