Mr. Speaker, in discussions with people in Edmonton East over the past number of months, one concern keeps coming up with increasing regularity: where is medicare headed in Canada?
Canadians value the system of universal health care. Medicare is one of the fundamental elements of our Canadian identity and of our shared commitment to fairness, equity and compassion.
However, Canadians recognize that the health care system must adapt and evolve within the guiding principles of the Canada Health Act. It is not enough to say that we spend $72 billion on health care without knowing whether we are spending it in those areas where it makes the most difference to Canadians.
Residents of Edmonton East want the government at the national and provincial levels to work together to ensure accessibility and quality in health care and to sustain a health care system that respects the five principles of the Canada Health Act: universality, accessibility, comprehensiveness, portability and public administration.
How do we renew our health care system to meet the needs of consumers in a cost effective and efficient manner? What are the implications of allowing greater private funding in our health care system?
There is concern in Edmonton East that private funding competing with a public system will create a two-tier system where access and quality will be based on ability to pay rather than medical need.
To the ideologically driven in Alberta, an increased private presence in the funding and delivery of health care is the answer to controlling costs and improving accessibility. But is it? In the industrialized world, the United States is the best example of a health care system which relies extensively on private funding.
Let us examine the U.S. health care experience in more detail. More private money in the U.S health care system should result in a better standard of health care for Americans but clearly that is a myth. A significant amount of health care spending in the United States is to support an extensive bureaucracy that has evolved under a multiple player system. The average American under a private insurance scheme pays $150 a year in administrative costs alone, compared to $23 for the average Canadian.
Respected Canadian health care economist, Robert Evans, put it most succinctly when he stated: "Canadians provide care. Americans shuffle paper". Not only is the U.S. health care system plagued by skyrocketing administrative costs and a bureaucratic jungle, it is also plagued by inequities and lack of access.
For older Americans, 65 years and over, out of pocket costs consume 23 per cent of their household incomes. For older Americans with family incomes below the poverty line, out of pocket expenses consume 37 per cent of their incomes. Most telling, the number of Americans who are uninsured continues to grow at an alarming rate. Nearly 40 million Americans or 15.3 per cent of the population had no health insurance coverage at all. The total number of uninsured American children under the age of 18 is 9.5 million or 24 per cent of all American children under the age of 18. The total number of uninsured Americans earning an average family income of $15,700 is nearly 15 million.
This leads me to a second element that private funding components have failed to address adequately: the ability to control health care costs. Cost containment is a necessity if health care is to be sustained and preserved in today's fiscal climate but cost containment in health care is not achieved by shifting the cost burden on the Canadian consumer through de-insurance, de-listing or user fees.