Hundreds of people gave feedback to the GNWT on proposed changes to some health benefits, with many saying the plans are neither fair nor equitable.
The territory is proposing changes to the benefits system that covers people who cannot access health coverage through work or other forms of government insurance.
Estimating that 2,200 NWT residents do not have access to benefits, the territory says its proposal “will ensure that all residents who need health benefits can obtain them.”
The GNWT says the existing system, known as Extended Health Benefits, is 34 years old and “no longer meets the goals of fairness and equity”.
But many respondents to a survey published across the territory say the proposed new system doesn’t address that barrier either.
In releasing the survey results on Wednesday, the Department of Health and Social Services said there were 729 responses – a large number for a territorial government survey of this nature. The figure includes online responses, emails, face-to-face meetings, and a virtual town hall meeting.
Of these, 51% said they disagreed or strongly disagreed with the proposed changes. Overall, 40% agreed or strongly agreed.
The planned new system uses income tests to determine how people are helped to pay for prescription drugs, eyeglasses, dental care, medical equipment and some medical travel – things NWT’s basic health coverage does not cover.
But critics say the proposal would take advantage of some people with serious existing conditions, most notably by ending what is currently called the Specified Disease Conditions program. This program guarantees coverage if you have a serious or chronic condition on the program’s list and cannot cover the costs through another form of insurance.
Some people who have conditions listed under the Specified Disease Conditions program say they will lose out under the new system because treatments previously covered in full will now require them to obtain health insurance — which can be expensive if you have an existing condition — and pay premiums and co-payments. until they reach a certain threshold, after which some help with costs will be provided.
Opposition to drug policy, income cap
The GNWT report summarizing the survey results states that many people supported expanding coverage to more people, “but not removing existing programs or reducing coverage” elsewhere.
“Many noted that they believed it was not fair or equitable to require people to pay to access medications or supplemental health benefits,” the report states.
Asked in October why the NWT cannot provide benefits to the 2,200 people who do not receive them without reducing coverage for others, Health Minister Julie Green said the territory simply does not have the money.
“Our health care system has a deficit of $190 million that is increasing by about 20% a year. At some point we have to stop giving things to those who can pay, and this is the moment”, said the minister.
Background: What is happening with the proposal to change health benefits?
Survey respondents were also concerned that affected individuals and families could face a greater bureaucratic burden under the new system.
Some said benefit programs for seniors and Métis people – currently excluded from the changes – should be included “to make the changes equitable for all”. However, the vast majority of respondents considered it appropriate to exclude senior benefits. (The survey did not ask material questions about programs for indigenous residents.)
More than 70 percent of respondents disagreed with the suggestion that people earning more than the program’s low-income threshold (designed to start at $32,601 and increase with family size) should purchase private insurance – and exhaust $3,000 of program drug benefits annually – before being eligible for NWT government drug benefits.
Some respondents said that “with the high cost of living in the NWT, the proposed limit of $32,601 with the dependent and spouse adjustment of $9,451 was too low,” the report stated.
The report also noted comments that “the income test does not take into account other costs that individuals and families incur, such as debt, cost of living, inflation and other medical expenses, especially for people with disabilities or those with chronic medical conditions.”
The document added, “Some residents felt that the proposed changes penalized moderate-to-high-income residents as their share of the costs was higher, noting that they already contributed more taxes to support government programs.”
Pharmacists prefer the existing approach
The NWT Disabilities Council, Cystic Fibrosis Canada, NWT Pharmaceutical Association and Alternatives North provided critical comments on the proposed changes.
The NWT Disabilities Council said the new system would result in “embedded discrimination” against people with disabilities. The NWT Pharmaceutical Association said the existing system is “superior to the current proposal in that it is easy to understand, requires minimal administration, and reduces financial barriers to accessing drugs and medical supplies.”
In an in-person meeting, NWT health authority rehabilitation staff “expressed concern that removing coverage for high-cost medical supplies and equipment would create financial barriers for residents above the low-income threshold,” the report states.
More: Read the GNWT feedback summary in full
The territorial government said the feedback would inform the development of a final proposal.
“The intent is that the new extended health benefits policy will be drafted and presented for consideration by Cabinet by Spring 2023, with the goal that the new policy will be fully implemented by April 1, 2024,” states the territory in your site.