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.

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.

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?