Mr. Speaker, it goes without saying that I will use my 20 minutes, and more if the House gives its consent. This take note debate initiated by the government is an important event, because there is no greater priority than health care and its availability.
I would like to mention a number of historical facts to help clarify the situation in which we find ourselves. In 1984, the Liberal government was about to lose power. This was a washed up government, overtaken by events, plagued by patronage and bad budget decisions. The result was that Canada found itself faced with an anticipated budget deficit of several millions of dollars.
What is often overlooked is the fact that, during the last year of its mandate, the Liberal government—under then Minister of Health Monique Bégin—introduced a bill which became a very important piece of legislation, namely the Canada Health Act.
Of course, this bill could not have been introduced if the federal government had stayed within the strict confines of the respective jurisdictions of the two levels of government. We all know that the federal government cannot get directly involved in the delivery of health services, except in the case of aboriginals, penitentiaries, epidemics, quarantines, drug certification and its logical corollary, drug licensing.
In 1984, the federal government, on the advice of the Privy Council, which is often said to be Canada's largest department of political science given the scope of its resources, used its spending power has an excuse to introduce a national health act. This sparked a more or less general outcry.
Even in Ontario, doctors went on strike for days because they feared that, under this national health legislation, they might be restricted in their ability to organize their work.
The Canada Health Act established a number of guiding principles to direct the way the provincial governments would organize the health system. This is why the majority, if not all of them, were opposed to the legislation. In this House, however, in 1984, all parties supported the Canada Health Act, including the opposition—Brian Mulroney had just come into power. I do not, of course, include the NDP here, as we are all aware that its approach has always been centralist. In short, all opposition parties, including the one now in government, were in favour of the National Health Act.
To recap briefly, this act encompassed five principles. There was to be public administration. There was to be comprehensiveness, in other words the provincial or territorial health insurance plan had a duty to cover all insurable health services. There was to be a specific minimum of coverage, or comprehensiveness. Then, of course, there was universality, which continues to be discussed to this day. There was the principle of portability, which implied that we were part of a common market as far as health was concerned. By virtue of his mobility, a person in Alberta, Saskatchewan or Quebec was supposed to have the same coverage. This, of course, was the principle of accessibility.
At that time, with the debates in the House of Commons, there was confirmation and reaffirmation of the commitment made in 1957 and again in 1961, when the federal government passed the legislation on health insurance and on hospital insurance.
It is important to recall that at that time the federal government made a commitment to be a partner and pay 50% of health care costs. That is the irony of the situation in which we now find ourselves.
There have been a number of commissions of inquiry by the federal government, by the Senate, the other House; there have been several studies, such as the report of the Romanow commission that is expected at the end of November. We have been asked to reflect on how the health care system should be reorganized. I do not mean to suggest that this should not be done, and I will come back to this later before my time runs out, but we are sidestepping the most fundamental fact.
That fact is that the government with the most resources, the federal government, the government which made promises in the past to cover 50% of health care costs, has completely, or almost completely, backed out of this promise. In what can only be described as a betrayal, it has broken its past promises and it has gotten away with it.
When the debate took place in 1983-84, the federal government was a significant partner in health care funding. Today, the situation is so troubling that all of the premiers, from Bernard Lord—I do not mean to bring up bad memories for the Tories—in New Brunswick, to the New Democrats in Saskatchewan, including the government of British Columbia, and the sovereignist Government of Quebec, have formed a coalition. They have mounted a campaign, with ads running on television almost every day, to remind people of the extent to which the federal government has backed out of its commitments.
Do members know how much the federal government is investing? For each dollar spent on health care, the federal government's contribution amounts to 14¢. For every dollar spent, the federal government's contribution is only 14¢. It is incredible. The federal government has a surplus of $6, $8, $12, $15, or $18 billion, yet it is unable to honour commitments it made in the mid 1980s.
I do not mind commissions of inquiry, to reflect on the issue of health care and how to solve the problems and how to reorganize it, but I think we must remember the following three facts.
First, as we speak, seven of the ten provinces have already set up commissions of their own; they have done a diagnosis of their environment and are well aware of the main challenges facing them in coming years.
In the years since 1996, Nova Scotia, Prince Edward Island, New Brunswick, Ontario, Saskatchewan, Alberta and Quebec have conducted their own commissions of inquiry. They have themselves done a diagnosis of their environment and are fully aware of what major changes lie ahead in health.
Before discussing the substance, let us look briefly at these major changes affecting health. Regardless of who is in power in the various provinces, some things are certain. For one, people grow old; our population is aging and people are living longer. Today, we are no longer talking about the old, but the very old.
In our ridings, it is not unusual to meet people who are 80, 85 or 90 years old and who are in relatively good health. But this puts considerable pressure on the health care system.
My friend, the hon. Parliamentary Secretary to the Minister of Health, is himself an internist, if I am not mistaken. This brings me to what the main pressures on the health care system are. People are living longer and want to stay in the community as long as possible.
This is the whole challenge of primary care, natural caregivers and home care. So much so that, at present, with the great pressures put on the health care system, it is matter of figuring out how to reorganize care to allow people who, again, are living to be not only old but very old, to remain in their natural communities. The information required to manage these situations is available.
We will recall that, in its 1998 budget, the federal government established three funds, one of which was for the acquisition of new medical technologies and another for monitoring the evolution of the health care system. It is within this fund that, on the basis of the expertise they had and the work of the task forces they had set up, most of the provinces identified the major changes that lie ahead. Home support is a very important issue.
The second—and not the least—challenge we face is the advancement of medical technology. Equipment and facilities are evolving so quickly that there is a new generation of equipment every three years on the average. Of course, these are what help provide care and extend life expectancy, so that a number of sicknesses that were fatal fifty years ago have been conquered and are now chronic conditions instead. Medical technology has, therefore, a major role to play.
The acquisition of new medical technology has, however, meant that now forecast investments are not in the thousands or millions, but billions. Where cardiovascular disease alone is concerned, we have the possibility of prolonging people's life expectancy, but often at a cost of $800,000 to $1 million per person. That is what we have to deal with. We are confronted with the cost of medical acts that have to be performed by specialists.
After the challenges of extended life expectancy and medical technology, we have a third challenge: a whole new generation of drugs. There is no longer any question of reopening the debate on generic versus the patented drugs.
Let us not forget that, last year, the House passed a bill that was the result of the ratification of a treaty. Since Canada is a member of the Council for TRIP, or Trade-Related Aspects of Intellectual Property Rights, this means that some things are now illegal. Canada would be in violation of the treaty if it did not provide a 20 year protection for all patents. This is true for patents that relate to copyrights and to the pharmaceutical industry. So, this is now a moot point. Canada cannot amend its legislation.
I was a member of the Standing Committee on Health when it reviewed the Patent Act, in 1997. I was also there when the legislation was reviewed in 2000. We can no longer think that Canada can reduce its protection for patents. Three factors must be considered, namely the increased life expectancy of people, the new medical technologies and the new drugs.
For example, let us look at hospital budgets. When I meet with hospital administrators, the first thing they mention is that the issue of drugs impacts on the pressure that contributes to the operating deficits of hospitals.
The debate that will have to take place in the House will have to deal with pharmaceutical companies that do research. Of course, I am not denying that it is a major investment. I am convinced that the Secretary of State for Amateur Sport is aware of that, because he runs and he is in good health. In fact, I would like to challenge him. I would be pleased to go for a run with him whenever it suits him. Mr. Speaker, I run half an hour every day and I am in relatively good shape. But let us not forget that some our fellow citizens need drugs.