Maria Minna

[Bosnia, June 13th, 1995]

Mr. Speaker, my question is for the Minister of Citizenship and Immigration.

In Bosnia-Hercegovina innocent lives are being lost every day. Conditions continue to worsen for the people in Bosnia. Our soldiers are doing a magnificent job in their attempt to protect citizens. What action has the minister taken on behalf of the Canadian government to assist those who are fleeing the bloodshed in Bosnia?

[Petitions, June 5th, 1995]

Mr. Speaker, I have five petitions with 188 signatures in which the petitioners call on the Parliament of Canada to act quickly to amend the Canadian Human Rights Act to prohibit discrimination on the basis of sexual orientation and to adopt all necessary measures to recognize the full equality of same sex relationships in federal law.

[Multiple Sclerosis, May 31st, 1995]

Mr. Speaker, I am pleased to remind members of the House that May was Multiple Sclerosis Carnation Month.

Multiple sclerosis, or MS, is a degenerative disease that affects the central nervous system. An estimated 50,000 Canadians suffer from this disease, one of the highest prevalence rates in the world. There is presently no known cure.

Research into finding a cure and better treatments for patients with MS is ongoing. Health Canada has contributed research dollars to help improve the lives of MS sufferers. However, there is still much work to be done.

During the month of May, volunteers from the Multiple Sclerosis Society of Canada were out in our communities selling fresh carnations to raise money for research and support services for those affected by MS. As in previous years, the Multiple Sclerosis Society hopes to raise $2 million throughout the carnation campaign.

Of course the success of this campaign depends greatly on the involvement of volunteers. To recognize their contribution this year's campaign slogan was "volunteers can work wonders". I salute the many Canadians who contributed their time.

[Missing Children, May 19th, 1995]

Mr. Speaker, Thursday, May 25, is missing children's day. Every year in Canada police receive thousands of reports of missing children. The overwhelming majority of these cases, about 45,000, are runaway children. Too frequently these runaway children turn to the streets and engage in delinquent activities as a means of support. This makes them extremely vulnerable to further violence and exploitation while on the streets.

A cornerstone of the federal government's efforts to protect Canadian children is the RCMP's missing children's registry. In operation since 1986, the registry is the major source of computerized information on missing children in Canada. It supports the efforts of Canadian and international police and concerned agencies in the search and recovery of missing children.

The RCMP has also joined forces with National Revenue Canada and citizenship and immigration in a joint initiative called "Our Missing Children". This partnership has resulted in a significant increase in the recovery and safe return of missing children here and abroad.

Protecting our children is a collective responsibility.

[World Red Cross And Red Crescent Day, May 8th, 1995]

Mr. Speaker, I am pleased to announce that May 8 is World Red Cross and Red Crescent Day. This day is meant to celebrate international understanding and promote the humanitarian cause of the Red Cross Society of Canada.

This year's theme is dignity for all and respect for women. World Red Cross and Red Crescent Day acknowledges the millions of people suffering from the consequences of war due to ethnic and other violence, natural disasters, and malnutrition. It appeals to people all over the world to respect the dignity of those most in need. For nearly 100 years, the Canadian Red Cross Society has maintained a Canadian tradition of providing humanitarian assistance whenever and wherever it is needed. Often the Red Cross is the only organization allowed to bring assistance to war zones.

Please join me in congratulating the many volunteers of the Red Cross Society for their selfless efforts and understanding work and in wishing them a very successful Red Cross and Red Crescent Day.

[Supply, April 27th, 1995]

Absolutely. I am quite proud to pay my taxes to help those people. I do not consider it charity which is why I am not for workfare or any such thing. These people have a right to be assisted by the system and the government. They have paid taxes before and they have earned the assistance.

With respect to the Gimble clinic, laser surgery and stepping out of line, I do not want that system. Before we know it we will have a system where the people who can afford it will always be stepping out of line. The best specialists can charge more money because profit as a motive will always be working in the best clinics. Before we know it we will end up with a two-tier system

no matter how we look at it. I have seen it happen in other jurisdictions and it will happen here. It is not necessary.

The publicly administered health care system is the most cost effective system in the world. It saves money because the motive is not profit, it is to deliver the best possible system to the citizens of the province.

Those are my comments and some of my questions. I would really like to understand what core services are to the Reform Party as I have not quite understood that yet.

[Supply, April 27th, 1995]

Mr. Speaker, I would first like to correct the first statement the hon. member made with respect to the two-tier system for MPs versus our staff.

The two tiers do not exist. Medically necessary physician or hospital services are the same. There is no difference. One gets the same hospital and the same doctor. The only difference is there is a TV in the room which one can decline. The hon. member chose the TV but she could have said no. The medical care is not different. There is no difference between the hospital one goes to, the doctor one gets, the services one receives or the nurses who serve us.

I heard today from the hon. member and other colleagues about core medical services and that core services should be identified. I am trying to understand what the difference is between core services and medically necessary services as defined in the Canada Health Act. What is the real difference between core and medically necessary? I think they are one and the same and that we are playing with words here.

I would like the Reform members to define for me what core services are and how it differs from what we now have in the act.

I am very proud to pay my taxes. I do not consider welfare to be charity. I consider welfare to be the right of needy people who have fallen on hard times.

[Supply, April 27th, 1995]

Mr. Speaker, I am having some difficulty understanding the logic of the hon. member for Edmonton-Strathcona. He is talking about transferring tax points with no strings attached. This is transferring more money to the provinces, giving them carte blanche and letting them decide what their core programs would be. Each province would decide what its core program would be and we would have different core programs from province to province.

He says he does not want to create a two tier program. I do not understand how the member can say that he would have an accessible health care system across the country where one province's accessibility would be defined in one way and another province differently. It is quite conceivable that in some provinces health care would not be accessible to people who are poor because they would have to pay certain types of remuneration or what have you.

I do not understand what the member is actually asking. Basically the current health care system structure has allowed the provinces to administer their health care systems as they wish as long as they are able to respect the five conditions. That is not so difficult. Those are not very difficult conditions to respect. His colleague earlier said they do not endorse the five principles. They are pretty broad.

I would like to know from the member exactly what kind of medicare system the Reform Party envisions. If it sees one different for every province with accessibility varying without any national principles, however broad, I have some difficulty with that. I would really like to understand where the provinces are now hampered in the administration of the health care system.

[Isabella Bay Sanctuary, April 27th, 1995]

Mr. Speaker, I am proud to rise in the House today on behalf of the students of Norway public school in my riding.

The young people of this school have taken up a very admirable cause. They wish to see the establishment of Igalirtuuq, a sanctuary on Isabella Bay, Baffin Island, for the bowhead whale. The bowhead whale is in danger of becoming extinct and so a sanctuary would help protect the species.

The 10 and 12-year olds at Norway public school have written letters to the Minister of the Environment and circulated a petition at a recent school open house. I will be presenting these letters along with the petition to the Minister of the Environment next week.

The students have worked very hard to inform themselves and others about the bowhead and other types of whales. They want to save the bowhead whale from extinction and they are asking the House to help them.

I congratulate the children for their strong commitment to their cause and I ask the Minister of the Environment to do everything she can to set up a sanctuary in Isabella Bay so that the bowhead whale may be protected.

[Supply, April 27th, 1995]

Madam Speaker, I am grateful for this opportunity to talk about medicare and the Canada Health Act. I want to explain how and why the government supports medicare and why we on this side of the House will continue to support it.

The Reform Party asks whether we have the will to uphold the principles of the Canada Health Act. There are no grounds for dire predictions that the federal government will not be able to uphold the Canada Health Act or that Canada's health care system will disintegrate as a result of the budget.

Let me remind the House how clear the budget speech was on this matter. The Minister of Finance said no change would be made to the Canada Health Act. The Minister of Health was equally clear when she spoke to the Canadian Hospital Association last March: "There is no change in the government's commitment or in my commitment to uphold and enforce the principles of the Canada Health Act". As the Prime Minister said in Saskatoon, for Canadians these principles are not negotiable.

The new transfers will be a block funding arrangement. That may worry some members but let us not forget that block funding for health and post-secondary education is 18 years old. The established programs financing funding mechanisms put in place in 1977 were a block funding arrangement. There is no requirement for the provinces to spend the money on health. What there is and what was nailed down in 1984 when the Liberal government passed the Canada Health Act is the requirement that provinces deliver health care services in compliance with the five conditions of the act or face a deduction from the money transferred to them.

Nothing in the budget will change the government's technical ability to enforce the Canada Health Act principles. The enforcement mechanism remains the same. If deductions from transfer payments are necessary they will be made.

Canadians can rest assured that Canada's social and health transfer will not reduce federal ability to enforce the principles. We will enforce them because these principles of universality, accessibility, comprehensiveness, portability and public administration are ultimately rooted in our common values. They are Canadian values such as equity, fairness, compassion and respect for the fundamental dignity of all. We will also enforce the principles of the Canada Health Act because they support an economically efficient health care system.

It is worth reminding opposition members the principles of the Canada Health Act are not just words. They have meaning. I want to touch briefly on each of these principles.

The first principle is universality, although residents in a province must be insured by the provincial health plan to receive federal support. What this really means is that we all must have access to services. People cannot be deinsured because they might be costly for the system to cover. We cannot be turned away at the hospital door because we have not paid our quarterly tax bill or provincial premium. If we need health care we will be treated the same as anyone else.

Accessibility on uniform terms and conditions is the second principle. It means we should not face any financial barriers in receiving health care: no extra billing, no user charges, no facility fees, no up front cash payment. If the service is medically necessary we will get it at a time defined by medical considerations, not by the size of our wallet.

Next is comprehensiveness. This principle recognizes Canadians have a range of health care needs and that those needs should be met. Scratch the surface a little more and we see that comprehensiveness again means we practise fairness. It would not be fair to ensure only some medically necessary services and not others. I do not believe we can, nor should we try to, choose at the federal level which service is medically necessary. We should continue to interpret the Canada Health Act as required coverage of all medically necessary services.

The government will continue to take the position that if a province ensures any part of the cost of a service, it is an indication it believes it to be medically necessary and all of the costs must be covered.

Justice Emmett Hall in his original royal commission on medicare recommended a very comprehensive package. Liberal governments of the 1960s, 1970s and 1980s accepted the concept of comprehensiveness, although not quite as broad a concept as Justice Hall's. Liberal governments in the 1990s will not turn their backs on this principle.

The fourth principle is portability. It means Canadians maintain their health plan coverage when they travel or move. The portability principle is rooted in one of the fundamental elements underpinning our federation. It recognizes our right of mobility. Canadians are free to work and travel anywhere in the country without fear of losing their health insurance coverage.

Portability is what makes our national health insurance truly national. Each separate health insurance plan may be provincial in origin but is recognized nationally in every province across the country.

The fifth principle is public administration. Our health insurance plan must be operated by provincial governments on a not for profit basis. In my view this principle never seems to get the same attention as the others but it should. It is at the core of our ability to contain costs in the system and thus to deliver quality care at an affordable price.

One would think that of all five principles, the Reform Party would be able to relate to this one. Public administration is the means by which we ensure all the other principles. When health insurance is operated and funded through government, we can guarantee that health care is universal, accessible, comprehensive and portable because we have direct control over it.

It is through public administration that we also demonstrate our collective responsibility for our health care system. Canadians are responsible for paying for their health care system. We do it collectively through our taxes. We pay so that everyone can benefit according to need. We have agreed to provide this most essential of human services together. We must not lose that.

Public administration also demonstrates something else about Canadians, our pragmatism. We want value for money and administering health insurance publicly is the best way to get it in health care. We need only look to the experience of our American neighbours to compare the efficiency of public administration with private administration.

Not only does public administration make sure more of our health care dollars go toward patient care, government can be more successful than the private sector in keeping health care costs under control.

In 1993 we spent about $72 billion on health care. This represents 10 per cent of our gross domestic product. The public component of that 10 per cent has been growing at less than 2 per cent. Compare that to private health spending, which has been growing at 6.4 per cent.

Over the last three years per capita spending on the publicly administered part of our system has been declining. Since our GDP has been growing, it is safe to predict that in 1994 and 1995 we will come in with less than 10 per cent of GDP devoted to health care.

Saying the federal government wants to maintain the principles of the Canada Health Act is not enough. We have to know the public is behind us. We all know that as politicians we cannot escape the will of our constituents. They put us in office and they can take us out. The same is true for the government. Canadians are all saying one thing to us very clearly: they want us to enforce the principles of the Canada Health Act.

In Canada's health care system there are no first or second class citizens. We enjoy rights and privileges as Canadians that are the envy of the world. We can live wherever we want in Canada and have access to health care when we need it.

The many values that make up Canada's social fabric are reflected in the five principles of the Canada Health Act. They reflect the Canadian concern for justice and equity in our health care system and they are not going to disappear. Canadians, including I am sure everyone in this House, will not allow that to happen.

As I said a moment ago, we only need to compare ourselves with the United States. They have been trying for years to get a health care system. They have a private health care system that people purchase from private companies. They spend between 13 per cent and 14 per cent of their GDP on health care. What does this extra money get them? There are 38 million people who are not covered at all, and millions more are minimally covered. That does not sound like a great exchange: more for less. Therefore, I do not see what good privatizing our health care system will do.

I also want to point out there are countries that have allowed extra billing. I know of one, Italy, that has allowed and allows to this date extra billing and private clinics. However, it may happen that a person is in a public hospital. The doctor will say: "I need to do a surgery, which is very expensive; I can only do it if you come to such and such a clinic, but it will cost you so much money". That is setting up two classes of services: if you pay more, you get served faster, and maybe that specialist will treat you there.

In this country it does not matter if one is poor or rich or even homeless. If you require assistance or surgery you choose the specialist or the doctor who will treat you. That is what a comprehensive and accessible medicare should be about. We need that kind of security, that kind of stability. Our health is the most precious thing we have, allowing us to do all of the other things we want to do. We talk about unemployment. If people are insecure about their health they cannot study, they cannot train, they cannot work.

This gives Canadians a sense of stability. They do not have to worry or lose their homes and become paupers because they are ill or their children or parents are ill.

Yes, we have a new world. We have a much larger population of seniors. We need to look at different treatments. That is true. That does not mean in any way retrenching one bit on the principles of health care, not one bit. I would never support any such direction. We must look at new treatments and new ways of assisting people.

Preventative medicine in this country must become the norm, and not, as it is now, a reaction. We are still treating symptoms in many cases, and not dealing with preventative medicine. If we were to deal aggressively with that over and above the costs we now have, we would lower health costs in this country considerably. We should be looking at how we can improve our medicare system and our health system and its delivery through preventative and other measures, and not diminish the principles of health care. That is totally unacceptable. This government would never support that.

We need to redouble our efforts to make sure even programs like psychiatric services are considered to be fundamental services. We have far too many children who are on waiting lists. Yes, a province has decided that is not a necessary service.

Maybe we need to look at that. It is a preventative service. This is what I mean by looking at innovative ways of dealing with the cost of medicare, not denying Canadians the right to access medicare.