Hundreds of people have given the GNWT feedback 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 can’t access health coverage through work or other forms of government insurance.
Estimating that 2,200 NWT residents have no access to benefits, the territory says its proposal “will ensure all residents in need of health benefits can get them.”
The GNWT says the existing system, known as Extended Health Benefits, is 34 years old and “no longer meets the objectives of fairness and equity.”
But many respondents to a survey published by the territory say the proposed new system doesn’t meet that bar either.
Releasing that survey’s 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, in-person meetings and a virtual town-hall meeting.
Of those, 51 percent said they either disagreed or strongly disagreed with the proposed changes. Forty percent agreed or strongly agreed overall.
The planned new system uses income testing to determine how people are helped to pay for prescription drugs, eyewear, dental treatment, medical equipment and some medical travel – things basic NWT health coverage does not cover.
But critics say the proposal would take benefits away from some people with serious existing conditions, largely by doing away with what is currently called the Specified Disease Conditions program. That program guarantees coverage if you have a serious or chronic condition on the program’s list and can’t cover the costs through another form of insurance.
Some people who have conditions listed in the Specified Disease Conditions program say they’ll lose out in the new system because treatments previously covered in full will now require them to get 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 threshold
The GNWT report summarizing the survey’s results states that many people supported expanding coverage to more people, “but not by removing existing programs or reducing coverage” elsewhere.
“Many noted they believed it wasn’t fair or equitable to require people to pay to access drug or supplementary health benefits,” the report states.
Asked in October why the NWT cannot provide benefits to the 2,200 people who lack them without reducing coverage for others, health minister Julie Green said the territory simply does not have the money.
“Our health system has a $190-million deficit that is increasing by about 20 percent a year. At some point we have to stop giving things away to people who can afford them, and this is that moment,” the minister said.
Background: What’s going on with the proposal to change health benefits?
Survey respondents were also concerned that affected individuals and families could face a higher paperwork burden under the new system.
Some said benefits programs for seniors and Métis people – currently excluded from the changes – should be included “to make changes equitable for everyone.” However, the vast majority of respondents felt excluding seniors’ benefits was appropriate. (The survey did not ask any material questions about programs for Indigenous residents.)
More than 70 percent of respondents disagreed with the suggestion that people who earn more than the program’s low-income threshold (projected to start at $32,601 then rise according to family size) should have to purchase private insurance – and exhaust $3,000 of that insurance program’s 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 threshold of $32,601 with the adjustment per dependent and spouse of $9,451 was too low,” the report stated.
The report also noted feedback that “income testing doesn’t take into account other costs that individuals and families have, such as debt, living costs, inflation and other medical expenses, especially for people with disabilities or who have chronic medical conditions.”
The document added: “Some residents felt the proposed changes penalized residents with moderate to higher incomes, as their cost share was higher, noting they already contribute more taxes to support government programs.”
Pharmacists prefer existing approach
The NWT Disabilities Council, Cystic Fibrosis Canada, NWT Pharmaceutical Association and Alternatives North all submitted feedback critical of 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 as it is easy to understand, requires minimal administration and reduces financial barriers to accessing medications and medical supplies.”
At an in-person meeting, the NWT health authority’s rehabilitation team “expressed concern that removing coverage for high-cost medical supplies and equipment would create financial barriers for residents over the low-income threshold,” the report states.
The territorial government said the feedback would inform the development of a final proposal.
“The intent is to have the new Extended Health Benefits policy drafted and brought forward for consideration by cabinet by spring 2023, with the goal of the new policy being fully implemented by April 1, 2024,” the territory states on its website.