Health minister threatens to turn Non-Insured Health Benefits program over to Ottawa
John Main says funding shortfall forces GN to subsidize cost of program that’s supposed to be funded by federal government
Nunavut Health Minister John Main says he “will be left with no choice” but to recommend turning the territory’s Non-Insured Health Benefits program over to the federal government to run unless Ottawa comes through with enough funding to support the program. Main gave an update on the territory’s funding talks with Ottawa during an update in the legislative assembly Thursday. (Photo by Jeff Pelletier)
Nunavut’s health minister says he will be “left with no choice” but to recommend the territory turn over administration of the federally funded non-insured health benefits program back to the federal government if the program is not fully funded by Ottawa.
Health Minister John Main gave an update Thursday at the legislature on Nunavut’s talks with the federal government for funding of the Non-Insured Health Benefits program.
That program, funded by the federal government and managed by the Government of Nunavut, pays for health-care costs not covered by Nunavut’s own health-care program. They include vision and dental care, mental health counselling, medical supplies and equipment, medications and medical travel.
Funding for the NIHB is the sole responsibility of the federal government, Main said in an interview Friday.
But for months, he has been concerned that the federal government’s funding doesn’t cover all the costs. This year alone, he said, he expects the GN will be forced to subsidize the program by $25 million.
That’s up $4 million from November 2023 when Main said the GN would have to cover a shortfall of approximately $21 million.
For the government’s fiscal year beginning April 1, the program is expected to cost $136 million, with more than half of that expense — $70 million — to be made up of medical travel alone.
Main noted progress had been made but the GN and Indigenous Services Canada, the federal department responsible for funding the NIHB, have been without an agreement since April 2023, he said in the interview.
“The most recent NIHB financing proposal does not meet our need for 100 per cent recovery of medical travel transportation expenses,” Main said during his minister’s statement in the legislature Thursday.
Nunavut is looking for a five-year agreement for Ottawa to fund the non-insured benefits program.
“We are looking for predictability,” Main said.
While other aspects of the program have been fully funded for years, medical travel continues to be a sticking point.
Currently, federal government funding covers about 75 per cent of the benefits program’s medical travel expenses, Main said in an interview.
The federal government wants a cap on the amount of medical travel spending it covers. But Main said the lack of a full funding stream for medical travel “sticks out like a sore thumb.”
Medical travel costs are unpredictable and it is unrealistic to cap that spending, he said.
“We cannot deny [Inuit] medical travel,” he said. “That is the fundamental crux of the issue.”
Nunavummiut “rely heavily” on medical travel and costs have escalated in the past few years, said Indigenous Services Canada spokesperson Jacinthe Goulet in an email Friday.
Negotiations between that department and Nunavut are working to address higher costs with “an understanding that Inuit and First Nations access to insured health services is a shared territorial and federal responsibility,” she said.
On Feb. 7, Nunavut MP Lori Idlout brought up the matter in the House of Commons during question period.
“The Liberals are skirting their responsibility by underfunding [the program]. Their actions are forcing Nunavut to divert funds to this program instead of their own health priorities,” she said, accusing the government of not living up to its responsibilities to Nunavut.
Prime Minister Justin Trudeau responded, saying his government “will continue to be there for the people of Nunavut. We will continue to be there for the people of the North.”
Main echoed Idlout’s concerns, saying the money Nunavut used to cover the federal government’s shortfall could be better spent to “develop, enhance and deliver territorial health-care services for Nunavummiut.”
Main said the GN wants an agreement by the end of the calendar year, otherwise Nunavut will have to look at all options including turning administration of the program over to Indigenous Services Canada, something the Nunavut government would rather not have to do.
No one will disagree that thirty cents out of every dollar spent by each level of government in Nunavut is pure waste. Not because of inefficiency or incompetence, not due to lack of training or availability of staff, not due to excessive bureaucracy or corruption – just pure waste. Money in the trashcan type of waste.
That applies to every level of governance: hamlets, GN, Territorial agencies, local associations, IAs. Every level, every organization. Add in the personal waste. Yup, minimum 30%.
That’s $700 million dollars wasted every year. Money in the trash can. If we add costs for inefficiencies, incompetence, bureaucracy, absenteeism, frittering, and so on, another 30% is wasted. That’s $1.4 billion dollars wasted in Nunavut. Every year. That’s $4 million every day. Wasted. No value for any of those dollars. Ever. $160,000 wasted. Every hour of every day.
Not enough money for the non-insured health benefits program? Seriously? We could make up the shortfall in a week if we’d just stop wasting.
Most governments are inherently inefficient so there is some validity to your comments. However I would be very interested in seeing some specific proof of all this waste.
I’m looking forward to seeing your research.
So, let me see…devolution on one hand, handing back responsibilities on the other.
Hmmm, doesn’t bode well for the future.
GN found its igjuk. About time. Dont back down!
John main for igalaaq on the next election.
MP, where are you, MIA again
John Main had a radio phone show in Arviat called “Huvaguuq”. That was the beginning of his political campaign. Then he started the Inunmarik Music Festival. He did great in both and held them for a few years. It paid off and brought him to where he wanted to land today. Yes, he go for third time! Why not eh?
Yeah he started huvaguuq show on tuesdays, but no he did not start the inumariit music festival the inumariit music started way back in 1990s or 80s, he started volunteering sometime around late 2000s.
You can search NIHB on Nunatsiaq and you’ll find a 2001 article where the Health Minister said the same thing. George Hicks said the same thing. Every Health Minister goes through this charade but not one has ever followed through.
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Running this program is voluntary. You only run it John because you know if you stop then Inuit will be upset. So what! short term pain for long term gain. Tell those who are upset to call Lori Idlout and ask her to get the NDP to make this part of their agreement to prop up the Liberals.
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Won’t ever happen. You’ll get a few more bucks thrown at you, chalk it as a major win and do a press conference saying you showed the Feds and we will see this again in 1-3 years.
I am already seeing this on my payroll which I believe is the NUI Tax this is ridiculous! Why should I be deducted as a GN employee working under an Authority is bad enough along with over a thousand in tax deductions now I am paying over $1200.00 in taxes this is outrageous!!!
The Nunavut Payroll tax, like its predecessor in NWT, has no bearing on any particular service or program. It is literally a 2% tax charged to every dollar earned for work in the territory. It was originally designed at recovering some taxes from transient workers (construction, flight nurses, etc) but nowadays it can hit remote workers who would otherwise claim residency and pay income taxes in other provinces or territories. It is not for your medical travel. No one but Nunavut and NWT has this tax.
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I remember once a nurse thought that this was a fee for Health HR to process her payroll and she was complaining that the nurses still had to calculate their shift differences but were paying this tax for no reason, lol.
Costs are escalating partly because so many escorts are sent, and medical travel is used as family vacations. The sense of entitlement around medical travel is staggering. It’s race-based, and shouldn’t be. Inuit had NO modern medical care pre-contact. Even Inuit should be respectful that the money pot is not endless, and that it needs to be spent very frugally. Escorts are even allowed to bring kids now (or if not allowed, it happens a lot, and it’s not breastfeeding babies, either).
Inuit are VERY lucky that all Canadians fund their medical travel so that they can keep living in remote areas with no modern economic reason to exist. Tighten the purse strings and make the huge sums of money you already have work to carry out the program, because it is enough, if you manage it correctly.
It’s about time.
Now…. GN. Just slowly hand everything back to Yellowknife and Ottawa. We’ll pretend nothing happens
Half the budget lost to rebooking flights for missed flights while on medical travel lol
It is a staggering amount of lost funds to change fees and no shows for flights. There are also zero consequences to the delinquents.
NIHB couldnt even get a drs signature for my prescription while my jaw was broken. not even after 6 weeks of waiting. pathetic.
Medical travel continues to be a sticking point. Ya think? With all the people being sent down with a broken toe or a sore knee, no wonder we spend so much on medical travel. Want to fix it?
1. Don’t send an escort unless absolutely needed (heart/stroke/life threating issues)
2. Miss a flight, too bad, no more second flights because you were too drunk to get out of bed to go to the airport.
With just those 2 things alone, you will save half the money. Its not rocket science.
Sometimes when it is absolutely necessary for an escort is up for debate. How about someone going down for a cancer screening? Maybe they should have emotional support there. How about someone that has literally never left their community? They don’t know how to take a taxi or check into a hotel. Why should escorts give up weeks of work to go down and provide a service for the GN? Who covers their childcare responsibilities for escorts?
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I think the solution 99% of the time is a culturally sensitive Inuit staff member of NTI or GN Health based in the hubs (no, not boarding house staff). Easier said than done, but I don’t know if there are easy solutions. Medical Travel is hard to deal with even if you have an advanced university degree and have strong written and oral communication skills, I can’t imagine operating on grade 8 and no life experience outside of a small community.
I agree sometimes it could be hard to figure out but going for cancer screening is a YES obviously. How about someone that has literally never left their community? They don’t know how to take a taxi or check into a hotel. Doesn’t LARGA look after their lodging, food, taxi services? Everything is paid is it not? Why should escorts give up weeks of work to go down and provide a service for the GN? Why should escorts give up weeks of work to go down and provide a service for the GN? HOW is this a GN service? Who covers their childcare responsibilities for escorts? Don’t go if you have children to look after, its not a vacation. Too many times people treat these trips as a vacation. In the end they should be a lot more strict on who is going down and for what, if people had to pay out of their pocket, there would be a lot less travelling for a broken finger.
My understanding is that in Yukon that the territorial government throws responsibility of this on the First Nations or back to the feds, why are we operating like its 1999? These are 100’s of millions of dollars over time that could be better spent on infrastructure and are instead being given to Canadian North to change dates or cancel flights.
Can’t You see the Federal govt gave You a hint, Invest in Doctors/Surgeons and Hospitals with equipment in Nunavut just like the two other territories.
After a fall knocked me out, I was medevaced to Ottawa. 13 hours later I was released into the ice cold Ottawa night at 1 am with no accommodation assigned. Fortunately, I had a cell phone and my husband on the other end of the phone with an address of friends for the cab driver. He arranged everything over the phone, and my friends met me outside their house, paid the cab and looked after me for 2 days while I recovered from the fall and the experience in the hospital, which was bad. My husband also arranged my trip back home as medical travel didn’t. Fortunately, he knew the system and knew who to call and what to do but he couldn’t protect me from the racism and abuse at the hospital emergency that I experienced and that I witnessed others who were unwell being subjected to. I wasn’t allowed an escort. But had I not had my phone, that could have been a very different story.
Idle threat, that’s all!
So devolved
Some people have mobility issues, casts etc and need an escort to help them go for med appointments down south. Not everyone goes to Inuit centers down south, ie government employees, retiries ( Inuit and non Inuit) with private health insurance go to hotels and are not eligible to go to to Inuit centers. We have no specialists, MRI, cts accessible in all our communities we have no choice but to travel outside our communities. So it is necessary to have escorts in some circumstances this includes pregnant women who have to be away for weeks at a time waiting to deliver their babies. Bad enough they have to be away from home, they need someone with them during this time . That is our reality and I do not see that ever changing.
When I am travelling between Winnipeg and Rankin inlet,I am starting to see more and more people in wheel chairs, and it’s a hard journey, people from outside Rankin sitting in that terminal in Rankin, I am hoping that the new 100 million terminal will have an area for medical travel residents to relax , I see the stress and fear in their faces, I feel sorry for them.weather is a issue please try and make their journey a little easier
First off, all nunavut nurses that come up here are just training. Ones training is done, they leave for the city jobs. Interns in training. Hence video calls with the actual doctors regarding a patient. The doctor asking the nurse to check for symptoms and signs. Nunavut needs doctors. The ones that fly in is good but their stay is short. Many people being sent home with just Tylenol or motrin under nurses.