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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11:45 a.m.

Bloc

Pierre Paquette Joliette, QC

Mr. Speaker, one should never hesitate to be patient and I am pleased to see that you agree and have given me the floor.

I, too, would like to congratulate the hon. member for Hochelaga—Maisonneuve, who has given a brilliant demonstration of the problems in the health systems in the provinces and Quebec, and the relationship between these problems and the federal government's withdrawal from funding.

I would like to return to the question the Minister of Health asked during his speech. We know that there has been a withdrawal, and everyone agrees on that, including the finance ministers and premiers of the provinces. The Romanow report also made reference to it and all parties in the National Assembly are agreed. At present, the federal government's share of transfers to the provinces for health care costs stands at 14 or 15%.

We have found one other measurement that I think the hon. members would be interested in. In a report prepared by the former president of the Quebec treasury board, Mr. Léonard, it can be seen that in 1994-95 for every dollar the federal government collected in revenue, in all kinds of taxes, it invested 4.5¢ in the CHST. If we look at the breakdown in the CHST, 60% for health and 40% for other social programs, it means 2.8¢ for each dollar in revenue the federal government collected. That was at the time the Liberals took power, with the current Prime Minister as Minister of Finance.

In 2002-03, the federal government's share in health and social programs was only 2.7¢, or 1.7¢ on health for every dollar of revenue. And they want to make us believe there has been no federal withdrawal.

Once again, for the benefit of the our audience, I would like the hon. member for Hochelaga—Maisonneuve to explain the Liberal government's mathematical sleight of hand.

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11:50 a.m.

Bloc

Réal Ménard Hochelaga—Maisonneuve, QC

Mr. Speaker, I thank the hon. member for Joliette who, as you know, is my former professor of economics—a most fascinating course.

Basically, when the Liberal government came to power under Prime Minister Jean Chrétien, the Canada Health and Social Transfer was $18.7 billion. It has dropped as low as $12.5 billion. Today, as we know, the federal government's contribution is not even 16% for health spending.

This is utterly unacceptable, and I am counting on the Minister of Health to correct this situation.

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11:50 a.m.

Papineau—Saint-Denis
Québec

Liberal

Pierre Pettigrew Minister of Health

Mr. Speaker, I would like some clarification from the member for Hochelaga—Maisonneuve, who says that we should take Mr. Romanow's 25% funding model. Mr. Romanow was very specific, however. He said that the Canadian government should invest some 25% of funding in health, but that money alone would not be enough.

The supplementary sums of money to be invested in the health care system must allow us to make some changes that would ensure the long-term sustainability of our health care system.

I would like the hon. member to explain just how far he is going with Mr. Romanow. Did he just happen to focus on the 25% but not think it necessary or important to look at the recommendations in the Romanow report, which states that this money must be invested, in a sense, to ensure the long term sustainability of our health care system?

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11:50 a.m.

Bloc

Réal Ménard Hochelaga—Maisonneuve, QC

Mr. Speaker, I thank the minister for his question. I follow the Romanow report right from its beginnings until it hands on the torch to the Clair report.

The latter identified the reforms clearly. First of all, the Minister of Health must be aware that seven out of ten provinces held commissions to reform their system from the inside, and they have carried out that reform. The Romanow report says reforms must be carried out. This is true. The provinces need to have the torch passed on to them so that they may accomplish this.

The difference between the minister and us is that he suggests our fellow citizens need to be accountable to the federal government, whose share of funding is less than 16% but who would like to become the guardian of the health care system.

This is where we deviate from the Romanow report and the minister's position. We say that it is not true that the government, which makes a contribution of under 16%, will become the guarantor, the definer, the guardian of the system. There must, however, be reporting mechanisms, and the National Assembly will provide them.

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11:50 a.m.

NDP

Bev Desjarlais Churchill, MB

Mr. Speaker, I want to acknowledge your indication to try to correct a technicality in our presentation of the motion. As a result of it, I need to seek the unanimous consent of the House to proceed with my speech.

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11:50 a.m.

The Deputy Speaker

Is that agreed?

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11:50 a.m.

Some hon. members

Agreed.

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11:50 a.m.

NDP

Bev Desjarlais Churchill, MB

Mr. Speaker, I want to reintroduce the motion so people throughout the country will know specifically what we are dealing with here. The motion reads:

That this House condemn the private for-profit delivery of health care that this government has allowed to grow since 1993.

I want to emphasize that by saying that we are talking about the private for profit delivery of health care and that there is no question that privatization and for profit services have been increasing in Canada since 1993 by great amounts. If there is documentation out there contradictory to that, I am certainly willing to take it in, but, quite frankly, I would be surprised if anyone found it because we have numerous documents that say otherwise.

Canadians still raise health care as their number one priority: access to new technology for testing, receiving care in a timely manner, cost of prescription drugs, cost of home care services, availability of services throughout the country and the numbers of health care providers, as well as the increasing costs for services that are not presently covered.

Canada is regarded as having the best, most affordable health system in the world. When critics of our system, mostly private for profit interests, highlight the faults in our system they tend to compare us with the U.S. and they tend to focus on two areas: one, Canadians have to wait too long for tests or treatments; and two, if those who can afford to pay want to go elsewhere or pay a private service they should be able to do so and this would free up spaces in the public system.

A few months back, Belinda Stronach, one of the Conservative leadership candidates, stated that she favoured a two tier system. That was no surprise. Two tier health care favours the rich, but even the wealthy have difficulty with the expenses of a serious illness. Thus, we have the push for private insurers.

Private insurers must market and make profit and, to sell their goods, make the need for private providers who can deliver to their clients quicker since they are paying. It goes without saying that those private providers want to make a profit so these costs are higher. To keep the costs down for their clients without giving up their profit, the private insurer and a service provider will argue that the public system should pay the portion it would have paid in the public system and the client should just pay the extra.

There have been a number of high profile reviews of Canada's health system. All those reviews came to the same conclusion: public funding of health care is more equitable and more efficient. The for profit supporters would have us believe their system is more efficient and more economical to the public purse. The facts do not support their statements.

First, Romanow's report on health care, which was extensive and included hundreds of presentations and meetings throughout the country, concluded that our health outcomes, with a few exceptions, are among the best in the world, and that a strong majority of Canadians who use our system are highly satisfied with the quality and standard of care they receive.

Medicare has consistently delivered affordable, timely, accessible and high quality care to the overwhelming majority of Canadians on the basis of need, not income. It has contributed to our international competitiveness, to the extraordinary standard of living we enjoy and to the quality and productivity of our workforce.

Opponents of our system fail to mention that in Canada administration costs amount to 16.7% of health care spending. In the U.S. the cost is 32%. Canada spends 10% of its GDP on health care, the same as in 1992. The U.S. spends 14.9%. In Canada everyone is covered. In the U.S. 44 million people have no health coverage. The same arguments that were used to oppose medicare in its beginnings are the ones being used today.

Canadian health economist, Bob Evans, described private pay advocacy for health care as a zombie: “intellectually dead but destined to keep rising”. Gordon Guyatt, in a Winnipeg Free Press article a few months back, noted that for the wealthy the security of universal publicly funded health care could not begin to make up for the necessity of waiting their turn.

One of my favourite quotes, and I apologize that I do not know who said it, is “The critics say in Canada we ration our health care”. That is true. We ration according to need, whereas in the U.S. it is rationed according to the bank balance.

I will gladly give whatever information people need on where I got my figures. I want that to set the tone for the discussion on whether or not for profit health care is what Canadians want. I suggest it is not.

Canadians want to have access to their health care services and to the new technology, and they should have that right. They would have had it made available in most instances without the long lineups had there been proper funding of our health care system.

When we have the health minister work around and fiddle with the fact of what is medically necessary, I am sorry I do not have the opportunity to question him or his colleague, the public health minister, because I am sure she would be indicating that if he has to work around what is medically necessary and possibly suggest that diagnostic tests are not medically necessary, I would question whether he should be the health minister.

No doctor worth his or her grain of salt would suggest that blood tests, when checking for different types of cancers, or an MRI, a mammogram or a PSA test for prostate cancer are not medically necessary when looking to make a diagnosis. To suggest that our health care system should not be funding those tests, I think, is unconscionable. Quite frankly, I think Romanow was very clear when he said that we need to enhance what is covered under our public system.

I will now go into the arguments on for profit health care. I have a pile of paper around me because there and so many reports that put to rest that ridiculous argument, which has been called a zombie, that private health care delivers quicker, is better and is more efficient. The facts just are not there.

Furthermore, it is not the best economically sound position for our government to be taking. The public system delivers a more cost efficient system.

In the United States the Americans have those figures. They have for profit and public hospitals. The figures show that the non-profits provide equal services, they are less costly per hospital patient to the tune of something like $1,000 U.S. It would be much less in Canada.

I will read into the record the following comment, “Independent health service providers, the private for profits, need to pay advertisers, investors, insurance companies, marketing and a whole host of other hidden costs which would in the end get passed on to the public deliverer”.

The government wants to use the argument that as long as health care is publicly delivered it is all right to waste taxpayer dollars paying a for profit company, when it can be provided, and the figures are there, for at least 15% less if it is in a publicly delivered system.

It is shameful that members of the Conservative Party, who at one time were reform and then alliance, who try to present themselves as the grassroots people and the protectors of the public purse, are in here saying that taxpayer dollars should be used to set up for profit clinics to provide health services. I make no bones about the fact that ideologically I do not believe anyone should be profiting from someone's ill health.

I firmly stand behind the principle of a balanced budget. Without question, we cannot do everything all at once. However, without question, the most cost effective way to provide existing services or new services is through the most cost effective measure, which is not for profit. The moment we bring in the for profit aspect, somewhere along the way there will be increased costs to the public deliverer or to the patient. I think that argument needs to be put to rest.

I would wager that most members have not read the Romanow report. I know most Canadians have not because, although the government supported the Romanow commission, the cost for a full copy of the report in hard cover is $50, unless people have access to the Internet. I know it may come as surprise to many members but not everyone in Canada has access to Internet services.

The report states that this is what private, for profit companies do:

--these facilities “cream off” those services that can be easily and more inexpensively provided on a volume basis, such as cataract surgery or hernia repair. This leaves the public system to provide the more complicated and expensive services from which it is more difficult to control cost per case.

I will say that this is like going to Shoppers Drug Mart for a loss leader sale. We buy something at a special rate, but we spend extra money. We should not be putting that kind of system in reverse into the health care system, where we have private companies that are going to deliver the services they will make a whole lot of profit on, but the public system has to pick up the real costs.

Here is what a colleague of mine once told me. The province of Manitoba had a program with Manitoba Hydro. To encourage sound energy resource use, it provided people with assistance such as loans if they wanted to put on new doors or new windows to conserve energy. These were loans, and people paid the money back. It came off their hydro bills. Someone asked me why it would do that when its whole intention should be to make a profit. I said, for crying out loud, if we had that kind of attitude on health care we would not do the preventive work to treat people with heart problems or diabetes. We would be waiting until people get really sick so we could make a buck. That is what a lot of private providers do. They want to make the big bucks. Quite frankly, that is what has happened in our health care system.

We have not provided the community clinics and the preventive measures. Health Canada or the Minister of Health did not come up with a piece of legislation to ban trans fatty foods. Those are the things that prevent excessive use of health care dollars. That did not happen.

There is something I want people to know. Frankly, I was quite surprised, because many times over the years I have heard about medicare and Tommy Douglas and the great things that were done, but I have to admit that I had not read the whole plan from way back then. Members should know that community clinics and preventive medicine were supposed to be there at the same time that medicare was brought in, but the Conservatives, Liberals and governments time and time again never did any of that stuff. As a result, we have greater costs within our health care system.

I do not believe in throwing the baby out with the bathwater, so I say we get in there right now, implement the changes that need to be done and put in place the community clinics. We absolutely need to do those things.

My colleague, the Minister of State for Public Health, mentioned Dr. Michael Rachlis. Dr. Rachlis mentions a number of different alternatives that we can do. They have been talked about time and time again, but the provinces have not been able to implement a lot of those projects or changes to the way things are done because they do not have the dollars. They have been fighting to survive and provide whatever services they could. Why? Because this Liberal government in the last decade has cut more from health care than any of the others all together. As a result, we are playing catch-up.

The time has come. There needs to be the commitment. There needs to be the sound commitment to our health system. My colleagues have asked how much has to go in and I will say that right now what is being recommended is to just get it up to the 25%. I think a good number of provinces have indicated that we should start with 25%. It was meant to be a fifty-fifty deal. We have heard that. The federal government provides 50% and the provinces provide 50%. I have yet to hear anyone argue that this is still not fair, but what we are hearing now is, “Let us just get it up to the 25%”.

What would that mean in actual dollars? We have to break down the health and social transfer payments, which covered a number of things. I think Canadians want to see transparency, not just within health care funding but within all the other government funding. We are seeing that there is not a lot of transparency. As a result, we are seeing a lot of misuse of taxpayers' dollars. Let us have some transparency. Let us look generally at the figures. It is not always easy to get the total figures, but the figure I have heard is roughly $24 billion. Right now that goes specifically to the health care funding that would apply under the Canada Health Act.

That is $24 billion. If we are looking at increasing funding to 25%, some have said it would be roughly $8 billion. I use those figures because those are the different figures that have come out. There is no specific breakdown because of the health and social transfers. We would be looking at $8 billion to bring it up to 25%.

My colleague from Winnipeg—Transcona mentioned Monique Bégin. At times I have been in attendance when she has spoken about public health care and its needs. She used a figure of 25% at one point too, but also said that it needs to be moved further. We should be back to the relationship where there was the agreement.

Again, I would not for one second suggest that we just throw a bunch of money at it and not have a guarantee that services will be provided. Or, quite frankly, what if we do not have the money? But if we have the dollars we should be putting them into the system and we should be ensuring that Canadians nationwide get the same services. It is not always easy to do. Sometimes we have to pay a little more in an area of the country.

I specifically want to mention first nation communities here. I want to tell the House about something that happens in first nation communities. Over the last number of years, through the First Nations and Inuit Health Branch, communities have been trying to get additional funding to have full time nurses in their areas. They could not get the additional funding through Health Canada. However, Health Canada was quite willing to pay out to a private agency to provide a nurse to the tune of $900 a day.

That was $900 a day to a private agency for the nurse, but Health Canada would not give first nations the dollars to provide full time services in the community. There has been a huge increase in agency nurses throughout the whole system. Hospitals may say they do not have to pay the benefits and stuff, and yet $900 a day was paid to a private agency to provide a nurse. That is way beyond the cost of benefits.

This being nursing week, I think it would be indicative to mention the stress on health care professionals overall but certainly on nurses as the government has cut time and time again. They were there because nurses tend to be the kind of people who cannot just say, “To heck with it. I'm not going to work here anymore”. They keep struggling along because people do not go into that profession unless they genuinely care about what they are doing. Anybody who has worked in a hospital will tell us that. People do not become doctors or nurses unless they care about their patients, and they have a hard time not continuing services and not giving their 200%. They have suffered a great deal under the cuts.

I mentioned the increase in agency nurses and Health Canada's position of not funding the first nation. The government says it does not want to encourage private health care but it seems to me that paying $900 a day is encouraging private health care costs.

There was another situation, and I can bring in the news articles about it to prove that this is accurate. Again it involved the first nations health branch. There was a mammogram clinic located in one of the remote communities. In order to make it cost effective, the clinic wanted to fly in patients from a short distance, from one community in the riding to another, to have the mammograms done. Let me tell members, though, that Health Canada would not cover the cost. The reason I was given by the health branch--and this is not just out of the blue--was that it did not cover the preventive side of health care. These patients could not just have a routine mammogram; that was their reason for not doing it. That is the type of health care service first nations are getting from this government, that is the position the government is taking, and that is not acceptable.

I know I only have a minute more. There is obviously a fair bit to comment on with regard to the private, for profit health care system. That is the key factor here and I make no bones about that fact. I am adamantly opposed, as most Canadians are, to someone profiting from someone's ill health. It is unacceptable. I do not think those private providers have any moral ground to stand on. There have been numerous situations involving drug companies in the States where court cases have been brought against them because of their illegal positions in a good many cases. I do not think they have any moral ground to stand on when they say they are going to give the same service. The proof is out there that private, for profit companies do not provide the best service.

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12:10 p.m.

Liberal

Paul Szabo Mississauga South, ON

Mr. Speaker, I would like to make a couple of comments and then finish with a question for the member. The member started by talking about health care, the term that is in the motion. Then she went on to mention drugs and home care and spoke in much of her speech about prevention and so on.

As members know, home care and pharmacare are not within the purview and jurisdiction of the federal government. These are not items that the federal government can withdraw or somehow police.

The definition of health care that we are talking about in regard to the motion is unclear. We should be talking about those elements of health care which are under the purview of the Canada Health Act and which are medically necessary. I think the motion is flawed in that regard.

Second, I notice that the member was shifting her definition of private, for profit care in terms of what she was referring to. In one instance she was referring to private, for profit care being the situation wherein a Canadian or a resident would go to some health care provider and pay that doctor for the services rendered. It is two tier. She talked about two tier, where, instead of getting it through the hospital and having it covered under the health card, someone actually paid. That is private, for profit care as most Canadians would understand it.

Then the member started to talk about private, for profit care--and confuse everybody--in the sense that it would provide the service and bill the public health system an amount which would include its return on investment. So the private, for profit scenario is one where the patient would pay and the other is where the public health system would pay. Those are two different aspects on which she was not clear.

My question for the member is with regard to the motion. If she agrees that the motion has to deal with items for which the federal government under the Canada Health Act has responsibility, and the motion says that these are items which the government “has allowed to grow since 1993”, could she give the House some examples of the specific matters, specific services or health care elements, which, under the Canada Health Act, under federal jurisdiction, we have allowed to grow?

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12:15 p.m.

NDP

Bev Desjarlais Churchill, MB

Mr. Speaker, health care might be unclear to the member, but I could pretty much wager that health care and what people see it as is not unclear to Canadians.

His colleague, the health minister, suggested that somehow the NDP was not in tune with what was happening today because there were more things that should be considered under health care now, such as technological changes and the difference in delivery. There is no question there have been changes to what people consider necessary.

I tried to make it clear, that there should be no question in some areas about what is medically necessary. We have private MRI clinics and we have doctors who order them because they are medically necessary. Should anyone pay extra money to get that or should dollars be provided through the system? Should this not be the position of the government, to make enough dollars available?

We have a situation with home care. Manitoba, under the Conservatives, tried to privatize home care. I urge members to get the results. We are talking about private for profit. Whether the member thinks it is federal or not, if he goes to the Romanow report, he will see that Canadians think this needs to be covered. I know it was a big report, but each member received one. They did not have to pay the $50.

Conservatives brought in private home care in Manitoba. It was so bad even they had to cancel it. The cost was that much greater. The service was much worse. It was horrible. They did not have to wait until the NDP got there. It was so bad they got rid of it because it did not work. There is not full funding for every type of home care service provided because the provinces are struggling to make a go of things. There is no question about the issue of what is being provided.

I mentioned a number of different things in my speech, and I am sorry it was confusing in the way it came across. However, it will be in Hansard tomorrow. I urge my colleague to read it. It was not my intention to mix apples and oranges. I want to be very clear that we do not support for profit delivery. I know later on one of my colleagues will mention a number of plans within our platform for our health care system.

We have not seen any plans from the Liberals, and I do not want to get into the election issues. We are quite comfortable where we stand on health care. We do have a plan in place. It is not all over the board. We are not just saying throw money into it. We have a plan on how we would proceed to improve the health care system, to improve access for Canadians, to improve the number of services covered and to decrease the cost of prescription medications, which is a huge part of it. I would challenge anyone to suggest that some of the prescriptions are not medically necessary. They certainly are.

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May 11th, 2004 / 12:20 p.m.

NDP

Wendy Lill Dartmouth, NS

Mr. Speaker, I want to thank my colleague for her comments about private for profit delivery. One of the ways provinces struggle with the cuts to health care funding is very clearly to put their money into such things as P3 facilities. We have seen this happen across the board in terms of schools. We now have public-private partnership schools and public-private partnership health care clinics. That allows the provincial governments to put off the payments until a later date and to get them off the books.

Everyone is struggling with the financing of both education and health care. The point is it is just putting the costs off. They pay now or they pay later. With these public-private health care clinics, we see an increase in long term care for people, an increase in user fees and an increase in hospital support services that the private companies need to put in place simply to get their profits. Could the member comment on the phenomena of P3 health care services?

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12:20 p.m.

NDP

Bev Desjarlais Churchill, MB

Mr. Speaker, there is no question that governments are trying to promote the whole P3, the public-private partnership, approach as an answer. There is also no question, in my mind, that the reason they are doing this is so those dollars will not show on the books. The reality is that the Canadian taxpayers will ultimately pay more out of their pockets. That is the one thing they fail to mention when they talk about this. Over the long term, it will cost the taxpayer more and, quite frankly, it will be a lot more.

The same scenario will show in toll roads. It will show in the partnerships. In the building of hospitals, schools, any of those things, it becomes a much greater cost. The government can get away with saying it does not owe this much money because it is not on the books.

I just want to mention a couple of things that happen with the private for profit providers. Investors expect 15% profits annually. This is a U.S. survey. We do not have all the comparisons within Canada because no one has bothered to go ahead and do that. I mentioned already the significant time and money that has to be put into strategies for defence, marketing, insurance administration and bill collection, which drive up the costs.

There is also a necessity to compete. Imagine one hospital or one clinic competing with another so it gets all the business and, as a result, it increases the cost because there is a duplication of services.

Here is the clincher, and I do not think many people out there will doubt this any more, the prevalence of fraud among for profit providers in the U.S. has become a major cost factor. The cost of monitoring, suppressing and prosecuting such behaviour has become part of the administrative overhead associated with for profit providers.

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12:20 p.m.

Liberal

Julian Reed Halton, ON

Mr. Speaker, I will be dividing my time with the hon. member for Dufferin--Peel--Wellington--Grey.

I appreciate the opportunity to make a few comments on the motion from the member for Churchill.

April 17 marked the 20th anniversary of the passage of the Canada Health Act, Canada's federal health insurance legislation and the cornerstone of the Canadian health care system. The five principles enshrined in the act reflect the values that inspired Canada's single payer, publicly financed health care system over 40 years ago. The Canada Health Act aims to ensure that all residents of Canada have access to necessary physician and hospital services without direct charges.

As Roy Romanow said in the Romanow Commission report, the principles have stood the test of time and continue to reflect the values of Canadians. No single issue touches Canadians more deeply than health care. Our health care system is a practical expression of the values of fairness, equity and solidarity that define us as a country. Medicare is part of our heritage.

Before the second world war, Canadians paid for health services in the same way they paid for any consumer service. Many Canadians had debts for health care and many suffered because they just could not afford the health care they needed. After the war, both commercial and non-profit insurance began to spread, but many Canadians could not afford that either.

I would like to inject, if I may, a very personal story. In 1941 our family was just beginning to recover from the effects of the depression. At that time, my late mother was admitted to hospital for a routine surgery, a tonsillectomy, that was botched. She ended up with blood in her lungs which caused a series of infections. She spent 13 weeks in hospital and nearly succumbed. In those days there was not even penicillin, so any drugs to combat infection were known as sulpha drugs in those days. At any rate she recovered and came home from the hospital, but the process bankrupted my father. He spent the rest of his life, until he passed away in 1957, paying off that debt. Therefore, the whole subject of medicare is particularly personal, as far as I am concerned.

By 1957, the year my late father passed away, 40% of the population of Canada still had no coverage at all. Medicare predates the Canada Health Act, but the passage of the act was a defining milestone. The Canadian health insurance system in fact evolved into its present form over several decades, and it will continue to evolve and continue to be improved as the years go by.

Saskatchewan was the first province to establish universal public hospital insurance in 1947. Ten years later the Government of Canada passed the Hospital Insurance and Diagnostic Services Act to share in the cost of these services.

By 1961, all provinces and territories had public insurance plans and provided universal access to hospital services. Saskatchewan again pioneered in providing insurance for physician services beginning in 1962. The federal government adopted the Medical Care Act in 1966 to cost share the provision of insured physician services with the provinces.

By 1972, all provincial and territorial plans had been extended to include physician services. Through cooperation between the provinces and the federal government, Canada developed a national health insurance program which became the hallmark of Canadian federalism.

The federal government agreed to contribute financial support and the provinces would administer the programs. The conditions were that each province had to guarantee that its program would be universal, comprehensive, portable and publicly administered. With these guidelines established, the interlocking provincial plans formed our national health insurance program. It was tailored especially for Canada. Coast to coast medicare was created.

However, in the late 1970s, extra billing by some physicians and user charges levied by some hospitals were increasingly becoming a cause for concern. Universal access was at risk. In 1979, at the request of the federal government, Justice Emmett Hall undertook a review of the state of health services in Canada. In his report he reiterated that health care services in Canada ranked among the best in the world, but warned that extra billing by doctors and user fees levied by hospitals were creating a two tiered system that threatened the accessibility of care. This report led to the adoption of the Canada Health Act in 1984.

The Canada Health Act was introduced to ensure that Canadians had access to the medical care they needed without out-of-pocket charges. The road to passing the legislation was not always smooth. It involved four years of intensive debate and negotiations before the Canada Health Act was passed with the unanimous support of all political parties by Parliament on April 9, 1984 and received royal assent on April 17, 1984.

The act consolidated previous legislation on hospital and medical care insurance, and set out standards and criteria that had to be met for the provinces to qualify for federal funding. Canadians were assured universal and timely access to the health care they needed on a pre-paid basis.

Universally accessible health care is not just a program. It is much more than a system. It is central to our way of life, a source of pride and identity. The Government of Canada is committed to protecting the health care system that Canadians consider part of their identity. The Prime Minister recently stated that our health care system is more than a program; it is a statement of our values as a nation.

Canadians continue to strongly support the principles of the Canada Health Act. They want a system based on need, not wealth. They consider equitable and timely access to medically necessary health care services to be part of our national character, not a privilege of status or income.

Times have changed considerably since the act was passed. What has not changed is the support among Canadians for the principles underlying the health care system. There are challenges and pressures to continue to provide quality services in the face of rising costs, emerging and costly technology, and increases in the ability of physicians to treat hitherto untreatable diseases.

The Canada Health Act has been instrumental in protecting reasonable access to medically necessary care by all, regardless of age, income or place of residence. Canadians have expressed their support for universal health care time and time again, and all levels of government remain committed to upholding what Canadians consider a top priority which is their publicly funded health care system.

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12:30 p.m.

NDP

Wendy Lill Dartmouth, NS

Mr. Speaker, I thank my colleague for his comments and for telling us of his mother's situation and the importance of, in his own life, the passing of the Canada Health Act and what that meant, and of the kind of duress his family was under financially. I do not think anyone could have said it better.

I think the problem is that many Canadians now feel that they are heading back to those bad old days and that they are actually experiencing them themselves. People feel that they can be just a step away from being wiped out financially because of the high cost of drugs. They do not have any drug insurance and they are in fact incurring huge costs that are taking years to repay.

In many parts of the country, and mine being one of them, there is no health care coverage for seniors in nursing homes. They are paying their own health care costs in nursing homes so that at the end of their lives they are finding themselves having to eat up absolutely every penny of their savings to pay for health care coverage that is available in hospitals for other Canadians across the country.

There are so many examples of people who do not feel they are protected in the way that some feel they once were protected. I would like the member to address the strong concern that Canadians have across the country with the state of our present health care plan.

Supply
Government Orders

12:35 p.m.

Liberal

Julian Reed Halton, ON

Mr. Speaker, I thank my hon. friend for those comments. There is no question in my mind that our health care system is constantly evolving, and constantly needs to be improved and upgraded as we go along.

We also know that the standards that are applied in different provinces sometimes differ. For instance, there are some provinces that charge for ambulance service and other ones that do not, and so on. It takes constant vigilance, if we like, to impress on the provinces that there is a standard to be maintained and that there are improvements to be made.

I do sympathize with the cost of the new drugs that come on the market. Some of them are very effective for curing or controlling illnesses that could not be controlled 20 or 30 years ago. They are, admittedly, very costly. It is the constant tossing the balls in the air as to how much of that can be borne by the taxpayer.

We still have excellent basic medical care in the country and I would not take that away for a minute. I talked to one physician who took the Canadian health care idea to other countries in the world. I met him at the Ottawa airport about a year ago. He said there was a lot that had to be continually improved and fixed in the Canadian health care system and when we do that we should never forget that compared to every other country in the world this is still the very best health care system.