Finance Committee on May 31st, 2012

[Linda Silas]

One hundred fifty-eight thousand.

[Hoang Mai, NDP, Brossard—La Prairie, QC]

I have enormous respect for nurses, because they are very important to our society.

You have been severely critical of the government because it did not negotiate with the provinces.

Can you explain a little again about the efforts made and what the government should have done to be really sure that the amounts, the transfers, are right for the federal government and the provinces?

[Linda Silas]

It should have actually done what it had promised to do: sit down at a table, as was done in 2003-3004, where it would have negotiated an agreement with the provinces concerning financial needs. There are things the provinces want regarding those financial needs. They want to know in the long term, in 5, or 10, or 15 years, what the federal government's contribution will be. It is now about 20% of total health care costs. Some people would like to see that rise to 25%, of course, but a majority agree on 20%.

In addition, there is the question of priorities: where are we going when it comes to health care? Ms. McLeod talked about Canada's position at the global level. I could tell her that we won the gold medal for emergency room visits: 58% of Canadians have to go to an emergency room to get primary health care, because they have no other choice. To Mr. Jean, I would say that this concerns young families, because there are no community health centres or primary health care centres in our communities.

I mentioned the costs of pharmaceuticals; we also have to talk about home care. Our seniors who are in good health, people who are 65 years old and healthy today: where are they going to go?

[Hoang Mai, NDP, Brossard—La Prairie, QC]

Thank you.

Mr. Noël, you also talked about a structural deficit. Can you explain a little about the problem stemming from a relative change in the transfer? We were promised 6% in the beginning, but what will happen then and what will the consequences be for the provinces?

[Alain Noël]

The Parliamentary Budget Officer has done evaluations of the long-term consequences. A little earlier, the question of whether we should continue spending more on health care was asked. In fact, what is proposed is not that we spend more, but that we spend less. The federal government's financial contribution to health care is going to decline. It is already below what was proposed in the Romanow report, which was 25% as a sort of target. It is going to decline gradually, and that necessarily means that the federal government's role in defining policy in the health care system will become less and less significant, since the resources will not be there.

[Hoang Mai, NDP, Brossard—La Prairie, QC]

What might the effects be on services provided to the public?

[Alain Noël]

Essentially, it will vary, depending on what the provinces decide to do. If we rely on what happened after 1995, when there were major cuts in federal transfers to the provinces.... Certainly health care represents the largest expense for the provinces, and so there will almost inevitably be cuts in that area.

[Hoang Mai, NDP, Brossard—La Prairie, QC]

At the federal level, we believe strongly in universal health care: every Canadian should have access to health care and should not have to decide between that and buying groceries, perhaps.

Is there a risk that there will be negative consequences in that regard? What do you think, Ms. Silas or Mr. Noël?

[Linda Silas]

Access to health care is a matter that the present and previous governments had made a priority. Some people have asked why we signed a health care accord in 2004. It was because parliamentarians were tired of being questioned about access to health care. And there were specific priorities: it addressed five conditions we had already discussed, but did not address home care, primary care and the cost of pharmaceuticals.

Access to health care is going to deteriorate in every respect because we simply have no comprehensive or Canada-wide plan.

[Hoang Mai, NDP, Brossard—La Prairie, QC]

You represent nurses. What is their position on the idea of raising the age of retirement age from 65 to 67? Will forcing people to work two more years have negative consequences for people who are working now and for future generations?

[Linda Silas]

We have to understand that our population is already quite old, with the average age being 48. We work at all hours of the day, all days of the week. This is not really an easy question for us, because of the shortage of nurses. Nurses are needed all the time, so we work all the time. Our profession has the highest sickness rate among all occupations. Nurses take the most sick days in the country, because of the working conditions.

So working two more years will be very difficult. And it will be difficult in any health care profession, not just for nurses and doctors.

[The Chair, Conservative, James Rajotte]

Thank you.

Thank you, Mr. Mai.

Colleagues, we have two rounds left. I believe Ms. Glover will be taking most of them.

I want to express my appreciation to our witnesses. We've gone a little bit over, but we did start late. I thank you for staying tonight.

[Shelly Glover, Conservative, Saint Boniface, MB]

It's actually Dean Del Mastro.

[The Chair, Conservative, James Rajotte]

Sorry.

Mr. Del Mastro.

[Dean Del Mastro, Conservative, Peterborough, ON]

Thank you, Mr. Chairman. I've really appreciated the opportunity to take part.

I did a little bit of artwork that I'd like to hold up for the committee.

Can you see that number, Ms. Wirsig? I'm not an artist, but it was a bit of artwork.

[Karen Wirsig]

Yes.

[Dean Del Mastro, Conservative, Peterborough, ON]

Okay. I wrote $100 million down on the page for colleagues. That's about double, roughly, the record lottery that's ever been held in this country.

Is that a big number?

[Karen Wirsig]

Sure.

[Dean Del Mastro, Conservative, Peterborough, ON]

It's a big number. Do we agree?

We give that to the CBC every month. It's a lot of money.

[A voice]

To do what?

[Dean Del Mastro, Conservative, Peterborough, ON]

For the most part, Canadians hear numbers like 1.1, 5.2, 3.6, whatever the number is, and then the fact of whether it's million or billion gets thrown out and we lose the idea of the significance of a number.

The CBC gets in excess of a billion dollars. If you started counting—one, two, three, four—it would take you 32 years to reach the number one billion. It's a lot of money. And there's a lot of responsibility that comes along with spending that much money.

One thing that really surprises me.... We've talked about how government resources are finite—they're not infinite—and that decisions have to be made. The government has made a number of decisions that I think are difficult but necessary, including the Department of National Defence. I understand you compared the CBC budget to fighter jets in your comments. Obviously we'll spend significantly more on the CBC than we will on fighter jets over the next 30 years.

We're providing this level of support, frankly, in a backdrop where I think you'd have to acknowledge that over-the-top and online media.... That's where young people are. I'm just curious. If we can acknowledge that's a lot of money, then why isn't the government being recognized, despite the fact that if it is faced with very difficult challenges, it's still going to provide in excess of $100 million a month to the CBC?

[Karen Wirsig]

By the time the proposed cuts are finished in 2014, the CBC will get less than $1 billion. So I can hardly see that it will be $100 million a month. My math isn't fantastic, but....

[Dean Del Mastro, Conservative, Peterborough, ON]

No, actually they won't. I was in Heritage. The CBC gets direct funding in excess of $1 billion. They get an additional roughly $200 million from the Canadian Media Fund. They have schedule 1 fees that they collect from CBC Newsworld from each and every Canadian—that's about 75¢ per Canadian—on their cable bill per month.

These are direct public subsidies that are coming into the CBC. And then of course you have government advertising, which would again go on top of that.

I don't want to dwell on this too much, but I think it's important to recognize that despite the difficult choices the government has made, we were the only country in the G-8, the only one, to increase funding for arts and culture during the recession—the only one. We made that difficult choice because we knew that if there was a sector that would be targeted and would hurt more than others, it was probably entertainment. When people are challenged, it's one of the areas they draw back.

So the government made that choice, and now the government has to move forward and balance its books. By providing the CBC the money it needs for its 2015 plan, I think we've demonstrated support for them—despite, frankly, a number of Canadians out there who look at it and say, “Are you really sure this is money well spent?” I recognize that there are a lot of Canadians on the other side of that debate as well, but we've indicated our support.

[The Chair, Conservative, James Rajotte]

You have one more minute.

[Dean Del Mastro, Conservative, Peterborough, ON]

Okay.

Mr. Noël, I just wanted to point out that you've referenced a funding model going back decades—without recognizing that in that time span, equalization was created, and without recognizing that significant tax points were transferred to the provinces. That's how the provincial share of health care funding actually increased, because revenues and a percentage of revenues that went to the federal government were decreased at the same time. Those were through agreements that went on for generations. I don't discount that there were significant federal cuts in the 1990s.

One of the things we also have to acknowledge in this country, and this is important, is that inflation is always tracked at 2%. That's the central bank's goal. That's the rate of inflation that's targeted.