Finance Committee on Sept. 21st, 2022

[Jay Goldberg]

I would not like to make a specific list. What I would say is that there are provinces that have been standing in the way of resource development or of getting resources to market. That's a simple fact. If these provinces were to improve in terms of resource development and if they had greater economic growth, then, naturally, there would be a change to the equalization formula, and that's what happens inevitably when resources are developed.

[Daniel Blaikie, NDP, Elmwood—Transcona, MB]

Thank you for the value of that contribution.

I would like to ask now, Mr. Staples—

[Philip Lawrence, Conservative, Northumberland—Peterborough South, ON]

Mr. Chair, I'm sorry. It's not appropriate to badger a witness. That's just inappropriate.

[The Chair, Liberal, Peter Fonseca]

Continue, Mr. Blaikie.

[Daniel Blaikie, NDP, Elmwood—Transcona, MB]

I wouldn't characterize that as badgering. I would characterize that as offering thanks to the extent it's due.

What I'm hoping to get at with Mr. Staples is some understanding of the health accord model. We've talked a fair bit about jurisdiction and the requirement to have an interaction between the federal government and provincial governments with respect to health spending. We had a model for this in 2004. It was a 10-year agreement.

When we talk about the Canada health transfer, increases in health funding and how to structure that, I wonder if you could speak to what you think there was of value in the health accord model. What lessons were learned from that period between 2004 and 2014, when it was unilaterally ended by the then federal government under the Conservatives? What could a model look like to introduce some of those questions of accountability between governments for health funding?

[Steven Staples]

Thank you very much. I may engage with Mr. Newman, as well, on this. He has more historical knowledge than I do.

I would say that, for one thing, the tax transfer system that was employed for health care funding in previous accords did not really yield very much benefit. The federal government still gets blamed for not spending enough, even though it tried to redo the calculations.

I think there has been a lot of fudging of these percentages over the last number of months with the provinces, because it's cases of.... The fifty-fifty split, for instance, was originally envisioned for doctors and hospitals, but the health care envelope has expanded a great deal. They're being blamed for not doing it fifty-fifty, but the overall calculation is being used for all health care costs. I think there is some fudging around the numbers here.

Essentially, we have to have some kind of negotiation. We have to find some way to break through this stalemate that we have, because the crisis continues in terms of the wait times and the terrible toll being taken on frontline health care workers. Meanwhile, it's just a blame game going on, which we saw in Victoria this year, and we need to somehow break through this impasse between the federal government and the provinces.

I believe the key is in the terms of the confidence and supply agreement between the Liberals and the NDP. The four health care points are excellent, and I think they can help us rise to a new level of negotiation between the levels of provinces and the federal government to get both programs that have deliverable outcomes and investments in the Canada health transfer that are governed by the terms of the Canada Health Act and the five principles. Bans on extra billing and user fees are absolutely critical if provinces are going down this for-profit privatization model.

Go ahead, Keith.

[Keith Newman]

Thank you very much.

We need a model with the federal government demanding accountability—I totally agree with that—for the money that is spent, as long as it's spent on health care and not used to do other things, such as reducing taxes. For example, I live in the province of Quebec. The Charest government—I think it was in 2004, but I forget right now—provided us with a tax break of $600 million. The Conservative government was appalled by that, because it had sent the money for the health care system. So what happened? Personally, I had no health problems, and I got a tax break.

However, that's not the kind of country I want to live in. I believe in a country that takes care of its people. We have a duty to our country to care for people and to help those in our community. Cutting back on these programs and finding ways to engage in double-talk and blame the next guy is wrong.

I would add this. If the federal government has a good program and offers good money with strings attached, would somebody tell me that the provincial governments will not say, “Okay, we're going to reject $5 billion, or $3 billion, or whatever it is for health care or for pharmacare”? Of course they won't. They will take the money as long as the federal government maintains its availability and the strings that must be attached.

[The Chair, Liberal, Peter Fonseca]

Thank you, Mr. Newman and MP Blaikie.

Members, we are moving to our second round. As in our first panel, in this panel we're down to about 12 minutes or so left. I'm just looking at how we do it. We will divide the time equally. In the second round, there will be three minutes per party. We're starting with the Conservatives.

I have MP Albas for three minutes.

[Dan Albas, Conservative, Central Okanagan—Similkameen—Nicola, BC]

Thank you, Mr. Chair.

Thank you to all of our witnesses for participating in today's study.

I'm going to start with you, Mr. Goldberg, and probably finish with you, because I don't have a lot of time.

First of all, you mentioned the concept of entanglement. Could you just explain again what “entanglement” means?

[Jay Goldberg]

The concept of entanglement is the idea that you have one level of government providing money to fund a service and another level of government trying to deliver that service, and there is a lack of accountability when it comes to everyday Canadians being able to hold a particular level of government accountable for that service delivery. In addition to that, it's getting levels of government involved in the areas where constitutionally they're not given the right to do so.

[Dan Albas, Conservative, Central Okanagan—Similkameen—Nicola, BC]

Thank you.

You've written a report along with Sean Speer, which you've been referencing throughout this. Would you be able to supply that to the committee so we can include it as evidence in our discussions?

[Jay Goldberg]

Certainly.

[Dan Albas, Conservative, Central Okanagan—Similkameen—Nicola, BC]

Thank you.

Now, specific to this particular motion, we're not just talking about fiscal federalism. Again, this was originally an NDP proposal, talking about “fiscal federalism in Canada, including but not limited to fiscal equalization payments, the Canada health transfer, the Canada social transfer and the possibility of a new federal transfer to equalize the disproportionate costs of climate mitigation and adaptation across Canada's provinces and territories”.

I'd like to focus a little bit here, because you've talked about entanglement and some of the issues of direct accountability and whether it should be provincial or the Canadian voters holding their government to account. How would your concerns around entanglement be adapted to some of the discussion we've had today around some sort of new climate mitigation/adaptation transfer?

[Jay Goldberg]

Well, I think it would be a similar situation to what you have right now with health care. I think it would be about the environment and the priorities, and what happens in terms of natural resources and in terms of climate change. Obviously, it's going to affect different provinces in different ways, but again, this is something where, if the provincial governments are taking the leadership in dealing with these issues, then the provincial governments should be those levels of governments that adopt policy.

[Dan Albas, Conservative, Central Okanagan—Similkameen—Nicola, BC]

Okay.

How much time do I have, Mr. Chair?

[The Chair, Liberal, Peter Fonseca]

You have 20 seconds or so, MP Albas.

[Dan Albas, Conservative, Central Okanagan—Similkameen—Nicola, BC]

Okay.

Maybe I'll just take the time to thank the witnesses for being here today, to again say that it's good to see everyone back, and to add my thanks to the staff that make our FINA committee run.

[The Chair, Liberal, Peter Fonseca]

Thank you, MP Albas.

Now we are going to hear questions from the Liberals.

I have MP Chatel for three minutes, please.

[Sophie Chatel, Liberal, Pontiac, QC]

Thank you very much, Mr. Chair.

I would like to say something about the first hour of our meeting. In view of the current climate crisis, I am very pleased that we welcomed Mr. Klein. This is not the first time we have faced crises, and, as we have seen a number of times before, it is also an opportunity to emerge stronger.

If we look at all the major economies in the world, they are all making the transition to a green economy, and I do not want us to miss the boat. A responsible plan will truly focus on innovation so that we can come out ahead. As with all transitions, there are winners and losers. I don't know about you, but I would like to be among the winners.

I am very pleased that we had this discussion.

I'll turn to the question for Mr. Staples.

I have one question. What would be the impact, in your view, of providing dental care, but also day care, as you mentioned? Also, is your coalition supportive?

[Steven Staples]

Thank you very much for the question.

Absolutely, we are in support of the public dental program that's being proposed. It is definitely an issue that we have long monitored. We have greater expertise on pharmacare, but these are equally parts that were left out of the original medicare system. I think this is an excellent opportunity to address some of those gaps through this dental program.

Millions of Canadians are now going to benefit from that. I think that's very good for people who are trying to deal with affordability issues right now—as everybody is—with rising inflation and interest rates. This is going to be a great help. These programs also help relieve pressures on our own health care system, because if people let dental care issues go for too long, they end up in emergency rooms, and that's not where we want to be.

I would add that we are supportive of universal social programs. We do recognize that this will help many people, many Canadians, but not everybody. We are concerned that at the end of this, there may still be some gaps. We have spoken to some members of Parliament who do support this eventually being a stepping stone to a universal program under which everybody is covered, and we're certainly hopeful for that. We realize that getting this program through will help a lot of people and also pave the way for the other commitments that are in the confidence and supply agreement.

As you know, the four health care commitments are spread out over time—the three years of the agreement—and next in line is pharmacare. We should be seeing a draft of a Canada pharmacare act this fall. I hope that we have a good discussion with the committee again when that comes, so certainly it's good all around.

[Sophie Chatel, Liberal, Pontiac, QC]

Thank you, Mr. Staples.

Another question—

[The Chair, Liberal, Peter Fonseca]

Your time is up.

[Sophie Chatel, Liberal, Pontiac, QC]

Oh, okay. Thank you.

[The Chair, Liberal, Peter Fonseca]

Thank you. I know that the time goes fast.

We are moving over to the Bloc. MP Ste-Marie has offered his time up to MP May.

You have three minutes.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

I would like to thank the Bloc Québécois.

Holy smokes, what a great day for the Green Party and the Bloc Québécois! Solidarity!

I have a question for Steven Staples from the Canadian Health Coalition.

I want to say right now, because my constituents would want me to say it, that we have a crisis. I'm 68 and I don't have a doctor. My husband is 74 and he doesn't have a doctor. We don't have a family doctor, and I worry, because although we're really young and vigorous, there are older people who have to worry.

I don't believe that the problem of health care and the crisis are solely about money. One of the doctors in my riding uses this expression: “What's the bed-to-bureaucrat ratio?” Would you use your imagination to tell us how one might construct measurable indicators of how a province spends money to make sure that we reduce the bed-to-bureaucrat ratio?