Thank you, Mr. Bromley. Minister Abernethy.

Thank you, Mr. Chair. I’m going to go to Ms. Mathison for that, but this is not Non-Insured Health Benefits.

Ms. Mathison.

Thank you, Mr. Chair. Okay, so it’s a different… It’s not related to Non-Insured Health Benefits, NIHB.

I know in the past we have been concerned because of transfers, I believe, for these expenses. I believe it’s an annual transfer that we receive and this department is up 8 percent this year and that’s not atypical, and that’s not atypical for hospital and medical care to go up at that rate in the Northwest Territories, yet the federal government only increased their contribution by 2 percent or 2.2 percent per year. This has been, obviously, a bone of contention. That’s a significant additional burden for us every year.

What is the status of that? It sounds like now there’s perhaps a new formula where we get 95 percent of costs of whatever they are and our liabilities are limited to 5 percent. I’d just like to ask if I understand that correctly. Thank you.

Thank you, Mr. Bromley. Minister Abernethy.

Thank you, Mr. Chair. NIHB covers things like dental and other extended benefits like medications and whatnot. The provision of care is provided within our facility for what would be considered more of the standard care. This covers that and it’s negotiated with the federal government. It was negotiated many years ago and I believe – and if I’m wrong, correct me – we have a 2 percent standard flat rate. So our rate here increases by about 2 percent a year, which is less than the 8, obviously.

Okay, so just so I’m understanding this, there are other expenses that are covered elsewhere for these two categories. Is that correct and how do we fund them?

Thank you. I don’t understand the question. Maybe the Member could clarify a little bit, that would be great.

I believe I heard that this represents 95 percent of the costs, these two figures added together, about $30 million of some costs and we pay the other 5 percent and perhaps that expense is listed in here somewhere. Maybe the Minister can give me a heads-up on where that shows up in our O and M on the other side of the equation here. But I’m assuming that there are other costs beyond these. How and where are they covered?

Thank you. In different jurisdictions in the country things are funded in different ways on reserves and whatnot in southern Canada. By way of example, health services are paid by the NIHB First Nations Inuit Health Branch. In Canada, in the Northwest Territories rather, when we devolve down the responsibility for health care, we agreed to pay all those costs within our system. These dollars that you’re seeing here, as far as revenues, were negotiated back then. They grow at, I think, about 2 percent a year. Our costs have far exceeded that. So anything that is not covered by these dollars coming in basically we eat as a health and social services system because we are committed to providing quality care to all residents of the Northwest Territories.

Thank you. I think I understand that. Perhaps I could ask the Minister to provide what total additional amount has summed up to over the last decade of additional costs that we are taking on because of the failure of the federal government to transfer payments at the rate that the real world is dictating and we have to suffer.

Thank you. We can certainly go back and pull out main estimates for the last 20-some years and show what was budgeted here and what was received here, but as far as what we spent or the cost for providing services to the Aboriginal people only would be darn near impossible to provide back that far.

Thanks. I’m willing to accept an estimate. We certainly know what the department has increased each year; it’s reported in these big thick documents. So just apply that and compare that to the 2.2 percent with it. That would be good to know.

It’s something obviously we’ve been talking about for a long time. I know we were actively negotiating pushing in the 16th and I’d love to hear that we’re

still getting serious with the federal government on this. Thank you.

Once again, this is based on formula financing and the amount we get as revenues increases 2 percent annually. We will go back and see, we’ll be able to pull out from the mains what was there. So we’ll get an idea of what we expected to come in. What we actually spent, we’ll do our best. I don’t believe we’ll be able to go back 10 years, but we’ll go back as far as we can and some of it still might be projections because it would be really impossible to figure out just for Aboriginal people what the cost of health care was in the Northwest Territories, but we will do our best and we will try to get something to Members.

Yes, I would very much appreciate that and I realize that that sort of level of estimate would be good. I don’t want to make this too onerous. I’d also appreciate learning how long this situation has existed. When did we enter this

agreement that started at the 2.2 percent escalation rate and, also, is this an agreement that expires? Is there an end date to this? Thank you.

Thank you. It started in 1988 and it’s a set agreement. There is no end date, there is no opportunity to renegotiate.

That’s all I have. Thank you, Mr. Chair.

Thank you. Next on my list I have Mr. Hawkins.

Thank you, Mr. Chairman. Mr. Dolynny’s questions kind of got me wondering and I’m aware of some of the reciprocal billing problems with Nunavut and sometimes there have been many occasions where they just outright refused the bills and refused to pay. Of course, there was a gap in that and I know that had been somewhat sorted out a number of years ago. What year I don’t remember exactly, but I am familiar that that had been sorted out. So we had been actually subsidizing the Nunavut citizen and I do have some great concerns about this process, just in general, because does it come at a cost to our citizens. In other words, are we sending experts who are specialists in their areas, be it physicians or other types of skilled professionals to Nunavut, and does it come at a cost to our citizens and how are we covering these costs? Are we actually making money off this under this situation? So I guess that’s kind of my first question.

How do we assess the cost? Do we make any money on this and is there any analysis? As we’re trying to make money off this situation, are we missing out on opportunities to serve our citizens, which really we should be doing first? Thank you

Thank you, Mr. Hawkins. Minister Abernethy.

Thank you, Mr. Chair. I remember during the last Assembly there was a lot of discussion around this because there was a fair amount owing at a particular point in time and there were some issues. I believe those issues, actually I know those issues were resolved before the end of the last government. Right now we have an inter-jurisdictional agreement that’s based on cost recovery. We don’t make money on this from Nunavut, but at the same time other provinces don’t make money off of us when our residents are receiving services out of jurisdiction. We collect the dollars, as I said to Mr. Dolynny, that we bill and we get everything that we bill.

Thank you. I’m going to say maybe broadly I don’t disagree with the philosophy then that if we don’t make money other jurisdictions don’t make money that, in essence, we’re covering costs, I understand that philosophy and perhaps maybe in the wash it all works out in the bigger picture.

The issue I’m really trying to boil down to here – and I’m going to try to directly put my finger on it – is what type of cost analysis do we look at? For example – I’ll use it by way of example – we sent a physiotherapist to, say, Cambridge Bay and I’m hearing that we’ve covered the costs of the flight to Cambridge Bay, those types of things, we’ve probably covered the cost of our physiotherapist we’ve taken out of Stanton to send there, but is there any analysis done on our patients having to wait for services back here, be it in Yellowknife or any other region they should be on we’ll call it the physiotherapy circuit? So, is there a cost and impact on our residents, because I can only assume so. I mean, I’ve heard, albeit not as of late, but I’ve heard people having trouble getting into these types of specialized services because these services are on circuit serving Nunavut residents, not NWT residents. Thank you.