Mr. Speaker, I am pleased to join with my colleagues to speak to Bill C-95, an act to establish the Department of Health and to amend and repeal certain acts. I want to assure all Canadians who are watching today's debate that this is a housekeeping bill. It is not a bill encroaching on provincial powers. It is not a bill kidnapping powers. It is not a bill discussing a two tier system, one for the rich and one for the poor.
In any of the polls done, it has been shown that 89 per cent of Canadians believe we have the most important and the best health care system in the world. They believe in the principles involved in the health act: universality, portability, accessibility, comprehensiveness, public administration.
Health Canada has certain responsibilities that are implicit in its mandate. Bill C-95 is attempting to make this explicitly acknowledged. Bill C-95 is before the House at a time when so many things within the world of biomedical technology are before us.
Bill C-95 affirms a whole series of things we promised in our red book. Partnership and co-ordination are words that are very important to us as we move on this issue. Those are the reasons for this proposed legislation. It is to confirm the existence of the Department of Health and to specify that mandate working with the provinces, working for a holistic approach to health, taking into consideration the social as well as the physical and mental well-being of our population.
This proposed legislation contains a series of provisions concerning the transfer of responsibility. I want to affirm-I think there was general agreement on all sides-that the history of universal medicare and the health department are intertwined.
The department has played an essential role in the evolution of medicare from its infancy in the 1950s and 1960s to its current status as one of the most respected health systems in the world. Why is Canada's health system so respected? One of the reasons is that it is predominantly a single payer, publicly financed health system. That unique feature of our health system has been there from the beginning.
When we were putting in place universal hospital insurance coverage under the Hospital Insurance and Diagnostic Services Act, the federal government cost shared the start up of this component of the health system. The same happened when it came time to establish universal coverage for physician services under the Medical Care Act. Federal cost sharing was essential to assisting provinces and territories in establishing their medical care insurance programs. Medicare as we know it would not have gotten off the ground without the federal role in and commitment to health and its financing.
Cost sharing gave Canada universal hospital and medical care insurance, but cost sharing had its shortcomings. The change in financing arrangements in 1977 to block funding under the EPF, established programs financing, provided the provinces and territories with the flexibility necessary to focus beyond the traditional hospital and medical components of their health systems.
Anyone who says that the federal government is not a financial player in health is not looking at the numbers, which I will provide. In 1995-96, $15.5 billion in EPF health contributions will go to the provinces and territories. The long tradition of block funding and the flexibility it affords provinces and territories in their health programs will continue with the Canada health and social transfer.
Scheduled to begin in 1996-97, the CHST will transfer $26.9 billion to the provinces and territories for their health, post-secondary education and social assistance programs. In 1997-98, the CHST will contribute $25.1 billion. No one is denying the importance of the CHST reductions but let us put these reductions in perspective.
The reduction of $2.5 billion for 1996-97 amounts to less than 3 per cent of total estimated provincial spending on health, post-secondary education and social services and less than 2 per cent of provincial government revenues. The CHST is a balanced and fair approach to dealing with Canada's deficit and debt in making our health system fiscally sustainable.
Federal transfer reductions do not threaten our universal publicly financed health system. The minister has said this over and over in the House. Let us not be fooled by those who say it will and that privatization will save the health system.
The Canadian experience bears out results from studies by the Organization for Economic Co-operation and Development and the World Bank. Both have said that cost containment is more successful in health systems with a high share of public financing. The public share of health expenditures in Canada was about 72 per cent in 1993. The rest, 28 per cent, came from private sources
ranging from employment based supplementary benefits to individual out of pocket purchases.
In terms of cost control the public sector succeeded in containing the rates of increase to 2 per cent in 1993. Private sector health expenditures grew three times faster, with an increase of 6.4 per cent.
Canada's publicly financed, single payer health system has the built in capability to pull various levers to rein in costs. Global budgets for hospitals and capping payments to physicians are two examples which come to mind. There are many others which provinces and territories can use without resorting to privatization or putting national health principles in jeopardy.
The federal government and the Department of Health played a key and necessary role in building our publicly financed, single payer health system which continues to reflect the values of fairness and equity on which the system was originally built. The need for a strong federal presence and role in health remains important in ensuring that fairness and equity are at the centre of our health system.
I assure all Canadians, especially the seniors in Etobicoke-Lakeshore who are watching the debate in the House, that Bill C-95 is a housekeeping bill and deserves the attention of all members.