Mr. Speaker, our health care system is one of the best things provided by our great country and Canadians attach a great importance to it. Without health, enjoyment of life can be greatly diminished. The protection of our health is dependent upon two major elements: the responsibility that each one of us has to adopt healthy habits, and our national health care program. The government cannot do much about the first element, but it can do something about the second one.
As a physician and a consumer I believe the Canadian system of health care is indeed the best in the world. It is one of which other countries are envious and one in which any Canadian in the country can get the best of medical care free of charge.
At the foundation of the system lies the Canada Health Act which is based on five tenets: universality of care for all Canadians, comprehensive coverage of all essential services, reasonable access by both providers and users, portability of benefits from one province to another, and the administration of health care on a non-profit basis.
The provinces and the federal government both share the management of payments. The care however, and the management of the whole system falls under the provincial jurisdiction. The federal government now provides approximately 25 per cent of the necessary funds so long as the provinces administer their health care plans in accordance with the Canada Health Act.
Over the last decade we have seen the emergence of a mounting fiscal crisis. If unchecked it will ultimately lead to the collapse of publicly funded health care in Canada.
The largest crisis which many of my colleagues have mentioned today is the mounting debt and deficit. In this country federally we have gone from $125 billion in 1980 to over $500 billion this year.
The amount of revenues that are required to service this obscene debt load has increased. Roughly in 1984 we were paying about 28 cents out of every dollar for interest payments. Now it is running around 33 cents. If our spending goes on as it is going on at current levels, in the year 2000, 40 cents out of every dollar will be used merely to service this debt. This means we have less and less money to spend on social programs such as health care.
Another interesting fact that people may not be aware of is that the amount of money the federal government spends as a percentage of total program spending has actually declined since 1970 from 10.9 per cent to 7.6 per cent. This means that the federal government itself is spending less and less money on health care regardless of anything else.
I am not taking into consideration the provincial fiscal crisis which is also going to impinge on the ability of governments to fund health care.
At the same time that the governments have been reducing their spending on health care, there is the other side of this equation. That is that the costs of medical care in this country are escalating dramatically. In fact they are going up over four times the rate of economic growth. This situation will only worsen in the future. There are many reasons for this such as an ever increasing aging population that consumes over 70 per cent of the health care dollar; technologies of intervention and equipment which are getting more and more expensive all the time; and new diseases such as AIDS which are very expensive to treat are raising their ugly heads. For all of these reasons and many more it is clear that health care in Canada is living not just on borrowed time but on borrowed money.
The health care crisis is a result again of dwindling funds and escalating costs. The problem is clear. The federal government continues to hamstring the provinces and is preventing them from getting their health care under control by using its fiscal contribution to the provinces as a wedge that will prevent them from enabling us to continue with publicly funded health care.
This as one can see is an unsustainable system. We must do something about it because it will ultimately contribute to the demise of health care in this country and to the suffering of Canadians. Is this a lost cause? No, it is not. There are a number of things we can do.
We must freeze federal spending for health care at 1993 levels. We need to modify the Canada Health Act to stop penalizing the provinces when they try to get their health care under control.
This suggestion is in a provincial jurisdiction but I am saying it for the record so that we can address it. We need to strike a committee to define what essential health care services are that will be covered across the country from coast to coast and we should delist other ones. Delisting services would be those services that would not be considered essential health care for Canadians.
We can make consumers more accountable. The current system encourages waste and will lead to unnecessary cost. Some suggestions have been bantered around and it is up to the provinces to decide on modest user fees and the use of deductibles. Remember, if we can save publicly funded medical care in this country, no one will go without essential health care services.
As a physician, one of the reasons I got into this was to preserve the system that we have in Canada. We do not want to get into a system like we see in the United States which I personally think is reprehensible.
We also need to inform the public of the cost of medical services. Perhaps we can do this with a statement of accounts at the time of consumption or perhaps annually or bi-annually. We also need to put a greater emphasis on health care education, particularly at the early grade school years. This will pay off in spades later on. I can guarantee that.
We also need to address health care professionals and we must educate them more, myself included, as to the cost of technologies and intervention. By and large we have not done a good enough job of that.
I would also allow the provinces to enable health care professionals to run privately funded services. This would serve two purposes. It would decrease the horrible waiting lists that we now have and ultimately it would be a win-win situation for all people those who would go private and those who would go public. People under that circumstance would get their health care services a lot quicker than before which would mean less pain and suffering. People would go back to work sooner and it would be far more beneficial for the economy, not to mention the insurance companies whose premiums would go down.
The current hodge-podge two-tiered system of rationing that we have is the last futile attempt to correct a system that is broken and will soon sink under its myopic tenets and fiscal mismanagement.
The second topic I would like to speak about briefly in view of the Auditor General's report is how we administer foreign aid. We can look at the CIDA disaster in conjunction with this.
Some fundamental changes have been considered and I would like to suggest a few of them today.
First, no government to government aid as much of this money lands in the Swiss bank accounts of despotic third world rulers. As a result of that the heads of many of these states are some of the richest people in the world.
Second, dispense aid directly to projects on the ground administered by foreign aid workers in conjunction with local peoples.
Third, focus on helping people to help themselves.
Fourth, concentrate on small projects that incorporate and are sensitive to local customs and practices. Expensive mega projects are usually expensive mega failures.
Fifth, focus on projects that involve family planning and birth control. Perhaps the greatest threat to the welfare of all peoples on this planet is the population explosion. We are rapidly outstripping our ability to provide for ourselves and are straining our resources to their maximum and laying waste to the environment.
I would not encourage foreign aid as a lever in developing nations as it only affects those most in need.
Make no mistake that what happens in other parts of the world will one day land on our doorstep one way or another. That is inevitable.