Health Committee on April 19th, 2021

[Luc Thériault, Bloc, Montcalm, QC]

Dr. Belanger was telling us that a colonoscopy costs $1,000. The patient who does not have timely access to a colonoscopy will end up with a chronic health problem and become dependent on the health care system over many years. You are telling us that it will not only cost a lot more to maintain the quality of life of such a patient, but it will also create other costs for the health care system. So we have to expect an increase in the cost of services in the health care system right now if we are going to treat these people. Yet we do not currently have the resources to care for them.

[Dr. Martin Champagne]

The already very limited resources are running out. Even during the lull we experienced between the second and third wave of the COVID-19 pandemic, we were never able to exceed the maximum activity level of 100%. As a result, we never erased the diagnostic delays that jeopardize our patients.

[Luc Thériault, Bloc, Montcalm, QC]

Currently, Quebec and the provinces believe that the chronic underfunding in health is, among other things, related to the fact that for the past 30 years, the federal government has not contributed enough to health transfer payments. Quebec and the provinces are asking for an increase, not of $0.22 but of $0.35 per dollar, which is equivalent to a 35% increase. The shortfall is therefore $28 billion. We're also asking for a 6% indexation, because we're at 3% right now. The system costs are at 5%.

During the first wave, the Prime Minister often said he would address the situation after the pandemic. Now we are experiencing a third wave. Do you think it's visionary to say that there is a before and after and that we need to invest in health care now to give the system some breathing room and care for people?

[Dr. Martin Champagne]

I practise medicine, not politics, but we can certainly imagine right now that without major additional investments, the health care system will not survive the financial burden imposed by the COVID-19 pandemic.

[Luc Thériault, Bloc, Montcalm, QC]

Have you evaluated the costs that will result from the lack of resources? For example, let's compare the cost of a $1,000 colonoscopy to the cost of the surgery and chemotherapy needed to treat colon cancer. How much would the costs be in the latter case?

[Dr. Martin Champagne]

In more advanced stages of cancer, each episode of care delivered over a trajectory of a few years costs several tens of thousands of dollars per year. For example, immunotherapy for lung cancer currently costs $35,000 to $50,000 per episode of care. Thus, the costs absorbed by the health care system to treat advanced lung cancer are very significant.

[Luc Thériault, Bloc, Montcalm, QC]

Do you feel that the appointment scheduling system is currently a bit antiquated? It often works through fax machines. Do you think we should also invest, as the Canadian Association of Radiologists is calling for, in a much more efficient system using cloud computing, for example, that would allow for patient self-scheduling?

[Dr. Martin Champagne]

These are things that could definitely make it easier to access care. A lot of hospitals are outdated.

It's also important to understand that the COVID-19 pandemic imposes physical distance. For example, when a common waiting room serves two rooms for ultrasound, two rooms for CT scans, and one room for magnetic resonance imaging, we can't proceed as we used to. We cannot accommodate 15 patients at the same time and send them one after the other to the different rooms. We have to impose a temporal and physical separation.

For example, if Luc Thériault needs a CT scan, Martin Champagne cannot be in the waiting room at the same time as him. He will have to wait. The system's capacity is therefore diminished. We do need modalities that will allow for better communication. Diagnostic means and contact with the patient have changed. Telemedicine is used a lot and many of the means put in place in a disaster situation could also facilitate access to care. Many records are not yet computerized, for example.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Thériault.

We'll go now to Mr. Davies for six minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

Thank you to all of the witnesses for being here.

I'm going to direct my questions to Don't Forget Students.

May I call you Brandon?

[Brandon Rhéal Amyot]

Yes, absolutely.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Brandon.

I want to zero in on a few things. I want to preface by saying that I know every single Canadian has been terribly affected by the COVID crisis, but I think that seniors and young people have particularly had their lives disrupted in certain ways—I think students in particular in that regard. I want to ask you a couple of specific questions.

What would be your recommendation to the federal government in terms of the appropriate policy to handle student debt and interest payments for student loans at the federal level?

[Brandon Rhéal Amyot]

I think that, short term, obviously we need to get through this pandemic. We shouldn't be charging recent graduates interest and student debt payments. We paused it for the first six months of the pandemic, so I believe the federal government should work with the provinces and territories to refreeze payments to the National Student Loans Service Centre for the remainder of the pandemic. Long term, we should be looking at progressively and aggressively writing off student debt federally—the federal portion—and urging the provinces to do the same because, at this point, we have reached a critical junction in post-secondary policy and in terms of student debt. It is not in the economic interest of Canada to continue to burden people with student debt.

Particularly if we're talking about the marginalized communities in Canada—low-income students, indigenous students, women—they have a longer and harder time paying off student debt than their peers. If we're looking at this through an equity lens too, we need to acknowledge that. We should be working towards the progressive elimination of student debt, but in the short term, student-loan interest payments and debt payments.

[Don Davies, NDP, Vancouver Kingsway, BC]

Just so that I'm clear, Brandon, right now as we speak, are graduates paying federal interest on their student debts?

[Brandon Rhéal Amyot]

It's my understanding that a freeze on interest has been implemented or is about to be implemented. They are still making hundreds of dollars in payments a month; there's just no interest. Frankly, the removal of interest is not sufficient, not during the pandemic and not in the best of times.

[Don Davies, NDP, Vancouver Kingsway, BC]

Let me flip to the other side of the equation.

I think many of us who have been to university know how critical that four-month period in the summer is for your making the money that you need for tuition and to pay your living expenses through the year. I also know that there's been a significant expansion by the federal government in terms of funding the Canada summer jobs program.

What is the situation right now with employment for young people? We're in the middle of a serious third wave across this country. Are there plentiful jobs out there for students this summer so that they can go out and earn the money that they need to pay their tuition and living expenses come September?

[Brandon Rhéal Amyot]

Jobs for young people are not at the high they were in May 2020. The job market for young people still has not rebounded. While I acknowledge the changes or expansions to the Canada summer jobs program, a summer jobs program is one part of a larger policy that we need to implement. Frankly, I have been responsible for administering a Canada summer job at a non-profit, and I've also been on the receiving end of a Canada summer job. There are inequities that exist within it. International students are not eligible. If you're over the age of 30 and you're a student, you're not eligible. We need to be creating larger programs that capture more students and young people to ensure that people are not slipping through the cracks, especially with the way the job market is, the financial realities of COVID. Those have a significant impact on mental health and well-being. That's part of why I'm calling for the reinstitution of the CESB.

[Don Davies, NDP, Vancouver Kingsway, BC]

I don't know if it's possible, but could you give us a bit of a glimpse into the mental health of students right now? They've been particularly dislocated. People can't go to class. They're learning online. They're isolated. Can you give us a general idea of how students are feeling in this country right now and whether there are specific challenges facing them that we should know about to respond to in policy?

[Brandon Rhéal Amyot]

Of course. It's difficult to capture in a short answer, but from my own experience, as much as the university and the student union and other organizations and friend groups have tried to maintain a sense of community, it is not the same. That's the case across Canada, not just for students, despite the whole point of being on campus being to build a sense of community student life. That aids in our education, in our coming out of these institutions, in getting jobs and finding community and volunteering. We've lost a lot of that.

In terms of the impact on mental health, some students have been working at grocery stores and if you're a health care student, you've probably been on the front lines in some capacity. From looking at the intersections, we see that students are struggling with mental health across the board, but some students in particular are more challenged by the pandemic.

I don't have access to my cultural ceremonies as much as I did before the pandemic, and that's of course because I want to keep my elders safe, but it's not the same over Zoom. You can't exactly [Technical difficulty--Editor].

[Don Davies, NDP, Vancouver Kingsway, BC]

That interruption may be particularly ironic.

[The Chair, Liberal, Ron McKinnon]

Yes, I think we lost Mr. Amyot.

Mr. Davies, go ahead with one more question if you can. I'll give you a little extra time.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thanks. I'll try to be quick.

It's budget day today, Brandon. It's an important day. What would you like the Prime Minister and the Finance Minister of this country to do for students if you could give them any single piece of advice? Improved Internet connections might be something.

[The Chair, Liberal, Ron McKinnon]

I think we've lost Brandon.

Is there anyone else?

[Don Davies, NDP, Vancouver Kingsway, BC]

Thanks, Mr. Chair.

I think I was pretty much near the end of my question time anyway.