House of Commons Hansard #52 of the 37th Parliament, 3rd Session. (The original version is on Parliament's site.) The word of the day was services.

Topics

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4:55 p.m.

Canadian Alliance

Art Hanger Canadian Alliance Calgary Northeast, AB

Mr. Speaker, I have listened to the hon. member across for 20 minutes as he was basically spouting Liberal propaganda on health care issues. I think he has kind of defined the Liberal position there somewhere. Unlike my colleague from Prince George--Bulkley Valley, I am not appalled by what I hear because this is pretty much the common mantra coming from the Liberal side.

I would like to ask the member a technical question. I know it might be hard for him to grasp this, but I am going to ask him to comment on it. Would the hon. member encourage his party to conduct a social audit, under the existing Office of the Chief Actuary, dealing with medicare and health care?

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4:55 p.m.

Liberal

Jim Karygiannis Liberal Scarborough—Agincourt, ON

Mr. Speaker, I guess the parties across the way are not hearing very well, so let me read another couple of quotes. On the Romanow report, the Leader of the Opposition said:

So why is the federal government going to spend millions of tax dollars to run an inquiry into the health care system? The answer is likely so that it can insist upon finding a 'national solution'--precisely the opposite of what the system needs...Given such a challenge, what we clearly need is experimentation--with market reforms and private delivery options within the public system.

I underline “private”. I capitalize it. I am astounded that they cannot read it, they cannot remember or, selectively, their memory has faded on them.

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4:55 p.m.

Canadian Alliance

James Moore Canadian Alliance Port Moody—Coquitlam—Port Coquitlam, BC

Mr. Speaker, I have a quote from a Liberal member of Parliament. The Prime Minister has authorized this person to become a Liberal member of Parliament, a Liberal member of Parliament sitting on that side of the House; this person is going to be a Liberal candidate in the coming campaign and this person wrote the following newspaper article when he joined the Liberal caucus. He said:

One option the provinces should consider is to allow private facilities to operate completely independently from the public system. The money to pay for these services would come from private hands, not the government.

That was said by a Liberal member of Parliament.

I want to know from this member, is the current Prime Minister going to sign this Liberal candidate's nomination papers, yes or no--

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4:55 p.m.

The Acting Speaker (Mr. Bélair)

Order. The hon. parliamentary secretary.

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4:55 p.m.

Liberal

Jim Karygiannis Liberal Scarborough—Agincourt, ON

Mr. Speaker, I would like to talk about the leader, never mind a backbencher. The leader of the Reform-Conservative-Alliance Party states--

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4:55 p.m.

An hon. member

Answer the question. Is he going to sign the papers?

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4:55 p.m.

The Acting Speaker (Mr. Bélair)

Order. We have only 40 seconds to go, so please hold it for 40 seconds. The hon. parliamentary secretary.

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4:55 p.m.

Liberal

Jim Karygiannis Liberal Scarborough—Agincourt, ON

Mr. Speaker, the Leader of the Opposition stated:

The Canada Health Act, at least it has been interpreteed, prevents co-paymnt, user fees, these kinds of things. Surely in some cases these would be preferable to taking services and options out of the public system entirely.

I am just wondering if opposition members have conveniently stopped learning how to read. Are they conveniently backtracking? Or do they just not know what they are doing? I think it is the latter.

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4:55 p.m.

NDP

Lorne Nystrom NDP Regina—Qu'Appelle, SK

Mr. Speaker, today I rise to support this motion in the House calling on the federal government to end the drift toward privatization of the health care system. I want to share my time with the member for Palliser.

I want to say at the outset that, despite protests, the Liberal government across the way, because of its cutbacks in funding, has provided a great deal of momentum for the privatization of health care. In fact, it is sounding as bad as the Conservatives across the way. We all know where the Conservative Party stands, that party of Brian Mulroney, that party of Mike Harris, that party of Grant Devine, in terms of calling for more and more private health care over the years. Now the Liberal Party is doing the same thing.

I wish we had a member across the way. They are terrified in downtown Toronto, where the Liberal Party is going to suffer many lost seats on June 28. When the Prime Minister drops the writ, many of the members across the way are going to go down in defeat to the NDP, mainly because the Liberal Party in this country today is led by a conservative.

The people of this country need an alternative and we are providing the only alternative for the people of this country, for a publicly administered, single payer, not for profit health care system in Canada. It is not being offered by the Liberal Party and it is not being offered by the Conservative Party. That member hangs his head in shame on the backbenches.

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4:55 p.m.

An hon. member

He should come back and take his medicine.

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4:55 p.m.

NDP

Lorne Nystrom NDP Regina—Qu'Appelle, SK

What has happened is that we have had radical cutbacks by the Liberal Party to health care funding in Canada. Back in the 1960s, the NDP managed to force the Liberal Party to bring in national health care. I know that the member across is running in shame and hiding his head.

When the NDP managed to force the Liberal Party under Pearson to bring in health care, it was funded on a fifty-fifty basis by the federal government and the provinces, but there have been massive cutbacks by the federal government. Now the federal government funds only about 16% of health care and the provincial governments about 84% in terms of cash payments for health care in the country.

What we in the NDP are saying, and it is what Roy Romanow said as well, is that the federal contribution to health care should be brought up to 25% of the total costs.

What does that mean? In my province of Saskatchewan, which is one of the smaller provinces of the country, the health care budget this year was $2.69 billion. That is an increase of 6.3% in the last year. In other words, the Saskatchewan NDP government has been funding health care at a rate higher than the inflation rate, so it has been keeping up, but despite that, health care is underfunded in my province, just as it is in other provinces. If the federal government increased its share from 16% to 25%, it would be an additional $306 million per year for the province of Saskatchewan. That would be a significant contribution to the Saskatchewan health care system.

In British Columbia--the member for Vancouver East is here--if the federal government paid 25% of the costs instead of 16% there would be an additional $1.1 billion put into the health care system there. In Alberta, it would mean an additional $751 million. In Quebec, there would be an additional $2.15 billion in health care funding. In Newfoundland and Labrador, it would be an additional $175 million.

In New Brunswick--the member from New Brunswick is across the way--it would be an additional $214 million if the federal government paid 25% of the costs as opposed to about 16% of the costs. Imagine what that extra $214 million would mean for a province like New Brunswick. That is an awful lot of cash for the health care system in the province of New Brunswick. We should not forget that is at only 25%. In the 1960s when the health care system was brought in, the federal government paid 50% of the costs. Now it pays 16% of the costs and the NDP is recommending 25% of the costs. That would be an extra $214 million for the province of New Brunswick.

Prince Edward Island would get another $43 million if the federal government paid 25% of the cost of medicare for Canadian provinces. Manitoba would also receive a large increase and Quebec, as I mentioned, would receive another $2.15 billion.

In every province in this country there would be a large increase if the federal government were to pay some 25% of the costs of health care.

Therefore, one thing that has to happen is more federal health care money coming into the health care system. The other concern we have is the privatization of health care in this country. It has increased during the Liberal Party's term of office. The main reason for it is that they have starved and strangled the health care system. When we starve the health care system, we force the provinces to look elsewhere and we have seen the establishment of some private clinics, some private health care facilities, some for profit health care facilities.

I believe that health care in this country should be provided on a non-profit basis. It should be a public system, accessible to each and every single Canadian, regardless of the thickness of one's pocketbook or wallet.

That is not the way the government across the way is going. The health minister himself was open to more privatization in the health care system. I do believe that is absolutely and totally wrong. The Minister of Health, just a few days ago, made this statement:

If some provinces want to experiment with the private delivery option, my view is that as long as they respect the single-payer, public payer, we should be examining these efforts.

So the Liberals want to explore the private delivery of health care, and we do not have private delivery in health care unless we build in the profit motive. The profit motive has to be there to attract private investment and the minister is open to private investment. He is open to for profit health care. I believe that is the wrong way to go.

It is the way of the Conservative Party. The member from Penticton is leaving. I remember that his great leader Brian Mulroney talked at one time of greater health care. His friend in Ontario, Mike Harris, did exactly the same thing, and Grant Devine in my province of Saskatchewan. Now we have this other great conservative party, led by the Prime Minister from LaSalle—Émard--

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5 p.m.

An hon. member

Oh, oh.

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5 p.m.

NDP

Lorne Nystrom NDP Regina—Qu'Appelle, SK

--that is also talking about health care, and now I am being heckled by the member from Vancouver.

With me I have a quote from the current Leader of the Opposition, from the Toronto Star of October 18, 2002, in which he was critical of the report on the future of health care and especially for its failure to call for privatization. He said:

Romanow virtually ruled out any new ideas for the provision of private-sector services within the public system, and even talked about expanding the existing system.

In other words, the Conservative Party is upset that Romanow did not talk about more private sector health care. It is upset that Romanow called for the expansion of public health care.

We know exactly where the Conservative Party stands. The Conservative Party wants two tier health in this country, a private system, a for profit system of health care in this country, where the rich can afford to pay for it and the poor line up at second-rate hospitals.

That is exactly where the member for Saskatoon—Rosetown—Biggar stands in support of her leader: for more private health care. I will be very interested when the people on the doorstep in Saskatoon—Rosetown—Biggar hear this from this party. People are watching this today. I will quote from the Toronto Star once again. The Leader of the Opposition is saying that he is critical of Romanow because of his failure to call for privatization of health care. He said:

Romanow virtually ruled out any new ideas for the provision of private-sector services within the public system and even talked about expanding the existing system.

Is it not a horror show that Mr. Romanow and the NDP want to expand public health care in this country? Here we are with the Conservative Party, which wants more private, for profit health care, that party of Brian Mulroney.

The people back home are interested in this too. The Conservative Party now has been endorsed by Brian Mulroney. In Moncton, Brian Mulroney, the great hero of western Conservatives, endorsed the Conservative Party. The current leader was happy to have that endorsement. The current leader is saying that history will judge Mr. Mulroney very well. Of course: this is coming from a Conservative about another Conservative. They are proud of Mike Harris, the Mike Harris who wanted to set up private hospitals and privatize health care and privatize everything in the world. They are proud of Grant Devine, another Conservative premier of my province of Saskatchewan.

That is the Conservative Party. The people of this country will not be fooled when they go to the polls and see this party of Brian Mulroney that wants to privatize health care. That is exactly where they are. I wonder where the old-fashioned, populist Reform Party has gone to. Those members get to Parliament for a few years and enjoy their salaries and their pensions, and then suddenly there is a metamorphosis and they come out as Brian Mulroney's Conservatives.

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5:05 p.m.

The Deputy Speaker

I just wanted to seek assurance from the hon. member for Regina—Qu'Appelle that in fact he was splitting his time with a colleague. If he is splitting his time, I would have to inform him that his time is up and we will go to questions or comments.

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5:05 p.m.

Canadian Alliance

James Moore Canadian Alliance Port Moody—Coquitlam—Port Coquitlam, BC

Mr. Speaker, I certainly agreed with one thing in the comments of my friend from Regina—Qu'Appelle. That is the idea that the fiscal reality that came from Ottawa that choked off health care spending in the mid-1990s was certainly a detriment to the delivery of health care services in this country.

There is a flip side to that coin which is that the delivery of health care services in Canada is provided by the provincial governments. We all know that. One side of this equation is that on the one hand the cut in transfers to the provinces by the Liberals in Ottawa certainly damaged health care delivery services.

As a member of Parliament and a citizen of British Columbia I have to say that the NDP has far from solid ground to stand on when it comes to chiding other levels of government about responsible fiscal management and what that means to the delivery of health care.

The member talked accurately about the $250 million sponsorship program and how that money might have gone to help health care. I agree with him on that but what was missing from his rant was his equal condemnation of the $500 million wasted on the fast ferry project in British Columbia. That money could have gone a very long way to helping the people who are dying while on waiting lists in the province of British Columbia. The quality of life and standard of living is being damaged in the province of British Columbia because of the dramatic fiscal mismanagement of his own party, the NDP.

The cutbacks that came from Ottawa did not help, but it is utter hypocrisy for any New Democrat to stand in the House and say that the NDP has solid ground to stand on. The NDP has utterly no ground to stand on when it comes to proper fiscal management, when it devastated my province of British Columbia and caused a total financial meltdown, that caused people's lives to be in jeopardy in British Columbia.

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5:10 p.m.

NDP

Lorne Nystrom NDP Regina—Qu'Appelle, SK

Mr. Speaker, I am glad the Mulroney Conservatives are applauding that comment.

The member from British Columbia must be deaf in his left ear because I never even mentioned the sponsorship program in my remarks. He was complimenting me on my comments about the sponsorship program but I never mentioned it at all.

If is funny if the people of British Columbia are that upset with the NDP because the NDP is now skyrocketing to the top of the polls. His friend Gordon Campbell now is trailing the NDP in British Columbia, or he is darned close to trailing. I have seen polls in British Columbia that are tied with the NDP slightly ahead. At any rate the NDP is skyrocketing in British Columbia.

I am glad he also raised the question of fiscal responsibility. The record in this country shows that the NDP provincial governments in Saskatchewan and Manitoba over the years have been leading examples of fiscal responsibility. When there was a Conservative government led by his friend Grant Devine in my province, he almost bankrupted the province of Saskatchewan. His Conservatives also had 16 criminal convictions of fraud in Saskatchewan.

That great conservative hero of the member for Port Moody—Coquitlam—Port Coquitlam, George Bush, is running one of the biggest deficits in the history of the world. We could go back to the 1930s and who had the great debts were the Conservatives under R.B. Bennett. All over the place it is the Conservatives who are fiscally irresponsible with taxpayers' money.

Here we have the Conservative Party--

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5:10 p.m.

Canadian Alliance

James Moore Canadian Alliance Port Moody—Coquitlam—Port Coquitlam, BC

Mr. Speaker, on a point of order, I do not believe that George Bush is actually the premier of British Columbia. Perhaps the member for Regina—Qu'Appelle could address his answer to the question about the province of British Columbia for once.

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5:10 p.m.

The Deputy Speaker

I do not think that is a point of order so let us get back to the debate.

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5:10 p.m.

NDP

Lorne Nystrom NDP Regina—Qu'Appelle, SK

Mr. Speaker, I did and I said that in British Columbia the NDP is skyrocketing in popularity. We will see on election night the great loss of Conservative seats in British Columbia federally as people react against the Conservative Party.

The member also asked about fiscal responsibility and about what social democrats do. I told him what happened in Saskatchewan and Manitoba, the record of Tommy Douglas and Alan Blakeney and Roy Romanow right up to the current day, or Ed Schreyer in Manitoba and Howard Pawley and Gary Doer in Manitoba. These are examples of governments that are fiscally responsible compared to the Conservatives.

The Conservative Party of Grant Devine, they worship people like them. They are their heroes. The Conservative government of Grant Devine almost bankrupted Saskatchewan. We could look to their great leader Brian Mulroney and the great debts that he had. Mulroney was the leader of the Conservative Party.

It is going to be very interesting in Blackstrap for example, to ask the ordinary people what they think of Brian Mulroney and the Conservative Party. There are some people here who fought really hard against Brian Mulroney and now all of a sudden he has endorsed the party, he is the former leader and they worship this guy. It is the same old party once again.

George Bush is running up a huge deficit in the United States and yet they worship him. They want us to go to war in Iraq. They want to send young people to Iraq who would be killed there. George Bush is the guy who lied to the world and lied to Congress about weapons of mass destruction, yet they support George Bush all the way.

People do not want that kind of extremism in our country. That is why the NDP is now the alternative to the government across the way. That is why the NDP is on the march. That is why that extremist republican party north is going to be marginalized after the next campaign.

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5:10 p.m.

NDP

Dick Proctor NDP Palliser, SK

Mr. Speaker, I want to congratulate my colleague from Regina--Qu'Appelle. We are debating, as we wind down, that the House condemn the private for profit delivery of health care which the government has encouraged since 1993, and of course I am delighted as always to have the opportunity to speak.

I have the opportunity to speak, and for that I want to thank the Conservative Party, because it has managed throughout the course the day, a full day of debate on this important topic, to put forward one speaker all day long, a handful of hecklers and people who would have questions and comments, but one speaker. It has 75 members and purports to be the government in waiting, the official opposition that is ready to take over. By any public opinion poll, health care is the issue in Canada. We have a debate on private for profit health care and it has managed to put up one speaker all day long.

The New Democratic Party has carried this debate from start to finish, as admittedly it should because it introduced the motion. It is absolutely mind boggling and bewildering that the so-called official opposition has been able to put up only its health critic to take part in a significant and important way in a very important debate. Presumably the Conservatives are suggesting that their leader said everything that needed to be said yesterday on the topic when he introduced that party's platform on health care. Of course there would be no need to add or embellish perfection, if that were the case, except that the leader of that party has over the years said many things on the topic of health care and the private delivery thereof. I would like to note one or two of those.

In the House in October of 2002, the current leader of the Conservative Party said:

Monopolies in the public sector are just as objectionable as monopolies in the private sector. It should not matter who delivers health care, whether it is private, profit, not for profit, or public, as long as Canadians have access to those services...regardless of their financial needs.

Also in 2002, the leader's website--and I cannot remember which party he was running for at that time; he has been in so many leadership campaigns--stated:

Favours diminishing the Canada Health Act to allow provinces to “experiment with market reforms and private health care delivery options. [The leadership candidate] is prepared to take tough positions including experimenting with private delivery in the public health system”.

The point I am driving home is the Conservative position is that it does not matter who delivers health care or how it is delivered, as long as it is accessible. That is the point they make repeatedly.

The for profit health care folks deny the same level of care. People have pointed out that where they have made comparisons, the death rate in the for profit health model is significantly higher. The point has been made by the Canadian Health Coalition that 2,000 more Canadians per year would die under a for profit system than under a not for profit system.

Mr. Mazankowski, a well-known former Conservative cabinet minister and deputy prime minister, asked at the Romanow commission hearings a couple of years ago why everyone is afraid of private provision of health care; if the customers are not satisfied they will go out of business. There was a similar comment from Senator Michael Kirby who did that institution's report on health care. He said, “We do not care if health care is privately delivered. Frankly we do not care who owns the institutions”.

I want to refer to somebody who does care about how health care is delivered and who pointed out the difference very clearly and very eloquently. I am referring to Dr. Arnold Relman, professor emeritus of medicine and social medicine at Harvard Medical School. He was on Parliament Hill a couple of years ago to tell a Senate committee about the U.S. experience on health care. Dr. Relman said:

My conclusion from all of this study is that most of the current problems of the U.S. system--and they are numerous--result from the growing encroachment of private for-profit ownership and competitive markets on a sector of our economy that properly belongs in the public domain. No health care system in the industrialized world is as heavily commercialized as ours, [referring to the United States] and none is as expensive, inefficient, and inequitable--or as unpopular. Indeed, just about the only parts of U.S. society happy with our current market-driven health care system are the owners and investors in the for-profit industries now living off the system.

Dr. Relman went on to say:

Private health care businesses have certainly not achieved the benefits touted by their advocates. In fact, there is now much evidence that private businesses delivering health care for profit have greatly increased the total cost of health care and damaged--not helped--their public and private non-profit competitors.

He pointed to the example of the failure of the commercial HMOs in the United States, an insurance system that was seen a few years ago. Senior citizens covered by medicare in that country were encouraged to obtain their care from private for profit HMOs that would be paid by the government. It soon became obvious that the costs of care out of the private system were much greater and that senior citizens were dissatisfied with the care they received. A wholesale exit of senior citizens from the private system ensued. They voted with their feet, in other words, for the public system. He concluded by saying:

--the U.S. experience has shown that private markets and commercial competition have made things worse, not better, for our health care system. That could have been predicted, because health care is clearly a public concern and a personal right of all citizens. By its very nature, it is fundamentally different from most other good[s] and services distributed in commercial markets. Markets simply are not designed to deal effectively with the delivery of medical care--which is a social function that needs to be addressed in the public sector.

We submit that there is a very significant difference in how health care is delivered. We want to see it delivered in the public domain. Our party's point is that there is really very little difference between the Liberal and Conservative parties on this subject. I know the government and the Prime Minister have been trying to suggest that there is a vast difference between what they would do and what a Conservative Party in power would do on the delivery of private for profit health care. We know there is very little difference.

Over the weekend and yesterday it was interesting to hear some comments by Tom Kent who has played a very significant role in this country, particularly in the federal government and in the Liberal Party over many years. He was talking about Paul Martin Sr. and the role that he played in health care after the Prime Minister's apparent outburst in caucus last week about how his father's party was not going to give up on this. Mr. Kent's recollection, as substantiated by Paul Hellyer who was in cabinet at the time, was that Paul Martin Sr. had a relatively minor role to play in all of that.

More important and in regard to today's debate, Mr. Kent was passionate in his complaints about what he felt the present Prime Minister did to undermine medicare when he was finance minister between 1993 and 2002. Mr. Kent said:

[The] 1995 budget...ended all pretense of a commitment [to medicare] and substituted just the [Canada Health and Social Transfer], which is an arbitrary amount...as distinct from a commitment to a share in provincial costs.... The contract for medicare was already tattered. In 1995, it was unilaterally and unceremoniously thrown out.

In conclusion, our position in this party is that there is very little difference between those two parties on the issue of private for profit delivery of health care. We think it is the New Democratic Party that will stand to speak on this issue and to benefit from the lack of direction from the government and the official opposition on this very important matter.

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May 11th, 2004 / 5:25 p.m.

Liberal

Jeannot Castonguay Liberal Madawaska—Restigouche, NB

Mr. Speaker, I listened with a great deal of interest to the presentations of the two hon. members who just spoke. I think we can agree that currently in Canada doctors are providing excellent services.

We also know that the majority of these doctors are private entrepreneurs. They are paid a fee for service, and if they do not work, they are not remunerated. If they do work, they are. It is up to them to take care of their own fringe benefits.

My colleague is simply suggesting that we stop this type of practice in Canada and that all doctors should be salaried public workers. I wonder if we would receive better care that way. Would the cost be any different?

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5:25 p.m.

NDP

Dick Proctor NDP Palliser, SK

Mr. Speaker, I certainly think people who work in the profession feel that if we had doctors paid on a salaried basis, it would help matters. I worked in the department of health in the province of Saskatchewan before coming to this place. One thing the department was working on was exactly that. It was trying to get doctors off of a fee for service arrangement and onto an annual salary.

I am pleased to say that I belong to the Regina community clinic on Winnipeg Street in Regina. There are roughly half a dozen doctors there and they are all on a salaried basis. Progressive governments that are looking for choices on this would like to see more doctors on salary rather than on a fee for service basis so we can try to reign in some of the costs.

When Mr. Romanow was the premier of the province of Saskatchewan, he used to say that the province could spend 100% of its money on health care and it still would not be enough. Of course there had to be money to pay down the debt left over from Grant Devine and for education, roads and a number of other things. However, this has become a juggernaut over the last 10 years that has grabbed provinces like Saskatchewan and most others in the country, and it will not let go because of the rising costs.

I have less concern overall about the doctors on a fee for service basis than I have on private MRIs. Inevitably, built into those private MRIs will have to be a profit motive. That is our concern. We want to limit and reduce the for profit delivery rather than see it escalate in the years to come.

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5:25 p.m.

Canadian Alliance

Lynne Yelich Canadian Alliance Blackstrap, SK

Mr. Speaker, I really have to wonder if the two members who spoke before are really from Saskatchewan. What I heard was incredible. They are talking about trying to debate health care. Health care is what we should be debating. All I heard was a rant. I do not believe they are really concerned about health care one iota. If they were, they would go home and try to access our health care. It is not always accessible to those with real health problems.

I can tell about a person who went in for a knee operation. He was quite healthy and was told to have both knees operated on at the same time. He had both done at the same time and never came out of the hospital. I can tell about a person who had to go back into the hospital to have a limb re-broken. What about the workmen's compensation patients who go to Calgary for MRIs because our province does not have an MRI machine available for Saskatchewan workmen's compensation clients?

That is why nobody wants to participate in this debate. It is sickening.

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5:25 p.m.

NDP

Dick Proctor NDP Palliser, SK

Mr. Speaker, one hardly knows where to start on that. I would just repeat what I said a minute ago. When provinces are carrying 84¢ of the dollar and the federal government is only putting in 16¢, it is very difficult for provinces like Saskatchewan, with a million people and a small taxpayer base, to do all that.

However, perhaps the member for Blackstrap could make some of those approaches to the health minister across the way and point out some of the realities with which governments are dealing.

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5:30 p.m.

The Deputy Speaker

It being 5:30 p.m., it is my duty to inform the House that proceedings on the motion have expired.

The House will now proceed to the consideration of private members' business as listed on today's Order Paper.