House of Commons Hansard #13 of the 35th Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was programs.

Topics

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6:50 p.m.

The Speaker

Order. You can only ask a question or comment on the speech of the hon. member for St. Catharines. Do you have a question?

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6:50 p.m.

Bloc

Laurent Lavigne Bloc Beauharnois—Salaberry, QC

Very well, Mr. Speaker.

Then I will simply follow your instructions and comment on this debate and on the position taken by our party and by the government. Obviously, we would like our party and the Reform Party to reach a consensus on the big issue of the allocation of public funds.

We know that Ottawa collects roughly $28 billion in taxes from Quebec each year and we would like to know how this money is redistributed. For the past several years-and the $500 billion debt confirms this-we have been making suggestions. We are always accused of harping on the same old Péquist arguments. However, if the government accepted our suggestions, then we not go over the same ground again and again.

We are calling for an end to duplication of services. This is nothing new. We are calling for an end to cuts in social housing. The situation is pitiful in my riding. There is a shortage of social housing and yet the government is poised to make further cuts in this area. A decade ago, the soup kitchen in my region served up about 35 meals a day. Today, it serves up 400 meals a day. This is completely unacceptable.

We have made suggestions to the government as to what measures should be contained in its upcoming budget. We proposed the elimination of family trusts and we targeted such areas as duplication in the taxation and services fields. For the sake of greater efficiency, we are asking that the federal government withdraw from manpower training programs and hand this responsibility over to Quebec.

In conclusion, let me say that Mr. Le Hir, the president of the Association des manufacturiers du Québec, as well as Mr. Ghislain Dufour, the President of-

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6:50 p.m.

Liberal

David Dingwall Liberal Cape Breton—East Richmond, NS

Question, Mr. Speaker.

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6:50 p.m.

Bloc

Laurent Lavigne Bloc Beauharnois—Salaberry, QC

Mr. Speaker, there was a report in this morning's edition of Le Devoir . The hon. member is upset by the truth. These people are not Péquists, Mr. Speaker.

Social Security SystemGovernment Orders

6:50 p.m.

The Speaker

Order, please!

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6:50 p.m.

Bloc

Laurent Lavigne Bloc Beauharnois—Salaberry, QC

Why have you called for order, Mr. Speaker?

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6:50 p.m.

The Speaker

I have no objections to what the hon. member is saying.

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6:50 p.m.

Bloc

Laurent Lavigne Bloc Beauharnois—Salaberry, QC

I am prepared to co-operate, Mr. Speaker.

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6:50 p.m.

The Speaker

Perhaps the hon. member has a question.

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6:50 p.m.

Bloc

Laurent Lavigne Bloc Beauharnois—Salaberry, QC

I do have a question, Mr. Speaker.

Why is the government not willing to follow the recommendations put forward by the opposition party, the Bloc Quebecois? Why will it not eliminate trusts, end duplication of services and tax large corporations? Why?

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6:55 p.m.

Liberal

Walt Lastewka Liberal St. Catharines, ON

Mr. Speaker, I thank the questioner. I think all Canadians have come to the point where they have had enough of paying taxes. I agree that we need to take a look at the various systems and the waste in the systems. However, we cannot forget about the important item of trying to improve the system. We need information and consultation from all parties and from all Canadians.

This a process the minister has started. I think it is important for us and for Canada that we continue to have debates and consult back and forth and that the people of Canada have an opportunity to provide input. Let us not forget that I am here representing St. Catharines and Canadians. Canadians feel it is important that we do something, that we eliminate the waste right across Canada.

I agree with that. However I have to do it for the good of all Canadians, no matter what province they live in. I am proud of my province of Ontario, but I am also proud of Canada. It is important, as we consult and debate, that we get input from coast to coast and that we make a better system for Canada on a continuous basis.

Let us not be afraid. For the next two or three years, let us make continued improvements for Canada.

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6:55 p.m.

Liberal

Andy Mitchell Liberal Parry Sound—Muskoka, ON

Mr. Speaker, with this referral of the review of social policy to a standing committee, our government is about to embark on what I consider to be the most important undertaking during its first term.

If we are to bring about social justice to this country, if we are to have any ability to bring our financial house in order, if we are to find new and innovative ways of conducting business in this country, then the reform of our social policy is absolutely essential.

Our government is committing itself to a most extensive public review process. This issue will be debated not only in this House, both during the preliminary stages and later when legislation is actually tabled, but also through the parliamentary committee to which this review is being referred. In addition, we will be dealing with both the political and bureaucratic components of the provincial government and, through a series of consultative processes, with constituency groups, the general public, and in particular those individuals presently charged with delivering our various and sundry programs.

In referring this matter to the standing committee, it is vital to outline what I believe to be important governing principles that should be considered in the deliberations. These principles include equity, effectiveness, co-ordination and accountability.

Whatever system we develop must be equitable. To me this means we recognize that as Canadians, as a government and as a nation we have a responsibility to each other.

Going back to at least World War II, there has existed in this country an unwritten but very clear social contract between Canadians and their government. This contract essentially says that on the one hand Canadians will tend to pay more for government than perhaps their counterparts in the U.S. and other nations, but on the other hand, in return for this we as Canadians and as a government have a responsibility to ensure that we will not allow individual Canadians to fall below a certain level. We have determined as a country that we will not allow people to die for lack of medical service, to go hungry for lack of food, to be exposed for lack of shelter.

This contract is basic to what Canada and Canadians are. Whatever the result of our social policy review, it must maintain this basic concept of equity that our parents' generation formulated, that our generation has attempted to maintain, and that we must protect for our children and our children's children.

The second governing principle that must be adhered to in our deliberations regarding social policy is effectiveness. Whether we are speaking about income support, job retraining or life skills development, we must ensure the program provides full value for each dollar that is spent. We need to set as an objective not a decrease in the number of dollars that are placed in the hands of individual Canadians but rather an objective that sees a reduction in the number of programs, a reduction in the administration costs and a reduction in the duplication of services. We do not need more money, we need money better spent. We need to bring to an end the bureaucratic practice of territoriality, we need to bring to an end the turf wars that consume so much of our precious resources, and we need to design our programs so that they put the necessary financial and other resources in the hands of recipients in a manner that does not require a massive bureaucracy be maintained.

The third principle that I believe should govern our deliberations is co-ordination; that is, co-ordination within our own government, co-ordination with other governments and co-ordination with the private sector. We must bring to an end the massive amount of duplication of services that presently exists in the area of social services.

If individuals today wish to receive training, the largest challenge they will face will not be the actual course they might take, but rather finding the correct entry point into the system. They will find that they have to choose from several entry points and sometimes from dozens. Our system must be designed so that individuals have one entry point into the system and one exit point.

Does it make any sense that our income support system is made up of numerous programs and that these programs are delivered by various levels of government and in some cases duplicate programs are delivered by duplicate levels of government? Income support should be provided by one system, administered by one bureaucracy and developed in as simple a manner as possible, one that reflects the economic realities of the 1990s and not of the 1950s or 1960s.

I can see absolutely no sense as to why an individual who has lost his job receives his income support in one form from one level of government for a period of time and then receives his income support from a different level for another period of time, administered by a different bureaucracy. We need one income support program, administered by one level of government and delivered in a cost efficient way.

The final governing principle that I believe should be adhered to in our deliberations is that of accountability, accountability both from government who administers the program and from the individuals who utilize the program. As a government we need to design our income support and training programs with clear objectives as to what they are attempting to accomplish. The effectiveness of these programs should be measured on an ongoing basis, both by this Parliament and by the people of Canada, as to whether they are achieving their objectives. We

should be prepared to change programs that do not work or amend programs that are in need of revision.

But accountability is not just on behalf of the government which delivers the programs, but also on behalf of the individuals who utilize them. Individuals who receive income support must have as their objective, where possible, re-entry into the work force and the ability to become self-sufficient. Their objective should not be to maintain an alternative lifestyle that entails perpetual government assistance from cradle to grave.

We do have individuals in this country, unfortunately, who will need our support not just in the short term but perhaps for the rest of their lives. But we also have individuals who, with properly designed programs and with the correct incentives, can become productive members of society, and we must ensure that our social policy review results in a system that will mandate this to happen.

In conclusion, let me simply state the one governing principle that I believe distinguishes a Liberal approach to the issue of social policy reform as opposed to one that has been pursued by the past government and that I believe is being pursued by some of the members opposite.

As Liberals, we start with the needs of individual Canadians, with the dignity of men and women, the importance of the human spirit and the sanctity of human values. From this will flow jobs, from this will flow renewed economic activity, from this will flow new personal and business prosperity.

If we begin the process with our concern being solely one of economics, solely one of business profits, solely one of bottom line, and we ignore the basic component, which is the individual Canadian, then we will continue to take us down a road that we have travelled for the past decade, which will create more hardship, more unemployment, less economic development and a nation that will not be living up to its true potential. It is the first option that Canadians have demanded and it is this option that we as a government intend to pursue.

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7:05 p.m.

Bloc

François Langlois Bloc Bellechasse, QC

Mr. Speaker, I listened with interest to the speech by the hon. member for Parry Sound-Muskoka. I had the chance to listen to the previous Liberal speakers. We heard three speeches and three different positions. One Liberal member who spoke a while ago was sensitive to the needs of the population and focussed on the poorest members of our society. Another shared most of the concerns expressed on this side of the House. Then we gradually moved away from this position with the address by the hon. member for St. Catharines.

I will keep my question short. It is fortunate that I still have my sight because I could see that the hon. member for Parry Sound-Muskoka was on his feet but I was hearing what sounded like a Reform speech. Could the hon. member for Parry Sound-Muskoka tell me what distinguishes his speech from those made by Reform members? He seems to be putting a great distance between himself and some of his colleagues who have spoken, it must be said, from the back benches, not his colleagues from the front benches who are conspicuous by their absence from this debate. We are fortunate to have a minister present in the House. It is interesting, but the viewpoint from the back benches seems a little pro forma and at times sounds like what we heard at the Spicer Commission, a kind of cantina where everyone brings their own wine and where the bill is prepared in advance. While we are talking, I am wondering whether the policies have not already been drafted.

My question to the hon. member for Parry Sound-Muskoka is this: Is there a difference between his own personal position and that of the Reform Party since this is an open debate?

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7:05 p.m.

Liberal

Andy Mitchell Liberal Parry Sound—Muskoka, ON

Mr. Speaker, I thank the hon. member for his question.

There is indeed a great deal of difference between my point of view, which is a Liberal point of view, and that of the Reform Party. It begins with where we start. If we begin our deliberations from a simple bottom line, which is need, then we are going to end up where the Reform Party is going to end up.

Liberals do not do that. We begin with the need of the individual Canadian. We believe in the dignity of individual Canadians. We believe in that unwritten social contract of the last 50 years where we as Canadians have believed that we have responsibilities to each other.

As I said in my speech, we believe we will not allow Canadians to fall below a certain level. People will not die in this country for lack of medical services, they will not go hungry in this country for lack of food, and they will not die exposed for lack of shelter, because Liberal governments in the last 50 years have constructed a social policy in this country that has protected individual Canadians, and we as a government in 1994 are not going to try to dismantle it but find a way to make it continue so that we will continue to serve Canadians. We will continue with that social contact so that my children and my children's children will enjoy the benefits of what Liberal governments for the last 50 years have been able to accomplish.

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7:05 p.m.

Reform

Jack Ramsay Reform Crowfoot, AB

Mr. Speaker, I have enjoyed listening to the hon. member and I would like to ask a simple, straightforward question.

Our country continues to plunge into debt, and it appears that before we can wrestle the deficit out of existence we could hit $650 billion of indebtedness. As each year goes by, we lose a little more of our ability to help the poor, whether it is the needy

refugees coming into our country or any other poor within our society. What would the member suggest? How would the member suggest we help the poor in this country when we lose the financial and economic ability to do so?

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7:10 p.m.

Liberal

Andy Mitchell Liberal Parry Sound—Muskoka, ON

Mr. Speaker, the way we are going to help the poor in this country is with what has been said for the last three weeks over and over again. We are going to help the poor by getting them back to work in this country, by giving them jobs, by creating jobs, by creating an environment in which the small business sector can create jobs.

That is how one gives them dignity. That is how one is able to afford it. The red book has outlined a policy through 122 pages. It details very clearly how we are going to renew the economy in this country, how we are going to put people back to work and how the poor will take care of themselves when they have those jobs.

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7:10 p.m.

Reform

Chuck Strahl Reform Fraser Valley East, BC

Mr. Speaker, I consider it a privilege to debate the reform of social programs in the country. For many here today, reforming them to ensure both their sustainability and their availability to those who need them is a significant reason to have run for Parliament in 1993.

We feel grateful that the government has given all members a chance to air their views on this issue before legislation is introduced. I am sure that all members share my desire that backbenchers and constructive opposition members alike will be able to see reflections of these debates in the legislative program to come.

Certainly there is general agreement in this country on the need for reform of our social programs. Members on both sides of the House again agree that cosmetic changes are not enough.

Questions are being asked that would have been unthinkable just a few years ago. Is there a better way to deliver this program or service? Do we need it at all? Are there built-in disincentives to people who need to be fully self-supporting? How much do programs cost? Can we sustain them?

Watching the finance minister's pre-budget consultation in Calgary on the weekend, I was struck by widespread agreement on these issues. Almost everyone said that our current method of funding social programs is killing jobs and export opportunities, that less government intervention is better and that government needs to spend less, spend smarter and tax less.

Spending less does not mean taking Canada back into the dark ages. What it really means is that funding must be refocused and it is incumbent on this House to lay down the principles that will guide a rechannelling of program assistance in a way that is fair, effective and compassionate.

Other speakers have already discussed a number of principles. One of them is that spending in the future must be based on need rather than entitlement. People with high incomes do not need the same kind of help as those with low incomes. Therefore the fact that they belong to a particular ethnic or demographic group should not automatically entitle them to extra government support.

We feel that tomorrow's programs will be delivered more in concert with private groups. People in need will work with a community based network rather than those who are simply paid to supply them a service. These private groups may be part of the answer in helping an individual emerge from this chronic position of need.

There should be also a stated objective of other programs that recipients be required to undertake training or community service that will enable these people to acquire the skills that will reduce their future dependence upon governments.

These principles are significant. I have the privilege of addressing the most important principle this afternoon and this evening. That is the position of the family in relation to the state. This principle is important because it questions the assumption of the welfare state that has become entrenched in the post-war era, the assumption that has spurred this magnificent fiscal situation in which we find ourselves today.

I am speaking of the concept of the paternalistic state, the notion that the state or the government has the capacity or even the duty to somehow replace the family as the basic unit of nurture in our society.

This sentiment, while never accepted by most Canadians, was heralded when Bonnie Kreps announced to Maclean's magazine in 1969 that her group's objectives included getting rid of the conjugal family unit. For decades this idea has occasionally found its way on to the desks of government policy makers. Many feel today that families have been unappreciated and under supported as a result.

While the role of the family has been questioned, the concept of the state is also changing.

People are disillusioned. They no longer believe it is possible for government to provide all of the solutions. Certainly its scope is shrinking because of its financial problems. In a way this could be a positive thing because with a little help human relationships could fill in the gaps left by government programs.

The basic unit of care should not be a government cheque or the department of something or other or a social worker. The

unit must be the family. Society has yet to develop a better way to care for the young, protect the weak and attend to the elderly.

People who come from dysfunctional families need special help at times and then the government must step in to do the best it can for the individual, realizing that it will always be an inferior choice to a functioning and loving family.

In some ways governments have even played a part in encouraging dysfunctional families because they support people without reference to their family ties. An example is a young person who rebels and leaves home only to end up on some kind of government assistance, or the husband who moves to another province to shirk his responsibility to pay for court ordered support.

Governments should require people to demonstrate at least this minimum level of responsibility toward their relationships and this might even lead to an increased incentive to make families work.

There are other positive things government can do to encourage strong families. I would like to see some aspects of our tax structure changed, especially encouraging couples with children. Last year's tax ruling against married couples in an Alberta court sent a mixed message to Canadians. Incredibly, the courts ruled that while married couples have suffered tax discrimination in years past, it is acceptable because families have suffered less discrimination in the past than other stereotyped groups. Surely this was and is wrong.

Another positive change could involve day care. Those who advocate the welfare state would like to see government workers control the care of children. However, the Reform Party prefers a de-institutionalized setting that gives the choice to parents.

As Margaret Wente mentioned in her column in Saturday's Globe and Mail , if we really want to help parents, why not put extra money directly into their pockets and let them figure out how to spend it? The government's role would be relegated to licensing and monitoring day cares, allowing parents to choose their own system, be it a day care, a nanny or some other personalized arrangement.

I want to touch for a moment on the reasoning of the welfare state and why it can be damaging. Advocates of government solutions feel that the government is somehow objective and that families are unobjective, unenlightened bastions of conservatism.

While it is probably true that families are more conservative than your average university professor, I do not believe that there is any such thing as a value neutral objective authority. If the authority of the state replaced that of the family it would simply teach and impose its own values through that system.

It is quite clear to me that the values of big government are frequently a fundamentalist mish-mash of left wing, politically correct dogma that in its own way is far more conservative and legalistic than that held by most families. Any concerted, large scale attempt to replace the authority of the parent with that of the teacher, the social worker or even the courts will be resisted on this side of the House.

Where is this debate going to take us? We have heard some discouraging debates in the last few weeks, talk of maintaining universality regardless of need or broadening the tax base and changing RRSP rules. Each of these proposals would adversely affect families.

How will they hurt them? By maintaining or adding new programs at the urging of special interest groups or failing to address our debt and deficit problem squarely and honestly, by refusing to prioritise the dwindling resources of our government we will harm the most vulnerable in society, including young families, in the years to come.

There have also been glimmers of hope during these debates. Speaker after speaker has begun his or her speech with passionate thanks to the people who count the most to them, their families. During the one minute presentations that precede Question Period, many single out family members for special recognition. Honourable mention for the international year of the family continues to sprinkle our discussions.

The death certificate of the family has been written prematurely. Statistics will show that Canadians, especially our youth, hold a strong family life as a measure of true success. It is my conviction that history will judge legislators, at least in part, by the way we treat our families.

I would like to read a quote from someone who shared this concern: "Men say to us, `there is this problem with the family. How are we to preserve it? It seems to be dissolving before our eyes'. This has been true perhaps always and everywhere. Everywhere good things have seemed to be going. Yet everywhere they are merely struggling to their new birth".

The family has been under many stresses in this generation but it cannot be extinguished. It is merely struggling to its own sort of new birth.

Our social programs as well need to struggle for a new expression in order to serve the needs of Canadians. We have been discussing principles upon which this rebirth can stand. I would suggest to this House that any principle upon which our social programs are reordered must strengthen the social unit which forms the historic bedrock of our nation and that foundation upon which all strong nations are built, the family.

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7:20 p.m.

Bloc

Pierre De Savoye Bloc Portneuf, QC

Mr. Speaker, I listened to the hon. member's speech with great interest. He emphasized the family as a basic core for the way people live and come together in Quebec and Canada. He is quite right, the family is a fundamental value. He also highlighted the fact that governments, our government, are jeopardizing this family unit. He

even used an expression, "The death certificate of the family has been written prematurely".

There is another kind of family in this country, namely the provinces. Indeed, does Ottawa's passion for centralization not endanger not only the family unit but also the provinces' ability to meet their responsibilities for their own people? Of course, I am talking about Quebec, but not just Quebec-all the other provinces. What is his experience? What is the hon. member's experience in his community?

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7:20 p.m.

Reform

Chuck Strahl Reform Fraser Valley East, BC

Mr. Speaker, I appreciate the comments and thank the member for the encouragement. He is taking quite a leap here from my discussion of family into the constitutional swamp, as we have talked about before, of trying to relate that somehow to Quebec and its relationship to Canada.

I would say that for many of us in the west if you are asking for the British Columbia perspective, or the perspective from where I come from and where I have been elected from, in many ways we do see Canada as a family in the sense that we think Canada has 10 parts, 10 equal members, 10 siblings, 10 people, all part of this family that together forms a country.

In many ways there is a support in the west, in B.C. particularly, for the idea that when you have a family everyone is treated equally. No one is put down and no one is elevated because a family works best when 10 provinces or 10 people are treated the same.

Although there are different programs and different priorities in different areas, and that is as it should be just as 10 children are unique, they are not treated specially, they are part of a 10 member family.

I will take the leap with the hon. member and I will talk about the family in that sense. Certainly, as has always been said in a family, all members are always welcome and all members are discouraged from leaving.

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7:20 p.m.

Cape Breton—East Richmond Nova Scotia

Liberal

David Dingwall LiberalMinister of Public Works and Government Services and Minister for the Atlantic Canada Opportunities Agency

Mr. Speaker, I have listened attentively to my colleague in his remarks. He went on at some length with regard to his high regard, and compliment him, for the family. Perhaps he would take a moment or two and explain to the House the definition of family to the hon. member but more important to the party which he represents.

Second, while he is on his feet if he would indicate to the House the role that he believes the state should play in facilitating and assisting the family. I refer specifically to the role of the Government of Canada.

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7:25 p.m.

Reform

Chuck Strahl Reform Fraser Valley East, BC

Mr. Speaker, I appreciate that. Most of my discussion tonight was about my concern for families and the tax disincentives. For example, the court decision I quoted was that in the past somehow married couples were not treated the same as couples who decided to live together. That is what the court ruling referred to.

I have been talking about the need for the state through its tax laws and through other means to monetarily encourage families especially while they are raising children. That is basically what I was talking about. We have to find ways to make sure that we do not penalize people for trying to raise a family.

I do not have the motion in front of me, but it refers to children, young adults and families. I do not think anyone will dispute the idea that we need to support families because families are our future.

We see the government's role as supporting the financial needs of people rather than picking a program and stating: "This is the program you have to try to fit into, whether you are a square peg in a round hole". Instead we should say: "If you have a financial need, then the social contract is there to make sure you do not fall through the cracks and be left to your own devices".

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7:25 p.m.

Reform

Keith Martin Reform Esquimalt—Juan de Fuca, BC

Mr. Speaker, tonight I am going to speak about a subject that is dear to everyone's heart and in particular to our electorate in this country.

When I was running for office I found, as I am sure many members did, that one of the biggest considerations and concerns of Canadians was what was going to happen to their health care. There were a lot of concerns and a lot of problems and nobody knew which way to go. Canadians are very concerned about what is going to happen to their health care in the future. To that extent I would say that their health care is probably the most valued thing they have in their lives.

The greatest guardians to good health that exists is our personal responsibility for a healthy lifestyle and our national health care system. The first one the government can do absolutely nothing about, but in the latter the government certainly can.

I believe as a physician and a consumer that our system is the best in the world. It is the envy of people outside of our country. We just need to look at the United States to see how they look enviously at our country to emulate for their new health care program.

Canadian citizens receive the best health care free of charge. They are governed by the five basic tenets under the Canada

Health Act. They are: universality of care; comprehensive coverage for all essential services. I under line the word "essential". It is a very important point to remember. It also provides reasonable access by health care providers as well as consumers; portability of benefits from one province to another; and, the administration of health care by a public agency on a non-profit basis.

To give an idea of what we are talking about in terms of figures, in 1990 over $60 billion was spent on health care alone in this country which represents almost 10 per cent of our gross domestic product.

The financing of the system is divided between the federal government and the provinces. The provinces manage the actual day to day affairs and how the money is spent but they have to do it under the Canada Health Act; otherwise the federal government will withhold funding. In other words, the federal government takes their money and uses it as a wedge or a threat to the provinces regarding what they can and cannot do.

Over the last decade some situations have occurred in this country that have greatly jeopardized publicly funded health care which will ultimately lead to the collapse of health care as a publicly funded system. Not only health care but every social program in this country will be jeopardized by the following situation. This has been spoken about quite eloquently by my colleagues in caucus today as well as other members in the House.

The escalating debt over the last 12 to 14 years that we have, which has risen from $125 billion to $500 billion today, is the biggest threat to health care and social programs in this country.

To give an idea of what has occurred, back in 1984 28 cents out of every dollar was spent just to service this debt. Today it is about 33 cents. By the year 2000 at the current rate of spending 40 cents out of every dollar will be used merely to serve the debt. As can be seen we have less and less money to spend on other things such as social programs. This is a system that cannot last.

The other side of the health care situation is that expenditures are escalating dramatically. They are growing at over four times the rate of economic growth. There are a number of reasons for this. Briefly, number one is the ever-increasing aging population which consumes over 70 per cent of the health care dollar. Two, our technologies and intervention and therapeutics are becoming more advanced and more expensive all the time. Three, there are new diseases such as AIDS which are increasing in frequency tragically which also cost a significant amount of money.

If we accept the facts as I have outlined them today the system that we can see now is living on borrowed time. The dwindling funds and increasing costs are going to crush this system in the future. That is inevitable.

Despite this fact, that the writing is on the wall, the federal government continues to hamstring the provincial governments by preventing their ability to get their health care under control by forcing them to adhere under the tenets of the Canada Health Act and threatening its contribution to financing health care under the health act.

There are a number of things we can do. Not to do this will contribute to the suffering of the Canadian people.

What can we do? We need to modify the Canada Health Act to stop penalizing the provincial governments when they try to get their health care costs under control. We need to strike a committee to define what essential health care services are, which means delisting some services.

I put to you, Mr. Speaker, that those services which the public and professionals decide to delist will not be essential for health. These will not be essential for a good life or for having adequate treatment in hospitals.

We need to set up an accountability system on the part of the consumer. Currently very little value is placed on a system and it is doomed financially unless there is some value placed on this by the consumer. Therefore I would suggest to the provincial governments to entertain the thought of such ideas as modest user fees and deductibles for some groups.

People believe that the Canadian public does not want this but recent statistics show that over 80 per cent of the people in Quebec for example, and some studies were done to show this, would not mind paying a $5 to $10 user fee. The lowest socio-economic groups I would emphasize would be treated regardless. These tenets are still consistent with the ideas of universality of coverage and access.

We also need to concentrate on education of the public in terms of the costs. One of the things we can do is to have statements of account at the time of consumption preferably or during the course of the year.

We need to emphasize health education, especially in the early grade school years. This will pay off dramatically in the future. We need to focus on preventative medicine, on leading a healthy lifestyle with the aspects of drinking excessively, smoking and diets. From a physician's point of view it is amazing and also profoundly tragic the lack of knowledge that some children have when they get into the teenage and adolescent years and we all know the manifestations of that.

Health care professionals must be educated in the cost of technologies and interventions and therapeutic options that they have. I can say again as a physician that we have not done a good enough job on this at all.

I would also suggest that health care professionals be allowed to run private medical services. This would enable some people to get health care services done in a private situation, but all people, whether they are in a public or private situation, would have their health care services done earlier. This would decrease

the amount of pain and suffering in the community, decrease the cost to the economy, decrease insurance costs and so on.

It is in fact a win-win situation. To anyone who would argue that this a two-tier system, I say to them that anybody in this country involved in health care will say that there is a two-tier system in this country right now.

The most important thing that the government needs to do with respect to health care is as I said before get their fiscal house in order. Until we get our spending under control as a nation we simply cannot afford to support social programs in the current state of affairs that we have. To not do that I think would be morally reprehensible and a tragedy for the Canadian people.

The last thing I would like to touch on for a moment is decreasing tobacco taxes. I feel this is an indefensible situation. Every year the cost to the country in terms of smoking is horrendous. It costs billions and billions of dollars. There is a loss of productivity and an increase in health care costs. Over 40,000 people in this country die of smoking related illnesses.

To increase the cost of cigarettes has resulted, as has been proven, in a decrease in consumption especially among the young. Therefore I suggest that instead of decreasing taxes on tobacco that we maintain them; and instead of caving in to the criminals who are engaging in this smuggling activity I would also suggest that we add an export tax to cigarettes going into other countries.

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7:35 p.m.

Liberal

Brent St. Denis Liberal Algoma, ON

Mr. Speaker, I want to say that I enjoyed the member's remarks but my curiosity was peaked by his comments about the Canada Health Act. It brought back vivid memories of the election campaign last fall when underlying many of the public meetings we had in our riding were questions about the future of our health system under a regime which might include Reform Party proposals.

I would ask the member to tell this House if he really believes that weakening in any way the Canada Health Act, in any way dismantling the thrust and the strength of that legislation to protect this country, that we can put our full faith in the provinces to maintain a national system.

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7:35 p.m.

Reform

Keith Martin Reform Esquimalt—Juan de Fuca, BC

Mr. Speaker, I want to thank the hon. member for his comment.

As the elected members of the provincial legislatures are answerable to the Canadian public it would be political suicide for them to create a health care situation where the people who elected them to office would suffer.

It behoves every elected individual in this country to face the writing on the wall, to realize that we have a situation where health care costs are increasing at four times the rate of economic growth and governments are dealing with deficit spending with less and less money being applied to health care.

We have to face up to this. It is not just dismantling or destroying the Canada Health Act, it is modifying it to make it a better situation. To accept the current situation as it is now is to merely stick one's head in the sand. It is incumbent upon all of us to do something about it in order to preserve essential health care services for all Canadians so that they are not going to suffer, they are going to have their operation and they are not going to die as they do down in the United States due to lack of care.

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7:35 p.m.

Bloc

Pierre De Savoye Bloc Portneuf, QC

Mr. Speaker, the hon. member for Esquimalt-Juan de Fuca has replied to the question I put to his predecessor who, by the way, left his parents to get married. The hon. member for Esquimalt-Juan de Fuca said:

"The federal government is preventing the provinces from putting health care under control by threatening to cut transfer payments". And he is right.

I like what the hon. member said because it is exactly what we feel in Quebec. This means that, both in the West and in the East, the federal government threatens the very principles of universality and accessibility. And that is a serious problem. A few moments ago the question was asked as to whether the provinces were in a better position to maintain these principles. Let us take a good look at the situation: in the last ten years or so, the federal government has been systematically cutting transfer payments and has now become the biggest threat to universality and accessibility.