Mr. Speaker, I rise to address the House in support of Bill C-95, an act respecting the Department of Health.
I would like to take this opportunity to congratulate the minister who proposes this bill for the efforts she has made over the past year to defend and strengthen the principles enshrined in the Canada Health Act that underpin Canada's magnificent medicare system. I might add, it is a system of which I was proud to be a part in my previous position as a health care professional.
The department this bill deals with is an essential part of the fabric of this nation. The minister has said that it touches the life of every Canadian every day. Medicare in Canada transcends medicine. It is both a service for Canadians and a critical bond with Canadian federalism. Without it we would suffer as individuals and as a country.
It is essential that medicare be sustained and strengthened and that it remain as a bond within the country. This is the challenge and the responsibility of this department. This is the reason for Health Canada, and the reason I will support Bill C-95 without reservation.
It is true that the provinces have primary responsibility for the design and delivery of health care services. This is as it should be. Health care is a local responsibility. Doctors and hospitals work in communities. Provincial control of health care is not a weakness of the system, it is a considerable strength. The values, beliefs, wants and aspirations that define Canada and the Canadian identity are not unique to any sector of the Canadian population or to any region of this great country of ours. But the circumstances in which health care is delivered differ across regions, and the health care needs and priorities of these regions will differ. What we have is an opportunity system, where 12 variations on a common set of principles all going at medical problems in slightly different ways provide administrators and practitioners in different parts of the country with the opportunity to learn from each other.
The provinces plan, manage, and operate the health care system, but through the exercise of the federal role and through its transfers to the province, a national health system is the reality in Canada.
There are clearly many important health matters that require national leadership and co-ordination. There would be little to be gained, for example, if the work of the federal laboratory for disease control were duplicated in each province.
Many federal initiatives in the areas of health promotion and disease prevention have stimulated provinces, public health authorities, and non-governmental organizations to work to improve the health of all Canadians. Health Canada also has a special role to play with respect to the delivery of certain health services to First Nations, which will continue until the process of devolving responsibility for self-government has been completed.
After World War II ended, our forefathers and our predecessors, federal and provincial, looked down the road and asked what kind of nation we wanted to have. What kind of health care system do we want to have? What kinds of values do we have? As a country, as a people, and as the Liberal Party, we concluded that top-flight medical care was of paramount importance. We also recognized certain principles of fairness, equity, and efficiency that reflect the ideal of Canadians. Out of all this, our system of medicare was assembled just over a decade ago. It was anchored by the Canada Health Act.
If I may remind hon. members, the Canada Health Act came into being in order to defend the principles that were the foundation of medicare, principles of equal and universal access, principles that were even then under attack by various schemes that allowed extra billing and user fees.
In 1983, extra billing in various provinces amounted to $100 million, a total that had doubled over the previous five years. An erosion of medicare was taking place. The erosion was stopped by the minister in 1984. When there were signs of it restarting in 1994 under the guise of private clinics, it was stopped again by this minister, who has insisted that the federal government will ensure that the fundamental principles of the health care act are maintained.
The minister has said that it is not her intention to preclude the use of private clinics, which are often a cost-effective way to deliver services. She has said though that they have the potential to create a two-tiered system of health care: one level of service for the wealthy and another for the rest of Canadians. This is unacceptable today, just as it has been unacceptable through all the years we have been building and defending Canada's medicare system.
There is no mistaking where Canadians stand on this issue. Canadians want effective federal leadership in the health field. This is evident from the favourable reaction to the minister's announcement regarding user fees at private clinics.
Hon. members who have concerned themselves with the evolution of the health care system will be familiar with the work ofDr. Michael Rachlis. He was co-author of Second Opinion , an influential book that examined the Canadian system. Dr. Rachlis recently criticized the combining of public and private medicare, saying ``it entails a wrong prescription for what is wrong with our health care system and then issues a wrong diagnosis''.
Frank Maynard, former Deputy Minister of Health for Manitoba, warned:
We already have the beginnings of a two-tier system; we should not enlarge it. Health care is not a commodity, so it is not a valid choice to offer the rich faster access to required medical service.
Wendy Armstrong, president of the Alberta chapter of the Consumers' Association of Canada, wrote:
What happens is private clinics choose to treat things with the least risk of complication, least overhead cost and with potentially high volume. It's skimming the cream.
I could multiply these quotations by the hundreds, but I will conclude with only one. This segment is from a letter to the editor published by the Calgary Herald on October 16, 1995:
It is time for Albertans to stand behind the federal government and demand universality of health care. This issue has nothing to do with political affiliation. It has everything to do with preserving a cornerstone of what makes Canada the best country in the world.
That just about sums it up. We are all in it together. For the most part we are all delighted to be in it, because there is no better system to be in, anywhere in the world.
The role of the Department of Health is to sustain and improve Canada's health system, to keep it intact. That is why I support the department, and that is why I support this bill.