Thank you, Mr. Speaker. Sunday past I watched an historic vote in the House of Representatives in the United States where Obama’s presidency was finally able to muster up enough support to pass health benefits to those who did not have health benefits. They did not worry about the cost as the driving factor. They worried about the principles of rights to make sure people were covered.

The problem we’re dealing with here now is that the Department of Health and Social Services has not identified the actual cost to delivering those types of rights to the people we have defined as the working poor. Would the Minister tell this House immediately how much it would cost to cover the working poor, that has constantly been referred to as the group that’s been left without, in order for this House to have a full and reasonable debate on this topic?

Thank you, Mr. Hawkins. The honourable Minister responsible for Health and Social Services, Ms. Lee.

Thank you, Mr. Speaker. If the Member really thought about that question, and I don’t mean to be, I mean this in a very, no disrespect. If the Member really thought about this question, he would know that he’s asking me to project what a health expense will be of our residents. How could anybody do that? For example, myself, I’m quite healthy. I don’t see doctors very well. I mean very much. I am a pretty low-cost NWT resident in terms of health care right now. Tomorrow I could develop an illness. I could have a heart attack. Who knows? I don’t know what I’m going to cost the health system. I do not know that. I could tell you what I contribute financially to

the GNWT. Remember, to say how much it would cost to bring everybody in is not a question anybody can answer.

On the other hand, we have provided the Members of the committee and Members of this House and the general public about in general how many people are going to benefit from the changes we are proposing. We know, and it’s on the website, that at least 2,299 people, who right now have either no benefit under supplementary health, or limited benefit, will gain access. Two thousand two hundred ninety-nine people. I can’t tell you how much that’s going to cost us because somebody may just have limited dental benefits or prescription glasses or a $2,000 drug cost. Somebody could develop a disease tomorrow and that could cost us $500,000.

We need to be reasonable about the level of information that we need to make an important public policy decision that is really aimed at and designed and is proven to help those who really need it.

I’m glad we have a low-maintenance Minister over there on our health system. I think the Minister answered the question herself. She has basically said that we’ve identified 2,299 people. How do you know that the messing around of the system will cover those 2,299 people? Tinkering with the system has not guaranteed anything. That’s the whole point of where I’m going with this. With all of these studies, analyses and changes, somebody should be able to give us context of what a projected cost of this would be. There’s been zero analysis on that to date.

The point I’m making is we have a butcher in charge of this policy, not the skills of a surgeon, going through this item by item. What is stopping the Minister from taking the time to direct her staff to do a thorough and complete analysis of what this would estimate out to be?

What is stopping the Minister? Nothing is stopping the Minister. I have a proposal right here. It’s on the website in colour. There’s no messing about. Certainly it’s far from zero analysis. We have not had more in-depth analysis of what our residents’ income profiles are and what level of claims they have been filing. The Member has right in front of him a proposal that would help the working poor. I don’t understand why he’s saying go back and do something that would help the working poor. This proposal right in front of him shows that 2,299 stand to benefit under this program who do not benefit right now.

I’m not sure what the Minister’s doing over there because if she can’t project what 2,299 people will cost, how do they project what a budget costs for the Department of Health? Why do we even bother with a budget for the Department of

Health? Why do we even bother trying to earmark costs for supplementary health benefits? If we have no idea what’s happening over there, why do we even bother having anyone manage it? It’s kind of confusing.

Those are the type of things we have experts who can predict costs for, who are able to follow through and find some reasonable assumptions. We make them all the time when people do estimating, budgeting and planning. The Minister says there’s nothing stopping her. Why doesn’t the Minister stop, order an analysis as to what this will cost, and bring that for full and reasonable and thorough debate in this House?

The issue here before us is that the extended health benefits as they are set up are not fair or equitable. We have statistical information that shows that the income spread of our residents are such that it has no boundary between ages or whether they’re sick. Our program right now covers by age or by specified condition. We are saying that all of our information shows that’s not the most fair and equitable way. We have tons of analysis that is on the website that we are sharing. What we are saying is, can we not change the criteria so that we look at one’s ability to pay? What we are proposing is such that anybody whose income is $50,000 to $150,000 would have 100 percent coverage. After that our residents will be asked to pay a little bit out of their own ability to pay. Nobody’s going to fall off right at that point. It’s just that people who can afford to contribute will be asked to pay some.

Thank you, Ms. Lee. Final supplementary, Mr. Hawkins.

Thank you, Mr. Speaker. At the beginning of this process when this side of the House and the champions in our communities came forward to say that this was completely wrong, this approach, there was a promise of a clean slate, the removal of an income means test as the philosophy, and yet that did not come forward. The Minister continues to say that the saving grace of this Supplementary Health Benefits Plan is to take from Peter to pay Paul.

What is stopping the Minister from doing a thorough analysis when we constantly hear about how much data and work they’ve done today? The one thing that can be the true factor for all of the basis of this discussion is the analysis of what it would cost to include this additional group called our working poor. No one wants that to happen. Why does the Minister keep defending every other topic under the moon, under the sun, under the heavens, other than dealing with that one question of why don’t we do that analysis and get it before this House so that we can have a true and thorough debate? Thank you.

Mr. Speaker, all the information is there for the Member to say whether he supports an approach that would make the program more fair and equitable and extend the coverage to those who need it the most. This is not a situation of taking money out of Peter and paying Paul. This is a situation where we are trying to increase Peters. We are trying to make more Peters; we’re not trying to take money from Peter to pay Paul. We want to expand the number of Peters. Thank you, Mr. Speaker.

Thank you, Ms. Lee. The honourable Member for Hay River South, Mrs. Groenewegen.

Mr. Speaker, I would like to ask questions to the Minister of Health and Social Services primarily from the point of view of the concerns of my constituents in Hay River who are senior citizens.

Now, I first of all want to say that we have a remarkable package of services and support under our health and social services system for the seniors in the Northwest Territories. We have chosen, we have paid for that, we have done that. I need to know what analysis has been done about the impacts or the potential impacts of now pulling that back and not having that. We hear about the cost of living in the communities. We hear about seniors on fixed incomes, and no doubt there are folks who are receiving these benefits who are in a higher income bracket, but this is what they have become accustomed to. They have a higher income bracket, but they also probably have higher expenses than most seniors who might live down south and we don’t want to lose...(inaudible)... Has the analysis been done on the impact if we were to lose seniors out of the Northwest Territories as a result of these changes? Thank you.

Thank you, Mrs. Groenewegen. The honourable Minister responsible for Health and Social Services, Ms. Lee.

Thank you, Mr. Speaker. I also received the letter that the Member is talking about and we are aware of the concerns that the seniors have. The important thing to know is that our information shows that this will benefit seniors on fixed incomes and low income in the same way as it would benefit every citizen who’s on a lower income. Our information has shown that there are people over 60 who have high incomes, just as there is for any other age group. So, Mr. Speaker, the fact is, even with these changes, this Extended Health Benefits Program will be very robust. So there will not be another program, even for the

seniors, that’s going to be much better that it would encourage them to move.

So, Mr. Speaker, I think we should look at this chart that shows exactly what the income level is and what the threshold is and who would continue to get 100 percent coverage, and at which income level they would start contributing to the cost of extended health benefits, and you will find that even for those who are making $190,000 of income, no matter what age, that they would still get support from this government. I have to tell you, in no other jurisdiction would you still get extended health benefits at $190,000 net income, of any age. Thank you.

Mr. Speaker, because the seniors who are currently receiving the benefit of this program regardless of income who are over 60 years of age in the Northwest Territories have planned that they would have this coverage, have become accustomed to this coverage, has the Department of Health and Social Services given any thought to grandfathering those folks who are already covered by this and phasing in a change to supplementary health benefits so that younger people like myself, for example, could begin at an earlier age to start to plan for the fact that they may need to think about insurance or putting money aside for sickness or so on? Has any thought been given to that? Because I’m just very afraid of the outcome of pulling this back from people who are already receiving it. Thank you.

We are interested in listening to our public about transitional measures or the option of grandfathering. That was discussed with the stakeholder groups. Some have said no. We are getting feedback on that on the website; people are divided on yes or no. But definitely that is a legitimate issue for discussion and I’d be happy to receive input from the Members and others out there. Thank you.

Mr. Speaker, to be clear, what is driving this change to our policy on supplementary health benefits? From what I understand is the projected costs going forward and the sustainability of those costs and also the people who are not currently receiving coverage, there’s a group, there’s a gap, there’s a group that are left out. If it is the cost that is driving this review, I think that the issue of cost, which Ms. Lee has indicated, is not something easy to quantify. It is difficult to have a fulsome debate on this when we don’t know what those costs would be. Because those are the kinds of decisions that government and policymakers can make, that they say it’s going to cost us this much, even on a projected basis. Well, we choose and we say that is a good expenditure of public funds and we want to do that. So, I mean, are there any costs that are part of this equation in this consideration? Thank you.

The Member knows and everybody here knows projecting to the last dollar what our health care expenditures are going to be, whether how much it will cost to run Stanton tomorrow or Extended Health Benefits Program, what’s it going to be at Hay River, whatever, that is, I mean, there are lots of formulas to do that, but at the end of the day, it’s a projection.

Mr. Speaker, sustainability of health care programs is a national issue. It’s an issue for every government. We know that on the whole that we will continue to see increases and we budget accordingly. So sustainability is an issue that we need to consider, but the thrust of this policy is not to reduce costs or to decrease costs, but it is to see how do we fix this program so that it works better. Because we know that it’s not working as well as it should. The program criteria that it has is not backed up by evidence, because we know that people of all ages have all different incomes and ability to pay and different medical needs. We are, right now, under the existing policy, excluding a whole bunch of groups of people, and we are trying to find a way to see if we can bring them on, and to ask those who can afford to pay something, to contribute to their health care costs. Thank you.

Thank you, Ms. Lee. Your final supplementary, Mrs. Groenewegen.

Thank you, Mr. Speaker. So it is about the redistribution of resources. It is taking resources which are now expended on behalf of those seniors who are in a certain income bracket and re-profiling those resources to a group of people who are not receiving them. So it is a redistribution of the resources this government has. But if we were given a number and we were told, Members of the Legislature, if we would commit to expend this much money, we could take care of the folks who aren’t being looked after plus we could leave the Seniors Supplementary Health Benefits the way they are. But how can we make that decision in a vacuum, in the absence of any kind of financial projections? That’s the kind of information I’m saying that we need in order to make a decision like that. Is there any effort on the Department of Health and Social Services, even on a projection basis, to estimate what it would cost to include those people who are not covered now, while at the same time not taking anything away from those people who are covered? Thank you.

I know that any debate about health benefits is difficult, it’s emotional, and it’s a difficult thing to do. In answering the Member‘s question, it is a little bit about redistributing resources, but most importantly, Mr. Speaker, it’s about fairness.

I hope you don’t mind if I use this example, but it just keeps coming at me. In this Assembly there is myself, MLA Bisaro, the Member herself, Member

Ramsay, Member Bromley, Member Abernethy and Member Hawkins who would belong to this program. Right now, when some of us hit 60 years old, they will get so many dollars for glasses and $1,000 dental benefits. We have very nice third-party coverage through our employer. I don’t know why anybody here among us that I just named, when they turn 60, they automatically get dental benefits and eyeglasses when I don’t -- I guess I will when I hit 60 -- when we could get that coverage by our employer insurance and especially when there are people out there who do not get benefit of that dental benefit and eyeglasses even if they can afford it because they are not 60 and we do not look at their ability to pay. I submit to you, Mr. Speaker, all six of us could afford to pay our own dental benefits. This is not just about redistribution of resources; it is about what is fair and what is equitable. Thank you.

Thank you, Ms. Lee. The honourable Member for Great Slave, Mr. Abernethy.

Thank you, Mr. Speaker. The Minister is right; this is about what is fair, this is about what is right, this is about what is just. I also can’t agree that the intent behind what we are doing here is sound. We want to support the low income families, the low income earners who don’t currently have insurance now. The problem is how this Minister and this department happened to be going about the process.

The Minister said we need to have a debate about substance. Yes, please, let’s have a debate about substance. The problem is it would be difficult to have a debate about substance when the information the Minister agreed to get after we passed our motion didn’t come forward. They didn’t go out to talk to the stakeholders. They didn’t consider options. They didn’t research around other options. That is what the Minister said she was going to do. If the Minister had done that, we would have the information to have a debate about substance, a well-rounded, thorough debate about substance. We can’t have it now. Why didn’t the Minister go get the information that she said she was going to get after the debate, after the motion? We need that information to have this debate. We can’t have this debate. All this dancing around she is doing isn’t helping us do the right thing to the people of the Northwest Territories. Thank you, Mr. Speaker.

Thank you, Mr. Abernethy. The honourable Minister of Health and Social Services, Ms. Lee.