Health Committee on Oct. 24th, 2022

[Adam van Koeverden, Liberal, Milton, ON]

Thank you. That's all I wanted to know.

[The Chair, Liberal, Sean Casey]

Dr. Ellis, go ahead, please.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you, Mr. Chair.

Just to be clear, and out of deference to what I'd like to say, I won't talk about the almost $11 billion for the whole program. That being said, the deputy minister of finance has talked about throwing stones into a lake. I think we have to really understand here that we have a significant difference with respect to how we should be spending Canadians' money and when we should be spending Canadians' money. The deputy minister of finance would say we're throwing stones into a lake. Well, if you're throwing boulders into a lake, there's a good chance that you'll actually fill up the lake.

That's really the point here. It's about how much this government wants to continue to spend, which of course we all know is fuelling the inflationary fire as well. That's the real point here. “Let's spend a billion here and a billion there; here a billion, there a billion, everywhere a billion.” That really doesn't make any sense to me. Those billions add up. I don't know that there's any billion-dollar money tree that exists out in the backyard behind Parliament Hill.

I think that's the difficulty and perhaps the entrenchment that we see. We have a significant difference in how we think we should be spending, and when we should be spending, Canadians' money. That's an important thing. Even the Minister of Health alluded to that today, talking about how people need to make good decisions about where and when they spend their money and how they spend it. That perhaps is a significant difficulty.

I just want to be clear on something. I know that this has been a bit belaboured, but what we're saying here is that in terms of all eligibility requirements being met with respect to salaries, age, etc.—this is just to be crystal clear—people who have a private plan will never qualify for this money, but people who are covered by their provincial plan and by NIHB will.

Do I have that right?

[Lynne Tomson]

You do. If you have access to private insurance—

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

You're out.

[Lynne Tomson]

Well, you're not eligible.

If you have access to a public program, and NIHB is considered a public program—also, provincial and territorial programs are very diverse across the country, which I've been hearing about today, with different coverage, different income levels and different elements that are covered—to ensure that there is more parity across the board, this would be eligible if there are out-of-pocket expenses.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you for that.

Just as a final point of clarification, if I didn't apply for my $650 now—not me, as I know that I'm never going to get it, which is perfectly fine—or if a person doesn't apply this year, is there a carry-forward provision? I couldn't find that in there anywhere.

[Lynne Tomson]

There is a provision. If an eligible person didn't access it in the first year because they weren't aware, etc., they could apply in year two for the first-year period. That's in clause 7.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Okay. I just didn't see it.

Thank you.

[The Chair, Liberal, Sean Casey]

You have the floor, Mr. Garon.

[Jean-Denis Garon, Bloc, Mirabel, QC]

I just want to raise a minor technicality, Mr. Chair. You know I'm new, so please be patient with me.

If I understand correctly, because we're currently debating the proposed preamble, which is in clause 2, that means clause 1, which is the short title, has already been adopted. Am I right?

[The Chair, Liberal, Sean Casey]

No, it hasn't yet been adopted. According to the established rules, we will do that at the end. We started with clause 2, but we'll come back to clause 1 later.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Okay, I just wanted to make sure. Thank you.

[The Chair, Liberal, Sean Casey]

That concludes the speakers list for now.

Is there any further debate on BQ-1?

Seeing none, are we ready for the question?

(Amendment negatived [See Minutes of Proceedings])

[The Chair, Liberal, Sean Casey]

The amendment is defeated.

The debate now is on clause 2, unamended. Is there any discussion on clause 2?

Oh, I'm sorry. There's another amendment.

Mr. Garon, you filed a second amendment. Would you like to move it now?

[Jean-Denis Garon, Bloc, Mirabel, QC]

Absolutely, Mr. Chair.

I think everyone here respects parliamentary institutions. I think that's an innate quality, so to speak. One of those parliamentary institutions is the Office of the Parliamentary Budget Officer, which serves parliamentarians. Its role is to enable us to make better decisions based on facts and calculations made by competent individuals.

As you know, we've been working in a strange context here. Today we're debating a bill, but we're not even allowed to move amendments. In addition, we're not allowed to move new amendments after hearing witnesses. The least they could have done is let us hear from witnesses. However, as you know, something magical happened between Tuesday, when we decided to set aside six hours to hear witnesses, and today. Suddenly we no longer have any witnesses. We would have really liked to call the Parliamentary Budget Officer.

Bill C‑31 was put together in a hurry, on the back of a napkin, with a certain lack of consideration for the parliamentary process, which we all claim is so important to us. We received the final numbers from the Parliamentary Budget Officer last Friday, after the deadline for submitting amendments. It's really quite simple: this is completely backward. As my grandfather used to say, this process is ass backwards.

You will see how what I'm saying rings true and how it relates to the amendment we're moving.

The Parliamentary Budget Officer told us that this bill leaves out a lot of Quebecers. I will reiterate what my honourable colleague theParliamentary Secretary to the Minister of Health , whom I respect, said, which was that today we had an opportunity to contribute, that we had a duty to work together. The Parliamentary Secretary told us that he was working for all Canadians, not just the people of Ontario who elected him. When he says all Canadians, that includes Quebecers. They would do well to remember that. About 130,000 of those Quebecers will be left out and won't receive the dental benefit.

To be honest, Quebec is being penalized for doing things well. We Quebecers are being penalized because, when it comes to Quebecers' taxes, we've made social choices, and we stand behind them. The tax burden is high in Quebec, after all, because we decided to fund a number of programs, including one for dental care. I'll say it again, it's not perfect coverage. It's for kids under 10. At the end of the day, 130,000 people in Quebec will be denied dental care because they already have public coverage. Moreover, these individuals already pay for these services through their taxes.

So, we're in an awkward situation. Sometimes we work too quickly and take shortcuts. I want to believe that we inadvertently forgot that Quebecers were going to be paying twice.

Having no respect for this principle puts public services at risk. Quebec is ahead of the curve. Nova Scotia has a generous program that already covers young people under the age of 12. What message are we sending to the Quebec government and the provincial governments when we tell them dental care is so important that if they have a universal program, they're going to be penalized. The day Ottawa steps in to make up for the lack of programs in other provinces, we will be paying double.

I like consistency, and I find that because it excludes Quebec and it penalizes Nova Scotia as well, by its very nature, Bill C‑31 will hinder the provision of dental care services by the provinces in the future. Every detail of that has been well laid out by the Parliamentary Budget Officer.

In Quebec's case, that's about 130,000 people who will not be entitled to a benefit of just over $500, but let's also look at Nova Scotia and New Brunswick. These are two neighbouring provinces with similar population sizes. The Parliamentary Budget Officer's document looks at the situation in detail. Nova Scotia, whose residents bear the tax burden of the province's choice to invest in a universal dental program, will receive $5 million under the federal program. In contrast, the neighbouring province of New Brunswick, which made a social choice not to invest in the same program, will receive $13 million. This is seen as an incentive to provide public dental care, but that's not right. If anything, the bill does the exact opposite of what it was originally intended to do.

There is a solution to this. From the federal government's perspective, how do you go about promoting public dental care while also accommodating what some provincial governments already have in place? I reiterate that some provinces already have an infrastructure and are able to provide dental care very quickly, without the hassle at the Canada Revenue Agency, without the need to be audited, without the need to submit invoices through the My Service Canada Account portal. I wouldn't wish My Service Canada Account on my worst enemy. Because you know that I like you, my colleagues opposite, I would not wish that on you. In Quebec, we already have an automated payment system.

Therefore, the solution is quite simple. If a province already has a program with similar objectives and is already providing the care, as is the case with Quebec and Nova Scotia, all you need to do is offer that province an opt-out and financial compensation equivalent to what that province would have received under the federal program. That's how you promote dental care. That's how you honour the responsibility that Quebec and Nova Scotia have taken up.

This is where my colleagues opposite will tell me that they have looked at all the programs in all the provinces and that some provinces have decided not to cover dental care. They will tell us again about the Beautiful Smiles Ontario program, which only covers urgent dental care. When you have a plethora of different programs, surely you can't introduce such a centralized law or measure without, at the very least, taking the time to sit down, properly list the provincial programs and figure out how to compensate them.

When we talk to colleagues opposite about the provincial programs, the funny thing is, they list off the worst provinces but they never sing the praises of Nova Scotia or Quebec. They talk about the Beautiful Smiles Ontario program and they talk about the provinces that have no coverage.

Strangely enough, it's almost like the administrative work to align the federal program and the provincial programs was done after the bill was drafted. It is almost like my colleagues opposite realized that this work had to be done after we read the document, completed our opposition work diligently and said that they were working against public dental care. That's no small thing: the NDP is working against public dental care. Its platform says the opposite, however. The Liberals are getting behind this to stay in power. It makes no sense.

We have a solution for this that's constructive, effective and respectful of the provinces and the principle behind the bill, which is to ensure that children receive a number of services. As you know, this kind of right to opt out with full financial compensation has to be negotiated. The federal government can call up the Quebec government— it has to find the telephone number first, of course—or the Nova Scotia government to ask them to enhance their program and provide services, if families and children are so important to them, and offer some compensation to those provinces.

I've said it before and I'll say it again, it's all about context. It's central to the delivery of care. It's not ideological or partisan. If we'd done exactly the same thing in the 1970s, which was to send cheques to people without talking to the provinces, without talking to Quebec, and telling them to use the money to go to a private sector provider, the NDP's legacy in Saskatchewan would never have happened. If they had done that, we would have no provincial public health care systems well funded with federal support. This is a long-term trashing of the NDP's historic legacy in Western Canada. Saskatchewan inspired all the other Canadian provinces to have public services. Those public services, which we are proud of, are provided day to day by Quebec and the provinces, like Nova Scotia, and they could be improved.

I appeal to all my colleagues: if it's important to you to have a dental care benefit that's quick, timely, effective and well funded, you will vote unanimously in favour of the Bloc Québécois amendment. A province that has a dental care or public insurance program for children with similar objectives to those of the bill—which doesn't recommend a service offering, by the way—must receive compensation equivalent to what would otherwise have been spent. If it's important to my colleagues, I'm asking them to support the Bloc Québécois amendment, since it's in the interest of all children in Quebec and Canada. This will allow us to provide quality dental care for years to come.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Garon.

Part 1 of Bill C‑31 enacts the dental benefit act, which provides for the establishment of an application-based interim dental benefit for eligible Canadian children under 12 years old across all provinces and territories. The amendment proposes to add a new clause, clause 2.1, which allows provinces to opt out of the dental benefit program and to receive financial compensation for opting out.

House of Commons Procedure and Practice, third edition, states on page 770:

An amendment to a bill that was referred to a committee after second reading is out of order if it is beyond the scope and principle of the bill.

The document further states on page 772:

Since an amendment may not infringe upon the financial initiative of the Crown, it is inadmissible if it imposes a charge on the public treasury, or if it extends the objects or purposes or relaxes the conditions and qualifications specified in the royal recommendation.

In the opinion of the chair, the amendment is contrary to the bill's stated principle of creating a national dental benefit program, since there is no mechanism to allow any province or territory to opt out of the program. In addition, the amendment proposes to alter the terms and conditions for spending provided in the royal recommendation.

Therefore, I rule the amendment inadmissible.

[Jean-Denis Garon, Bloc, Mirabel, QC]

On a point of order, Mr. Chair. I'd like to share my opinion on your decision.

The bill's short title, Cost of Living Relief Act, No. 2 (Targeted Support for Households), has little to do with dental care. In fact, it doesn't mention dental care.

Based on the debate about the preamble of the proposed legislation and the fact that the first Bloc Québécois amendment did not pass, it's safe to assume that we're talking about the provision of dental care today.

I am, of course, debating the substance of your decision, Mr. Chair. In my view, the purpose of the program was supposedly—

[Don Davies, NDP, Vancouver Kingsway, BC]

I have a point of order.

You have made a ruling, Mr. Chair, that the proposed amendment is inadmissible. It strikes me that what Mr. Garon is doing, and I was arguing that point....

I ask whether or not that's in order.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Mr. Chair, I can assure you of the relevance—

[The Chair, Liberal, Sean Casey]

One moment, Mr. Garon.

Mr. Davies, I agree with you.

Mr. Garon, you really only have one option at this point. You can't debate the decision I just made, but you can challenge it if you wish. The committee will therefore decide if the chair's decision should be upheld.

Mr. Davies made a very good point: A decision by the chair cannot be debated. Your only option is to challenge my decision.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Thank you, Mr. Chair. I will take that option: I will challenge your decision and call for a vote.

[The Chair, Liberal, Sean Casey]

The ruling of the chair has been challenged and a vote has been requested. That's a non-debatable motion.

Therefore, the question for the committee is, shall the ruling of the chair stand?

(Ruling of the chair sustained)

The ruling of the chair is upheld. Therefore, we are now ready to debate clause 2, unamended.

Go ahead, Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

I have a very novel, unusual request here. I'm hoping that we can get unanimous consent regardless of what the rules are.

This is with great respect to Mr. Hanley. Under clause 4, on eligibility, in paragraph 4(1)(d), the last words are “plan established by the government of Canada or of a province”. I think that's just a drafting error and it should say “or territory”.

I'm just wondering. I think this committee has worked well on this to ensure the territories are included. I would just ask if we could have unanimous consent to add that word in both English and French.

[Jean-Denis Garon, Bloc, Mirabel, QC]

On a point of order, Mr. Chair. We no longer have interpretation.