The Minister of Health and Social Services, Ms. Lee.

Thank you, Mr. Speaker. The Member is right; there is a provision there that would allow me to go back to the Cabinet for revision. We heard and analyzed and reviewed the feedback that we got from the public, and based on the analysis we had, we did not conclude that we had to go back to Cabinet for revision, but we did go to the Cabinet with options on what we have heard. Thank you.

Mr. Speaker, I would like to know which public she was listening to. Thank you, Mr. Speaker.

Mr. Speaker, the fact of the matter is, the Minister and this Cabinet and this Legislature has to consider supplementary health benefits in the context. As the Member for Sahtu has mentioned, and others, the government is responsible for insured benefits as well as non-insured. Supplementary health is non-insured. The government has a priority to use its money on

insured services. For non-insured services, it is to come up with a program that is as fair and as equitable as possible. We have to realize that there is some personal investment that has to be made into this program. We are asking the people to do that in this context. Thank you.

I still didn’t hear an answer to my question. I’m not sure which public she is listening to. Clearly, there’s a significant amount of people out there who have concerns.

I want to go back to the policy for just a second. The statement of the policy is that the Government of the Northwest Territories will provide certain supplementary health benefits to non-aboriginal residents and their families who are not eligible for either -- and it’s an or question -- either supplementary health benefits available to aboriginal people or for supplemental health benefits available through employer programs. Aboriginal people are entitled to top-up for things such as specified medical conditions, the catastrophic conditions. Under this new program that she’s proposing, people with insurance who have catastrophic conditions are completely out of luck. I’m curious how we can ignore those people with catastrophic conditions who happen to have insurance, given that the statement of the policy actually would cover those individuals. Thank you.

Thank you. The proposal that we have, that’s under discussion and we will continue to have that discussion to hear out what the Members have to say. This policy has a suggestion for a cap, and also we are working on a catastrophic drug coverage and other programs, Mr. Speaker. Thank you.

Final supplementary, Mr. Abernethy.

Thank you, Mr. Speaker. I am listening, but I’m not really hearing any responses. So I’m just going to ask a related question slightly different.

Consistently the Minister talks about a program that is generous and equitable. Clearly, there are people excluded from this. Anybody with insurance in the Northwest Territories is excluded completely from any top-up. In some cases, most people, if costs aren’t high, that might be alright, except in some cases people do have catastrophic conditions where the costs are clearly high, and I think those numbers are larger than the Minister is accepting. I’m curious if she could explain to me in detail how a system that clearly excludes people who have insurance and catastrophic conditions is in any way, shape or form, generous or equitable? Thank you, Mr. Speaker.

Because, Mr. Speaker, I think that the one thing that we need to remember is that all governments try to have a program that supports

the residents on low income, or seniors, or a person with disabilities, those people who need the government for non-insured health benefits. So in that way, this program that we have designed is very generous and much more comprehensive than any that is available in the rest of the country.

The fact of the matter is, Mr. Speaker, we have to put this in the context of other obligations that the Department of Health and Social Services and the government has to provide health care services to the people across this Territory. Thank you.

The honourable Member for Weledeh, Mr. Bromley.

The honourable Minister of Health and Social Services, Ms. Lee.

Mr. Speaker, I just need to correct that. I was not in any way suggesting that anybody couldn’t put an input into this unless they wore a title. So if the Member understood it that way, I do apologize. What I meant to say yesterday in answering the question why have you not consulted with the pharmacy association or Nurses’ Association or any other medical related health care professionals, and my answer was yes, we did. We wrote a letter to the pharmacy association. I have actually asked the staff to put that on the website. I have consulted with many people about this supp health plan. My point is, the pharmacy association did not respond to that, but Mr. Dolynny later on did respond and say you didn’t consult us. My point is that we did contact the associations and

we are listening to anybody who wants to tell us. Thank you.

Thank you. Again the Minister has refused to answer the question. Why did she not respond favourably to the stakeholders panel she put together for inclusion of the Pharmaceutical Association? I also understand now about the five-day notice the department had to participate the in the Pharmaceutical Association’s AGM. The association actually invited the department quite early on in a timely way, but the department was very slow to reply. By the time the reply was received by the association office, only five days remained for the by then scheduled AGM, apparently a time too short for the Minister to arrange for a person to attend. But I have to ask the Minister to explain why is it this department, again, would have not been knocking on their door in the first place, and certainly why could they not free up a person to attend and take notes on the insights of a front-line provider like the Pharmaceutical Association of the Northwest Territories.

This is an important issue and I’m not sure if we want to talk about who sent what e-mail and when. I can assure you that I do have a chronology of the invitation from the pharmacy association and our response was prompt and swift. Having said that, Mr. Speaker, the pharmacy association is welcome to give their input, but the fact of the matter is, yes, they’re a front-line provider.

The Supplementary Health Plan we are suggesting is in place in every other jurisdiction in Canada. That’s what all the other pharmacists and pharmacies do use. So, Mr. Speaker, as a front-line provider, that’s not where the input would come. As a pharmacist, we consult with them regularly. All of the legislation we’ve had, all of the policies we have, we consult with the pharmacies and pharmacy association and other professional associations on a routine and as a regular course of business. Thank you.

Thank you. It’s sad that the Minister doesn’t realize what the main point is here, that this consultation process has been a sham and that some extremely important aspects and sources of good insight for us have been skipped over in the process. I’ve had many comments from constituents on the quality and bias, for example, of the on-line survey, and I know the Minister has received those same comments, a survey which was also difficult to fill out with complete comments. Many have noted that the survey may not have been available to seniors that don’t have computers. I’m told that the, well, I’ve concluded the results of the survey itself indicate highly equivocal responses. I’m sure the Minister must recognize that by looking at the answers, the proportions of answers, the yes or no answers provided, entirely

equivocal responses, which is exactly what you would expect from a questionnaire with ambiguous questions. Can the Minister explain how she thinks this survey was at all meaningful? Thank you.

Thank you. Later today I will be tabling a document called What We Have Heard, and we outline everything that we have heard in all of our consultations and meetings we have had. We’ve had very frank and direct comments from our people. Also on the website there might have been yes or no questions, but there was always room for somebody to put in their input.

People have called us; people have e-mailed us; people have talked to me on the phone; they have called me. In the Northwest Territories we live in a very small space and we know everybody, a big space, but we know each other, and so I have had input from the people, as have the MLAs.

The challenge we have here is what we are talking about is a very, very difficult thing to talk about. When you are talking about anything to do with health benefits it is a very, very difficult thing to do. There are certain things we have to talk about: universality versus co-payment, non-insured health services versus insured health services, catastrophic drugs versus regular drug costs. All those things a lot of people don’t want us to change that at all. So I don’t think it’s necessarily true that there was a flaw in the consultation. It’s just that, at the end of the day, it is difficult to make changes. Thank you.

Your final question, Mr. Bromley.

Thank you, Mr. Speaker. Again, there’s quite a disagreement both from the public and the Members here on the Minister’s perspectives on this. The Minister continually refers that we follow a system that’s a commonly used model in other parts of the country and so on. We’re not interested in that. We want to develop a specific system for the North.

Mr. Speaker, when I asked whether an analysis of the cost of administration had been made, the Minister replied, according to Hansard, “we will be going for RFP to find a service provider such as Blue Cross or any other insurance company. They are equipped and trained and set up to deliver a program like this.” Mr. Speaker, Blue Cross fills forms, not prescriptions. Why are we to have any respect for a consultation process that was biased, narrow, controlled, and based on pre-determined actions? I’m asking for a new consultation process where everyone can develop the respect for it that is needed, and that would indicate that a good process has been had and a good solution has been found. Thank you.

Mr. Speaker, this issue has been discussed in and out of this House since

2003. You will hear very frank input in the report that we have submitted today. I know people are very concerned about these programs and whenever you are making changes, it is difficult. It is difficult for us to talk about what we need to do. We need to be clear about what we need to do. We need to be able to find a way to help those who are currently excluded. We need to be able to do it in a way that minimizes the impact of the changes. We need to do it in a way that we have a sustainable health care system where our resources go to insurer services, nurses and doctors and health centres, surgeries, all those things. No government has all the money they need. This is not about cost cutting at all, it’s not about dollars, but it is about sustainability. It is something that we need to work through and I’m willing to work with the Members on the other side to see how to make this work. Thank you.

The honourable Member for Sahtu, Mr. Yakeleya.

Thank you, Mr. Speaker. Mr. Speaker, my questions are to the Minister of Finance, the money man, in terms of the supplementary health benefits. In terms of this issue, I want to ask the Minister of Finance, in his understanding that if we are to continue on with the existing program as it is now, could we, in his financial forecast, can we sustain this type of program?

The honourable Minister of Finance, Mr. Miltenberger.

Thank you, Mr. Speaker. Mr. Speaker, like every jurisdiction in the country and probably in the world, we are facing an increasing and consistent rise in our health expenditures. Member Bromley said it should be at the top of our list when it comes to our priorities, but when it comes to our expenditures it definitely is and it continues to be.

We have, on the supplementary health side, a growing demand for the service. Plus we know, as the Minister has pointed out, we’re trying to capture those folks that aren’t currently captured, about 2,300 people.

As we have every budget, we are going to be pressed to make decisions. We have far more needs than we have resources and we are constantly looking at how do we control and manage our expenditures. At the same time, are there ways to boost or increase our revenues? We are talking now about trying to consolidate what we’ve done. We’re talking now -- having lived through the last two years of the most turbulent

economic times since the Great Depression -- of that pressure that is still there for us to be very vigilant and frugal.

So are things sustainable? We are going to continue to have to make choices. We’ve been asked and told to look at ways of being creative, look at how we do business. The program review unit was put together to help us find those efficiencies. This has been identified back in the 14th Assembly as an issue that needs to be

addressed, and we are constantly going to be, until the end of this term, working to manage our finances. Thank you.