Inuvik (Sep 26/03) - A helping hand from the territorial government designed to help a minority may have the adverse effect on the majority.

In the mid-1990s, the GNWT instituted a $250 co-payment for anyone travelling due to medical reasons.

While some people are covered through their employer and aboriginals are reimbursed through Non-Insured Health Benefits (NIHB), others have no coverage.

Health and Social Services Minister Michael Miltenberger instituted interim changes to the plan that will cover those without insurance or NIHB plans.

Gerry Uswak, CEO of Inuvik Regional Health and Social Services Board, said the issue requires more thought.

"There is a segment of the population that has been designated as 'indigent,' who does not receive that co-payment, so they were personally responsible for those costs," Uswak said. "This was a change in the medical travel policy to bring those folks into the fold."

If the program is perceived by NIHB to be a universal service provided by the GNWT, they may withdraw their support to aboriginals who are currently covered.

"There is a potential risk for (NIHB) cancelling it for status clients, then the territory will be on the hook," Uswak said.

Pulling the rug out

IRHSSB chair Nellie Cournoyea said the federal government will likely interpret the program as a universal program and cease coverage to NIHB beneficiaries.

"They will claim that they are a funder of last resort," Cournoyea said. "We want to preserve the integrity of the Non-Insured Health Benefits in the long term."

"We're concerned that in making these decisions, it will allow the federal government to abrogate their responsibility." In the interim, the IRHSSB has to perform income verifications to all travelling patients.

"If we don't, we may have to incur a medevac cost that is not covered," Uswak said.

Even for a patient to travel South for a routine appointment with a specialist, the authority must first deem the patient eligible for the benefit.

"Do we ask them to bring in their tax return to see if they are over or above that $80,000 limit?" he asks.

"It's adding another level of administrative burden to continually do income verifications."

The authority has no power to demand income statements and should a client chose not to divulge their income, the authority could be left to recover the cost of the travel, which would add further administration costs and potentially more debt.

"Then do we have to chase down clients for payment and how will we make that payment if they don't," he asks. "It's a liability to us."