Pettigrew hints at more funds for NIHB

With a federal election just a few months off, Paul Martin’s government looks ready to increase the amount of money it spends in Nunavut through the Non-Insured Health Benefits program.

Pierre Pettigrew, the new federal minister for intergovernmental affairs and health, stopped briefly in Iqaluit this week where he met with Premier Paul Okalik and Health Minister Ed Picco.

Pettigrew has been on a cross-country tour to prepare for a first ministers’ meeting on health, possibly in late January.

The NIHB is a federal program that pays for extra health care services – such as medical travel and prescription drugs – for aboriginal people who are not included in regular territorial health insurance programs.

Nunavut officials have long complained that the current NIHB doesn’t meet Nunavut’s needs.

After discussions with Okalik and Picco, Pettigrew said “clearly it [the NIHB] is going to be one of our priorities.”

Pettigrew said reducing the financial pressure on Nunavut’s health care system would help other areas of government that also need money.

“Health monopolizes so much of the resources, it is also more difficult for the administration here to deliver other services, whether it be in education, housing [or] infrastructure… health penalizes the rest of the development,” Pettigrew said.

Ottawa has already promised the territories and provinces that they can look forward to an additional $2 billion in health care transfers this year, but this funding, which is distributed per capita and amounts to only a few million more a year for Nunavut, won’t resolve Nunavut’s health spending woes.

Nunavut still wants Ottawa to increase its NIHB spending in the territory – a move that wouldn’t cost much.

“If they would allow us to bill an extra $10 to 15 million in NIHB, that would be money well spent for us,” Picco said.

Right now, Nunavut gets about $37 million a year in NIHB reimbursements for Inuit medical expenses, an amount based on costs calculated 16 years ago.

“A good example is the $250 they gave us per airline ticket. In 1988, when they did the health transfer, the amount of an airline ticket was at $750, so they contributed $250. Today, a ticket from Pond Inlet-Ottawa return is at $2900. They still give us $250,” Picco said.

An increase in the NIHB transfer, Okalik agrees, would help Nunavut.

“It would allow us to spend some money on other programs that we are spending in health now. It would help us, but at the same time, help our health care system,” Okalik said in an interview following his meeting with Pettigrew. “We have a lot of issues, but if we can make progress on one of them, it will be a good sign.

Nunavut may also receive more money from Ottawa for emergency preparedness, in the wake of a series of health emergencies and natural disasters in Canada.

Picco told Pettigrew Nunavut has no containment capacity to quarantine the sick during an epidemic, such as SARS.

“‘The health system is only as strong as its weakest link.’ They sat up and took notice when we spoke about that,” Picco said in an interview.

At their meeting with Pettigrew, Okalik and Picco also spoke about other unresolved issues, including the need for a regional economic development strategy, more access to fisheries, devolution and a larger voice in national security matters.

“It was a wide-ranging discussion, very frank… I explained, giving us our fish won’t cost you any money if you’re trying to save money. That’s one area we can make progress on. The same as devolution, it doesn’t come with a price tag. You give it to us and it will help us out,” Okalik said.

Pettigrew also said issues aren’t “always about funding” or “money,” but about reform – something his government appears ready to consider.

One of the no-cost gestures Ottawa may offer Nunavut and the two territories is an expanded voice and role in any development of a North American ballistic missile defence system.

Last week, Defence Minister David Pratt wrote the U.S. defence secretary that Canada is seeking “a mutually beneficial framework” on the BMD – exactly what Nunavut would also like to see.

“In the last major work with the U.S., we’re still cleaning up the mess and we don’t want to get stuck with those things. We want to avoid those problems,” Okalik said. “[And] we want to be involved in any work to be done.”