Thank you very much.
Thank you, Chairperson and members of the Standing Committee on Finance.
I also want to extend a thank you to everybody who met with our volunteers in March. I know that many of you spent very valuable minutes of your day with our volunteers. It's very much appreciated.
My name's Steve Staples. I'm the national director of policy and advocacy for the Canadian Health Coalition. We were founded in 1979 to defend and expand public medicare in Canada. We're comprised of frontline health care workers, community groups and experts.
I'm delighted to speak to you on the topic of Bill C-47. I last met you in October during pre-budget consultations.
We would like to address “Chapter 2: Investing in Public Health Care and Affordable Dental Care”.
Today, I'd like to focus on three aspects. Number one is the enforcement of the Canada Health Act and conditions for federal funding to provinces and territories. This includes reining in private, for-profit delivery of publicly insured services. Number two is the importance of universality, given the means-tested approach to the dental care program that leaves untold numbers of families behind because of their incomes. Number three is the need to extend the goal of providing public coverage of medically necessary services to include prescription medicine through public, universal pharmacare.
In October, the Canadian Health Coalition recommended that the government work with provinces and territories to increase federal funding through a Canada health transfer that's accountable, while improving outcomes for people in Canada through new public health care programs, such as dental care and also pharmacare. There's more work to do. We applaud the additional funding provided by the federal government to the tune of $198 billion over 10 years, including $46 billion in new CHT funding and $25 billion over 10 years through bilateral agreements with the provinces and territories.
Concern remains that this money could yield limited results in improved health care without conditions and accountability. It's a dirty little secret that the Canada health transfer, the money that goes from the federal government to the provinces, doesn't actually have to be spent on health care. The money flows from Ottawa into the general revenues of the provinces and territories, and they can spend the money as they like. It's a sad day when the federal budget that just came out promises to—and I'm quoting here—“Ensure that new federal investments are used in addition to provincial spending, and that provinces and territories do not divert away health care funding of their own”. How can the federal government ensure transparency that the money is actually going to be used for health care and not be diverted away, as the budget says?
The Canadian Health Coalition is very concerned that billions will be spent on publicly insured services in private, for-profit clinics—putting Canadians at risk of user fees and extra billing—and be wasted on profit-taking by inefficient private providers. Health Minister Duclos' own annual report on the Canada Health Act cited eight provinces violating the act. They withheld $82 million with respect to patient charges levied during 2020 and 2021 for medically necessary services that should be accessible to patients at no cost. We know that's probably just the tip of the iceberg.
Furthermore, data uncovered by the public interest group in Quebec called IRIS revealed that the cost of a carpal tunnel surgery averaged $908 in the private sector compared to $495 in the public sector. The list goes on. A short colonoscopy costs $739 in the private sector compared to $290 in a public institution. This is our health care money, yet the federal government has been silent on this matter. In fact, remarks by the Prime Minister about Ontario's privatization plans reported widely in the media were very worrisome.
One of the principles of the Canada Health Act is universality. The budget says, “Canadians are proud of our universal publicly funded health care system. No matter how much money you make, or where you were born, or what your parents do, you will receive the care you need.” Well, we can all agree on that.
Why does this principle of universality not apply to dental care?
The Canadian Health Coalition applauds the $13 billion committed to this program, a result of unprecedented collaboration among political parties. However, there's unfinished business. What about the self-employed or the gig workers who have no benefits but might have a family income of just over $90,000? We asked the Parliamentary Budget Officer how many families would be left behind. They know the number, but they won't share it with us.
Finally, we look forward to Canada's pharmacare act being passed this year, but we were disappointed to not have it acknowledged in the budget. In October, we requested $3.5 billion for essential medicines, as recommended by the 2019 government-appointed advisory council on the implementation of national pharmacare and the Hoskins report, led by Dr. Eric Hoskins.
When the pharmacare act is brought forward this year, we expect it to reflect—