Medical Travel Premiums

Thank you, Mr. Speaker. Medical travel. Where do I begin: there’s issues with scheduling, there’s issues with where patients are sent and how those decisions are made, there’s issues with escorts.

But, today I want to talk about an issue that doesn’t receive enough attention in this House or from the Government.

Most people in the Territory have some sort of  extended health benefits which cover virtually all the costs associated with medical travel: the GNWT provides such coverage to its employees and their spouses and dependents, as do other public entities and many private companies. Similarly, benefits are extended to individuals registered under the Indian Act, Indigenous Metis, seniors, and those from households with income under $80,000 per year.

This means that the only NWT residents who don’t qualify for full medical travel coverage are those from households that earn over $80,000/year.

To be fair, there is some coverage for those who earn above the threshold. Return flights to medical appointments only cost them $250, they receive $50/day for accommodations and $18/day for meals when on approved medical travel trips.

According to the government, the fact that these amounts don’t cover all the costs of medical travel is a recognition that medical travel costs need to be shared between the GNWT and those who can afford it.

But, Mr. Speaker, can they afford it? A young, relatively healthy, single individual who makes $80,000 may be able to foot the bill for the few times he or she must travel for medical purposes. What about a family of 4 that earns just above the threshold? What if a child has a medical condition that requires monthly visits to a specialist? What if a parent must take time off work to accompany their child to the specialist in Yellowknife or Edmonton, and what if they have to bring his or her other two children along as well because there is no one else to look after them. Suddenly, that $50 accommodation allowance and $18 meal allowance aren’t cutting it. I’ve had constituents who’ve had to push back specialist appointments because they just couldn’t afford it that month.

A “living wage” in Yellowknife (according to Alternatives North) for a family of 4 is actually above the current threshold. That calculation doesn’t include exceptional medical costs, such as monthly specialist visits. Assuming a similar living wage for other communities, it’s clear that the current threshold is too low.

How did the government settle on this threshold? The government announced it as an interim measure, 14 years ago. If we adjust it for inflation, that number should be over $100,000 today.

Mr. Speaker, it’s clear that this threshold and the policies surrounding it need to be updated. I’ll have questions for the Minister of Health and Social Services.

Questions

MR. SIMPSON: Thank you, Mr. Speaker. Further to my Member’s statement about the ministerial policy on medical travel, I have questions for the Minister of Health and Social Services. The $80,000 threshold for medical travel that I spoke about earlier does not take into account how many people in the household that $80,000 is supporting, if there is an ongoing medical condition that requires frequent trips out of town, and the fact that it essentially punishes citizens for living outside Yellowknife where most of these services are offered. I’m not a socialist, but I don’t think that costs should get in the way of people in Hay River receiving the same medical care as people in Yellowknife. First, I would like to ask the Minister: what is the rationale for this $80,000 threshold? Thank you, Mr. Speaker.

HON. GLEN ABERNETHY: Thank you, Mr. Speaker. Mr. Speaker, I do not know what the rationale for the $80,000 co-payment is or, rather, the level of the $80,000 co-payment. I know that my predecessor once referred to it as an arbitrary number. Clearly, we need to review the use of co-payment and the amount of the co-payment. That work is currently being done as part of the medical travel review, where we are reviewing a number of aspects of the medical travel policy, including the co-payment. We want to take into consideration not just the family income, but the size of the family; the illness that the individual might be suffering from; and the fact that some individuals, when they are ill, may not be able to earn, and looking at last year’s tax return might be the complete wrong thing to do.
These are the types of things that we are doing. We are hoping to have this work done late in this calendar year so we can present to committee early in the next calendar year so that we can make important changes to medical travel to benefit all residents in the Northwest Territories and to make sure that they can get to the treatment they need when they need it. Thank you, Mr. Speaker.

MR. SIMPSON: It seems like I am late to the game and the Minister is already on top of this, but I have been hearing about the medical travel review for quite a while now, and it always seems like something bumps it from the agenda. Can the Minister commit that this review is going to be completed when he says it is going to be so that I can tell my constituents that they won’t need to worry about these arbitrary numbers anymore?

HON. GLEN ABERNETHY: The review of medical travel actually started in the last Assembly. There was a significant amount of public consultation that was done. The department went out and sought information from users of the system from across the Northwest Territories. A lot of data was gathered.

A number of things have happened. We have put in an appeal process, I personally think it still needs a little bit of tweaking, and we have put out a handbook to help people understand and navigate the system, but clearly, more needs to be done. The area the Member is talking about is certainly one of the areas in which we need to make more progress, as is looking at the rates that we provide for individuals who are on medical travel for ground transportation and for per diems for accommodation.
I have made a commitment already that that work will get done. My intention is to have that work done late in this calendar year so that we can make presentation to committee early next calendar year so that we can bring the changes into effect April 1, 2018.

MR. SIMPSON: I had a bunch of pointed questions, but the Minister is actually doing this work already, so he’s off the hook for most of them. How about this, though? Because this is a ministerial policy, I assume you can change it with a stroke of a pen. How about at least adjusting that $80,000 threshold for inflation? For the next few months, until changes are made, people could get the care they need and it would not cause an economic hardship. And Mr. Speaker, I want to note that this is not an academic exercise. I have people in my constituency who bring this up to me, for whom this is a real issue, and it affects them every single month. So, would the Minister be willing to make that change immediately?

HON. GLEN ABERNETHY: I appreciate that the Member thinks that this is easy and it can be done with the stroke of a pen, but if we are going to make a change on some financial levels, we need to understand the implications of those. We need to understand why. I will say that in cases of undue hardship, where a family is experiencing some significant difficulty, we are willing to look at these on a one off, one on one basis to make sure that we are not really disadvantaging families where there is undue hardship.