Picco says he’ll press Ottawa for more NIHB money

MONTREAL — Health Minister Ed Picco says the federal government is short-changing Nunavut through its main aboriginal health funding program, the NIHB, and that he wants Ottawa to fix the problem. Health Canada’s Non-Insured Health Benefits Program provides medical goods and services to all Inuit and First Nations peoples, including drugs, dental care, vision care, medical supplies and medical transportation.

Payment for these non-insurable benefits comes mainly in the form of direct transfers to the Nunavut government.

But Picco says the amount of NIHB money spent in Nunavut doesn’t meet the actual costs or needs of Nunavut’s young and growing population.

To fix this, Nunavut’s health minister plans to lobby for changes in the way Ottawa calculates Nunavut’s NIHB payments.

“All I’m asking for us is a fair share,” Picco said.

While the federal government, in theory, pays the full cost of providing various benefits, in reality, Nunavut is shortchanged. That’s because what Health Canada pays out doesn’t cover the full cost of offering the services.

As well, the NIHB pay-outs aren’t keeping pace with Nunavut’s rapidly increasing health costs. “There’s an escalator in the NIHB of 3 per cent, but my costs are increasing by 9 per cent,” Picco said.

This difference alone costs the territorial government a few millions dollars a year, Picco said. Some non-insurable benefits also have individual caps, too. These put a limit on the number of certain medical treatments an eligible person may receive in one year.

The territorial government isn’t always fully reimbursed, either, for special services such as speech pathology, physiology or audiology.

“Either we’re without the full billing or not at all,” Picco said.

This means Nunavut is hit with a whack of additional expenses per year simply because it’s providing Inuit with the health care they need.

Picco attributes this shortfall to the agreement that Ottawa struck with the government of the Northwest Territories in 1988 to devolve responsibility for health care from the federal Department of Health and Welfare to the territorial government.

“The government of the day was so hot to take over the health care that a better deal could have been struck,” Picco said.

Under the current agreement with NIHB, for example, Ottawa pays only $250 of the cost of each medical travel trip required by Nunavut residents, only a small fraction of the actual cost of airfares to and from Nunavut.

Picco wants this amount to be increased and the formula changed so that it covers up to 20 to 30 percent of the real cost of getting a patient to medical services. This move alone could boost Nunavut’s health budget by a few million dollars.

Over the next few months, Nunavut plans to prepare its case for more money for Health Canada. A new NIHB deal, which was to have been signed for March 31, has a renewable extension, without prejudice, until at least the end of June.

In order to strengthen its hand, Nunavut health department officials want to know exactly where, how and on whom money is spent.

The whole picture isn’t easy to see, however, due to the complex method Ottawa uses to hand out NIHB money.

Most of the money spent on medical travel is thought to go towards the delivery of health care to babies, children and expectant mothers.

In this year’s throne speech, the federal government promised to spending more money on aboriginal health and children, promises that may help Nunavut’s arguments for more money.

Federal Health Minister Allan Rock was to have visited Iqaluit in March to learn first-hand about Nunavut’s challenged health care system, but because of a recent operation prostate cancer, Rock has postponed this visit indefinitely.