After fighting for years with the federal government to get greater reimbursements for extremely expensive Non-Insured Health Benefits medical travel, Finance and Health Minister George Hickes is threatening to dump the problem in Ottawa's lap.
photo courtesy of the Government of Nunavut
“I will not be signing another extension. I will not be signing a contribution agreement, and the responsibility will go back to the federal government,” a frustrated Hickes said in the legislative assembly on March 12.
The minister gave an example of a medevac from Whale Cove that costs the GN approximately $22,000. He said the federal government offsets just $125 of that.
However, the federal Non-Insured Health Benefits program – which pertains to Inuit and First Nations residents – will pay 100 per cent for dental work or cover the full cost for medical escorts' flights, Hickes explained.
Arviat North-Whale Cove MLA John Main was puzzled by this.
“On the one hand, (it) sounds like they are doing the right thing when it comes to certain types of travellers. What is the rationale for treating different travellers different ways? I am just trying to understand why they would have made an agreement that does not seem to make sense to me,” said Main.
Hickes replied, “That is the exact same stance that I have been taking. It does not make sense. When I look up Non-Insured Health Benefits on the federal website, it clearly states medical transportation as an allowable expense, yet we are only getting a fraction reimbursed from our expenses.”
In the past fiscal year, Non-Insured Health Benefit travel cost the GN $78 million, said Hickes. Of that, Ottawa only compensated the territorial government $3.7 million, according to the minister.
The federal government provided a different figure to Nunavut News – $49.5 million – although that number accounts for patient accommodations and ground transportation in addition to medical air travel in 2018-19.
“We acknowledge the broader financial pressures facing the health system in Nunavut and are committed to working together, in partnership with Nunavut Tunngavik Incorporated, to ensure Inuit have seamless access to the health supports they need,” stated Rola Tfaili, spokesperson for Indigenous Services Canada.
Hickes said he recently received word from Indigenous Services Minister Marc Miller that “they are looking at increasing co-pay by a very marginal amount. In addition to that, they reneged on their commitment that it would back-dated.”
“The inequity in this program is something that I have been very clear with the federal government on – that unless we are compensated appropriately for it, they can have it back. It is not our program. I have made that message very clear,” Hickes said. “We have been underfunded since 1999.”
Main was shocked at how little the GN is receiving considering the rising costs of medical travel, which he described as a “bucket without a bottom.”
“Well this needs to be fixed somehow because our medical travel budget just keeps going up, and
up, and up,” said Main. “I just want to state that I think, based on the minister's explanation, it's ridiculous that Nunavummiut who are sick, who are sicker than most of the country, would be getting shortchanged by our own federal government. I think it's sad and I think it's something that Nunavummiut should know about. I'll just use the word 'ridiculous.'”
Regardless, Hickes said the Department of Health is examining ways to reduce medical costs, possibly by using telehealth more and better coordination of specialists visits to the regions.