Non-beneficiaries in Nunavut need supplementary health coverage

The recent uproar over Rev. Mike Gardener’s financial plight has, understandably, generated much heated reaction.

Some of this anger is rooted in long-suppressed resentment over government policies and social attitudes in Nunavut that have led to the not inaccurate perception that non-Inuit residents face widespread discrimination.

For many others, this anger is rooted in their deeply-held affection for Rev. Gardener and his family, and their not inaccurate perception that he received shabby treatment from territorial government officials who should have done better.

But at the same time, it’s important that the Government of Nunavut and other interested residents recognize the root cause of this fiasco and find a way to fix it.

That root cause can be divided into three parts.

One is the absence of supplementary health insurance for non-aboriginal people who are retired or don’t work for governments or large employers.

The other is a near-universal ignorance about why such coverage is essential in Nunavut.

The third is the GN’s refusal to distribute and communicate simple, basic information about its own programs so that people in difficult circumstances understand their options.

First,we need to backtrack a little. Many Canadians still labour under the illusion that everyone in the country is automatically entitled to “free” health care. If that’s what you believe, you’ve been watching too many third-rate CBC documentaries about Tommy Douglas.

Canadians don’t get free health care. Depending on the province or territory, Canadians do receive a limited form of free medical insurance, through 13 provincial and territorial health insurance schemes. Each must meet certain minimum standards set out in a federal law, passed in 1984, called the Canada Health Act.

These health insurance plans do not cover all health care costs. They cover the cost of doctor appointments, hospital stays and care provided within those hospitals and a few other things.

But in most jurisdictions, these government-run plans do not cover medical transportation, prescriptions, medical devices, prosthetics, time spent in medical boarding homes and extended care centres, meals, dental care, vision care, and many other expenses.

For those costs, someone else has to pay. If the patient is lucky enough to have supplementary health insurance, their private insurance company will foot the bill. Otherwise, the patient pays out of her own pocket.

That’s how Nunavut’s bare-bones health insurance plan works.

Inuit and First Nations people living in Nunavut, however, don’t have to worry. A federal scheme called the Non-Insured Health Benefits Program, also known as the NIHB, takes care of all those extra costs. The NIHB works, in effect, like a free supplementary health insurance plan for aboriginal people.

If you’re a non-aboriginal person living in Nunavut, it’s more complicated. If you work for a government or some large company, you’re probably covered by a supplementary health insurance plan. Your employer does this by working out a deal with a private insurance firm, such as Blue Cross.

But if you’re a non-aboriginal person who is self-employed, unemployed, retired, or working at a very small business, beware.

Because if you suddenly need medical care in the South, the GN will hit you with a nasty and financially crippling surprise.

If you’re an uncovered non-aboriginal person living in Nunavut, the GN will pay part of your air fare, but they will not pay for most other expenses, including accommodation, meals, ground transport, prescriptions and many other things. Most non-Inuit in Nunavut deal with this inequity by keeping their mouths shut and paying the bill.

Ironically, the GN actually does have a program that Rev. Gardener could have used to defray the costs of his lengthy stay in Ottawa.

It’s called the “Extended Health Benefits Policy.” Métis and non-aboriginal Nunavut residents over the age of 65 are eligible for it. Among other things, it provides patients and approved escorts with $50 a day for accomodation and $20 a day for meals — stingy, but better than nothing.

But how does one find out about this “Extended Health Benefits Policy?” How does one apply for it?

The GN health department’s website contains no information about it. It contains no information about the Nunavut health insurance plan. It doesn’t even provide information about how to get a health card.

To get that information, you have to call the GN’s dysfunctional health department office in Rankin Inlet, where, as we all know, nobody ever answers the phone.

In any event, this extended health benefits policy isn’t nearly enough to bridge a health insurance gap that discriminates against non-aboriginal people who don’t have supplementary health insurance.

To fix the problem, the GN should talk to Blue Cross and other private health insurance companies to explore the idea of a group supplementary insurance plan that could cover non-Inuit residents of Nunavut.

The Government of the Northwest Territories, for example, uses Alberta Blue Cross to administer certain health benefits for seniors of all ethnicities, as well as all Métis people in the NWT.

In the mean-time, the GN must act now to provide basic information about its health insurance programs and how they differ according to the ethnicity of patients.

The health department’s information vacuum is appalling and inexcusable. It’s bad enough that they effectively discriminate on the basis of race.

But it’s even worse not to tell anyone about it until after they’ve racked up many thousands of dollars in supplementary health costs. Armed with this information, many non-aboriginal people in Nunavut could, for example, be encouraged to buy their own supplementary health insurance from any number of private providers.

Incidentally, if you want to view an example of how a competent government provides information , visit this website maintained by the GNWT.

Was division of the Northwest Territories and the creation of Nunavut a historic blunder? The GN still seems eager to prove that this was the case. JB

Related story:
• Iqaluit man gets $17,000 bill for boarding home stay because he’s not aboriginal (Ottawa Citizen)