Premiers say yes to Nunavut health needs

Canada’s premiers said yes to Nunavut’s special health funding needs last week, boosting Premier Paul Okalik’s hopes that a three-day first ministers’ conference on health care reform starting Sept. 13 will produce real help for Nunavut.

The 13 territorial and provincial premiers emerged from a two-day meeting in Niagara-on-the-Lake west of Toronto last Friday with a bold new demand at the top of their wish list: the creation of a nation-wide pharmacare program, whose multi-billion dollar cost would be paid entirely by the federal government.

But it’s their second wish list item that pleases Okalik the most. Premiers now back the idea that Ottawa should pay the full cost of medical travel for all residents of Nunavut, an arrangement that could save the GN millions of dollars a year.

“In keeping with the principles of universality and accessibility, the health agreement must include dedicated funds to reimburse 100 per cent of all medical travel costs in respect of the residents of the three territories and Labrador,” the premiers’ communiqué says.

In doing so, the premiers agreed that the “challenges and special circumstances of remote health care delivery in the Territories and Labrador” must be part of any new health funding deal between Ottawa and the provinces and territories.

“What my colleagues recognized is that in Nunavut, to get health care, we have to travel, whether it’s within Nunavut or to southern Canada, and we understand that is an added cost that should be borne by the federal government, because it affects us as Canadians, and we should be entitled to the same type of service as any Canadian,” Okalik said in an interview with Nunatsiaq News.

There’s no guarantee that the federal government will agree to the provinces’ wishes. The 100-per-cent medical travel measure simply represents part of the position that provinces and territories will take into next month’s health care reform meeting, which will be broadcast live on television.

Prime Minister Paul Martin promised in his recent re-election campaign that he wants to use that meeting to create a permanent fix for Canada’s perennial health funding woes.

Right now, the federal government, through its Non-Insured Health Benefits program, pays only $250 per flight, per patient, for medical travel and for Inuit patients only. The Nunavut government pays the rest out of its general revenues.

For non-Inuit, medical travel is a confusing labyrinth, especially for people who work for employers that don’t offer supplementary health insurance. Some non-Inuit have to pay a portion of their medical travel costs out of their own pockets.

And despite the GN’s new medical travel contracts with airlines, the ever-rising cost of moving patients, and patient escorts, to and from hospitals in the South or to and from one part of Nunavut to another, has caused Nunavut’s health department to overspend its budget in every fiscal year since 1999.

As in all other jurisdictions, the cost of running the health care system is now sucking money out of other areas of government. For the 2004-05 fiscal year, the GN’s finance department clawed $20 million out of every other territorial government department to find enough money for the Department of Health and Social Services.

So Okalik is pleased that premiers also gave support to the idea of restoring cuts to the formula funding base used to calculate Ottawa’s annual transfers to the territories.

In Nunavut’s case, those annual formula financing grants represent about 90 per cent of the money that it gets from Ottawa every year to run the Nunavut government.

“My colleagues also recognize that there are additional costs that Nunavut must bear because of past cuts in relation to things like housing or education, that affect Nunavut, and they support us in our efforts to renegotiate the financing formula to cover those costs from the national government,” Okalik said.

In 1995, when Paul Martin was the country’s finance minister, the federal government cut the territorial formula funding base by 5 per cent. Despite years of lobbying by territorial leaders, the federal government has never restored those cuts.

Okalik says it was useful to have three national aboriginal leaders attend last week’s premiers’ meeting, especially Jose Kusugak, the president of Inuit Tapiriit Kanatami.

“Jose was very helpful in explaining the issues that we need to deal with in Nunavut and making sure that they were adequately addressed,” Okalik said.

In their communiqué, premiers also pressed the federal government to live up to its responsibilities for aboriginal health care in Canada.