Evidence of meeting #22 for Health in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was point.
A video is available from Parliament.
Bloc
Maxime Blanchette-Joncas Bloc Rimouski—La Matapédia, QC
The allocation of funding isn't necessarily consistent with the distribution of asylum claims.
Did I understand correctly?
Liberal
The Chair Liberal Hedy Fry
Thank you. Your time is now up.
Maybe we can follow that question up in another round.
I'll go to the second round. This is a five-minute round.
We begin with the Conservatives and Mr. Strauss for five minutes, please.
Conservative
Matt Strauss Conservative Kitchener South—Hespeler, ON
Thank you, Chair.
Thank you, officials, for being here. Thank you for the study that you've done.
My colleague Mr. Mazier pointed out that, in 2016, the cost of this program was $86 million, and this year, according to your projections, the cost will be $1 billion. That's more than a 10-time increase in just 10 years.
I'm new to government but, in looking at that myself, even in terms of government standards, I would use adjectives like “runaway”, “unsustainable” and “reckless”. What words would you use to describe that sort of cost increase over 10 years based on your experience in government?
Interim Parliamentary Budget Officer, Office of the Parliamentary Budget Officer
Oh, I think we've used quite a few words in the report. In the English version, there are about 1,800 words that we've used to explain it and, in the French version, there are close to 2,000 words.
Something I've mentioned at other committees is that it is a very challenging fiscal time for the federal government and for Canadians. There's an affordability crisis. The government, as part of budget 2025, has a plan to cut $60 billion worth of spending and lay off 40,000 public servants. As part of budget 2025, they're also looking at this program as well. Obviously, the government potentially shares some of your concerns about the need to slow the growth in spending in this specific area.
Conservative
Matt Strauss Conservative Kitchener South—Hespeler, ON
Thank you. I definitely hope that is the case.
This past December, Global News reported that Canada Border Services Agency was doing an extortion investigation and found 15 individuals who they were investigating for deportation because they were engaged in the violent crime of extortion. Immediately after that investigation started, 14 of the 15 individuals claimed asylum. An immigration lawyer who Global News interviewed for the story said that these 14 gentlemen had just bought four years of subsidized health care.
Is that true to your understanding of the program? Do these 14 individuals who were set to be deported now get four years of free health care under this program?
Interim Parliamentary Budget Officer, Office of the Parliamentary Budget Officer
While anyone has made a claim and while that claim is being adjudicated, they are eligible for the program, to the best of our knowledge.
Conservative
Matt Strauss Conservative Kitchener South—Hespeler, ON
On the government's website for this program, it says that, even after the claim is deemed ineligible, individuals continue to receive supplemental health coverage, which senior citizens in Kitchener do not receive, until they leave the country. From my understanding, if you are ordered deported and you don't show up to the deportation, you're still in the country, and you would still be covered for these supplemental health services. Is that your understanding of the program?
Advisor-Analyst, Office of the Parliamentary Budget Officer
As we've mentioned before, our assumption for this costing is from the guidance we've received. The criteria that was highlighted is that the coverage ends when an unsuccessful claimant leaves Canada after exhausting all appeals.
Conservative
Matt Strauss Conservative Kitchener South—Hespeler, ON
Even if the government orders you to leave Canada, until you actually physically leave, or if you go missing, you would continue to have your insurance covered.
Advisor-Analyst, Office of the Parliamentary Budget Officer
According to this guidance.
Conservative
Matt Strauss Conservative Kitchener South—Hespeler, ON
That's incredible.
We talked about the cost increase. Previously, during our study on immigration and health care policy, this committee heard that anaesthetists in Alberta are routinely charging five times the going rate, the Alberta Health Services rate, for procedures to this program. Indeed, the Alberta Medical Association recommends that physicians charge two to five times the rate. The OMA, I believe, recommends 2.9 times the rate.
If it is the case, as we've heard, that physicians are charging more for a service given to somebody covered under this program than a Canadian senior, would that contribute to the overall costs of the program?
Advisor-Analyst, Office of the Parliamentary Budget Officer
In our analysis, we didn't make specific assumptions about billing or the cost structure; we really just looked at the cost per beneficiary. What I can say is that we have seen that those costs, while remaining on a nominal level below the Canadian average per capita, are growing significantly faster over history.
Conservative
Matt Strauss Conservative Kitchener South—Hespeler, ON
Okay.
Your projections show that the cost will increase another 50% over the next five years. My understanding is that is because new claimants enter the system faster than claimants are leaving the system, that is, being deported. We can project that even further to say that, if nothing changes, the costs will continue to grow indefinitely. Is that correct, as long as there's that basic imbalance between processing and new incoming claimants?
Interim Parliamentary Budget Officer, Office of the Parliamentary Budget Officer
That's correct, and at the same time, if something can't go on infinitely, it will come to an end at some point.
Conservative
Matt Strauss Conservative Kitchener South—Hespeler, ON
Surgeons say that all bleeding stops.
Thanks.
Liberal
The Chair Liberal Hedy Fry
Thank you very much.
I'm now going to go to Ms. Chi for the Liberals for five minutes, please.
Liberal
Maggie Chi Liberal Don Valley North, ON
Thank you to the officials for appearing today.
To begin, could you clarify for the committee the fundamental design of the interim federal health program, specifically whether it's intended to provide full health insurance equivalent to provincial coverage, or whether it's structured as a limited and temporary bridge while individuals await a legal determination?
Interim Parliamentary Budget Officer, Office of the Parliamentary Budget Officer
I believe in my opening remarks I characterized it more in terms of the latter. It's supposed to be providing a temporary bridge to individuals, while their claims are being adjudicated or while they're being resettled in the country.
Liberal
Maggie Chi Liberal Don Valley North, ON
In the report it indicates that the annual average cost per IFHP beneficiary remains well below the average per capita public health expenditure for Canadians of similar age.
Can you please confirm whether this is accurate, and explain what types of services are included or excluded under the program that accounts for the lower cost profile?
Advisor-Analyst, Office of the Parliamentary Budget Officer
The number of per capita...for Canadian...refers to all public health expenditures on a per capita basis. The costs for beneficiaries include both basic health services, which would include doctor visits, hospital visits, etc., and also supplemental health benefits.
Liberal
Maggie Chi Liberal Don Valley North, ON
Thank you. Just to confirm, you weren't able to project based on the changes proposed in budget 2025 and all the changes included in Bill C-12. Is that correct?
Interim Parliamentary Budget Officer, Office of the Parliamentary Budget Officer
In terms of the changes in budget 2025, the details were only published in late January, so we weren't able to incorporate that in the analysis, and we did not include Bill C-12, because it's still under consideration by the Senate, so hasn't yet received royal assent. We would be very happy to extend the analysis to incorporate those two elements.
Liberal
Maggie Chi Liberal Don Valley North, ON
Okay. You didn't have enough time to take a look at the fulsome picture. Budget 2025 came out last November with the high-level details, so it's concerning that it wasn't included in the report, because it was already provided in the budget document. It really didn't give us a clear picture, because a lot of the assumptions that were made in the report didn't account for the changes. I would say to everybody to take the projection number with a grain of salt.
Interim Parliamentary Budget Officer, Office of the Parliamentary Budget Officer
I'm sorry, because I think that might have been a question. I would disagree with you.
Again, I would go back to what I said about 45 seconds previously. The actual details around the copayment information were only released by the government in January. Production was well under way by then, and given the timelines for actually furnishing the committee with our analysis, there wasn't sufficient time to incorporate it—