To charge, or not to charge.

That is the question before government with respect to recommendations for new and higher fees for medical services made in last year's Yukon Health Care Review.

Among the recommendations are $54-per-month health care premiums for individuals, user fees for out-of-territory medical travel, higher premiums for chronic care plans (based on a person's ability to pay) and higher costs for long-term care.

While Premier Dennis Fentie maintains the government will not implement any new fees, Opposition Leader Arthur Mitchell believes Health Minister Glenn Hart is sending mixed messages.

"The minister said, '... the installation or implementation of a fee for health services, that's something that will have to be determined by cabinet and not by me, and we will go from there,'" Mitchell said, quoting Hart's remarks during Monday's budget debate. "It's clear the premier and the Minister of Health and Social Services are not in agreement on this issue."

But the premier called that reading of the situation "mistaken" before attempting to school the Liberal leader on Yukon Party decision-making, via Fentie's view of the "democratic process"

"At least under this government, cabinet does make decisions and that's how (it) works. So of course the minister would present that (view) to the House," said Fentie. "It's not the minister's position to dictate to matters of decision; that's a fact."

Another fact, according to the review, is that increases to health care spending are unsustainable.

"If nothing is done to control the rate of growth of health care expenditures or increase revenues to fund it," reads the September 2008 review, "the growth of health care expenditures will result in a funding gap that could be as much as $250 million by 2018."

In the 2009/2010 budget currently before the House, $229 million is allocated for health care. Since Fentie's government took power in late 2002, operating costs for the Department of Health and Social Services have ballooned by 54 per cent.

Like the review, Dave Hrycan, the deputy finance minister, also calls the upward spending trend unmanageable.

"The more allowance you give to one child, the less you have for the other, and I think that's what the health care report is getting at," he told the Star last November.

Then, Mitchell and Fentie clashed in the assembly over what the government plans to do about addressing the rising costs of health care delivery.

"We don't need a public consultation to tell us that Yukoners don't want to pay more for health care," said Mitchell. "The answer is obvious and the answer is no."

Health care premiums were a reality in the Yukon until 1985, when the Yukon Liberal Party, supported by Tony Penikett's minority NDP government, called for the fees' elimination shortly after that year's territorial election.

The purpose of the health care review and subsequent report on what changes, if any, would be made to the current system, according to Fentie, is to make the business case for the continuance of access funding arrangements with Ottawa.

Yesterday in the legislature, Fentie went on record that the government will not raise current health care fees, stopping short of offering a guarantee that no new fees will be implemented.

"Is the government intending to raise fees? No - as has been articulated in this House before, and will continued to be articulated in this House."