Madam Speaker, today I rise to speak in support of Bill C-95. It is with great pleasure that I do so.
To me the bill symbolizes a fundamental feature of our federation: the ability to achieve an appropriate level of the decentralization of powers between the federal government and the provinces. This is illustrated by our system of federal-provincial transfer payments for health. The system embodies a balance between the powers of the federal government and the powers of provincial governments, which is serving our country well. It provides for the national character of our health system while at the same time recognizing the constitutional jurisdiction of the provinces and territories over health care.
Our system of transfer payments for health has gone through an evolution over the last 30 years, an evolution that parallels the evolution of our health system as overseen by the Department of Health and the evolution of our federation.
In the 1950s, in an effort to foster the development of a national hospital insurance plan, the government passed legislation enabling it to cost-share health programs. The passage of the Hospital Insurance and Diagnostic Act in 1957 encouraged the development of hospital insurance programs in all provinces and territories. Through the offer to cost-share hospital and diagnostic services on roughly a 50-50 basis, the HID legislation allowed the government to share in the cost of provincial hospital insurance plans that met a minimum eligibility and coverage standard.
By 1961 all ten provinces and two territories had public insurance plans that provided comprehensive coverage for in-hospital care for all residents. Then in the 1960s came legislation enabling the federal government to cost-share medical care insurance programs. In 1966 a federal offer to pay about one half of the cost of physician services insurance programs operated by the provinces became law in the medical care act. The act was actually implemented in 1968.
At this point I would like to digress and perhaps bring a more human and local tone to the piece of legislation we are dealing with today. I would like to inject just how important this piece of legislation is to the territory I come from. I could probably exemplify that by using the particular issue of tuberculosis.
In the Northwest Territories tuberculosis is still a major problem, as it is among the aboriginal population throughout Canada. In fact, I am an individual of the aboriginal population who spent 14 months in a sanatorium for tuberculosis, which was the treatment in the early 1960s. There were many other people who also did. It became almost routine that families had members who were afflicted or died from tuberculosis or were treated for an extended period of time.
The rate of tuberculosis among Canadian natives is 43 times higher than among non-natives. According to Statistics Canada, the rate of TB among status natives was 47 per 100,000 in 1993. By contrast, Bangladesh has a TB rate of 43.6 per 100,000. The rate for non-native Canadians across the country was 6.9 per 100,000.
One big problem that has an effect on these numbers is the accessibility to the health system and proper testing facilities. The availability in the north is difficult, often as the result of a lack of proper equipment. Many of the communities where people are afflicted are very remote and very hard to reach.
Lack of accessibility is also a problem for other communicable diseases, such as sexually transmitted diseases. In the north the STD rates are estimated by the Government of the Northwest Territories Department of Health and Social Services at 10 to 12 times higher than the national average.
Life expectancy numbers are another indicator of the general health levels of a population. Earlier this year the National Advisory Council on Aging, NACA, released its report, which contained more distressing numbers for the aboriginal population. A highlight of the report is that life expectancy for native women and men is 47 and 46 years, respectively, compared to 75 and 68 for the non-native population. The median age of the native population is 10 years younger than that of the Canadian population. The native elderly often experience premature aging, leading to death
due to high rates of degenerative diseases. Native people use much more informal care, family and friends, for certain dimensions of life-meals, shopping, et cetera-than non-native people.
The needs of older native persons for core services, for example adult care services, exceed the needs of the comparable non-native population. Aboriginal seniors residing off reserves are frequently excluded from the communities in which they live and the native communities from which they come.
It is also important to note that the Northwest Territories has the second highest alcohol consumption rate in Canada; five to six times the national average in reported violent assaults; and a suicide rate that is two to three times the national average. These are all symptoms, perhaps not directly related to health, but they have a huge impact on the wellness of a community and as a result have a huge impact on the health care system, either directly or indirectly.
The approach in relating this to the whole health care system is to look at preventative health measures. That is the innovation all levels of government are looking at. Organizations, aboriginal, non-aboriginal, those who live in the north are looking at ways of cutting costs, looking at ways of taking preventative measures and innovative measures that are going to help provide a more efficient and effective system that will serve their people.
One difficulty in the north that is taken for granted in southern Canada is interpreters. In many cases, without them a proper diagnosis cannot be made. Follow-up for major surgery is often difficult because patients have long distances to travel, often to the south. Often the follow-up does not take place for three to six months.
Accessibility is often difficult. As mentioned earlier, people often have to travel long distances away from their families, their primary support system, to receive care. Also, accessibility to medicine and prescription drugs is a problem.
We also have another important issue that aboriginal people and non-aboriginal people in the remote regions really take seriously, and that is nutrition. Nutrition and sustenance for those people are very important. The principal objective, for instance, of the food mail subsidy program is to improve nutrition and health in northern communities, which do not have year-round surface transportation. They are mostly isolated. There is usually air service and prices are from 30 per cent to 60 per cent higher.
Thank God for the country food chain that the aboriginal people have sustained for themselves. This is very important. Last year the government extended the program for one year with a budget of $17.1 million pending a review of the program. The north experiences the highest levels of unemployment, poverty, and child malnutrition. This subsidy only applies to nutritious foods that require refrigeration or have a short shelf life, as well as infant formula, infant foods, and non-carbonated water. The cost of living in the north is currently 30 per cent to 40 per cent higher than anywhere else in Canada, and in some areas it is even higher.
We have a great health system in Canada, and we would like to support it and continue it and make it even better, especially for me in my riding in the Northwest Territories as part of Canada.