Mr. Speaker, I am pleased to speak on Bill C-95. Today I wish to address the leadership role and responsibility which the federal Department of Health has had in shaping the development and the evolution of Canada's health system.
Our national health system, popularly called medicare, is made up of 12 interlocking health care insurance plans administered by the provinces and territories. The provinces and territories are responsible for the administration, organization and delivery of health care services, including human and financial resource allocation, financing and regulating health professionals.
The system is referred to as a national health care system or program in that all provincial and territorial insurance plans are linked through adherence to the national principles of the Canada Health Act, which comes under the authority of the federal Minister of Health.
The federal health legislation sets out the basic principles and conditions for the payment of federal financial contributions to the operation of the provincial plans. This year the federal government will contribute over $15.5 billion to the provinces and territories in support of their health programs and services through established programs financing.
The federal Department of Health is also responsible for the promotion and protection of public health, for example through our public health intelligence and awareness initiatives and drug approval regulation activities, providing health services directly to registered Indians.
Canada has an excellent health system and the federal Department of Health has been a key player in its evolution. It was under the leadership of the Minister of Health, the Hon. Paul Martin Sr., that the federal government introduced and passed legislation to implement the first component of our national health system.
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. This legislation allowed the government to share in the cost of provincial hospital insurance plans that met minimum eligibility and coverage standards. By 1961 after all 10 provinces and 2 territories introduced public hospital insurance plans, Canadians no longer had to worry about facing crippling hospital bills if a member of their family became ill.
The Department of Health followed with respect to medical insurance in the 1960s and with the introduction of public insurance for physician services in 1962. The federal government offered a cost shared program to the provinces and territories in 1966 to encourage the development of a national medicare insurance program.
The federal medicare act was implemented in 1968 and by 1972 all Canadians enjoyed public medical care insurance in addition to hospital insurance. Leadership was shown again by the Department of Health in 1984 when medicare was reaffirmed by Parliament with the passage of the Canada Health Act.
The Minister of Health of the day, the Hon. Monique Begin, detected an erosion of the principles that support medicare. Canadians were telling her their access to necessary health care was being impeded by user fees and she took action to restore medicare.
The Canada Health Act with special provisions to discourage provinces from allowing extra billing by doctors and user charges by hospitals was successful in eliminating user fee medicare. The act provided for an automatic dollar for dollar penalty deducted from the transfer payment. For every dollar a province allowed to be charged in the form of extra billing or hospital user charges, one dollar was deducted from that province's transfer payment for health. Within three years all provinces that had allowed extra billing and user charges eliminated them. Canadians across the country were once again enjoying unfettered access to necessary health care services.
The Canada Health Act is a great symbol for Canadians. It symbolizes the values of our society: equity, compassion and caring. It is also more than a symbol. It embodies the principles which underlie the Canadian medicare system and provides the mechanism for preserving medicare.
The first national principle is universality. Every eligible provincial resident must be entitled to coverage by the provincial health insurance plan. Coverage is linked only to residency in the province and not to jobs and not to the payment of premiums.
The second principle is comprehensiveness. The provincial plans must provide coverage for all medically necessary hospital and medical services.
The third is accessibility. Insured services must be reasonably accessible and without financial barriers. This means in part there can be no point of service charges for medically necessary services, no extra billing by doctors and no user charges in hospitals. Patients do not receive medical or hospital bills for insured services. The province pays the bills directly on their behalf.
The fourth principle is portability. This is vital to a national system. It means that when Canadians travel or move they continue to be covered by provincial plans.
The final principle is public administration. The health insurance plan must be operated on a non-profit basis and must be accountable to the provincial government.
It is adherence to these national principles that gives the provincial systems a set of common features. This commonality is what makes our health care system a national system. The Department of Health monitors provincial and territorial compliance with the principles of the Canada Health Act and informs the Minister of Health of any problems. Where there is non-compliance the act provides the minister with the authority to direct deductions from transfer payments. These deductions are the mechanism by which the Minister of Health enforces the Canada Health Act and protects medicare.
The government is committed to a national health insurance system, to medicare. That is why the Minister of Health has taken action against semi-private clinics that charge user fees in the form of facility fees. Barriers to access must be discouraged.
The government has also shown its commitment to medicare by making sure the new Canada health and social transfer supports medicare. In order to qualify for full cash contributions under the CHST, provinces and territories must comply with the Canada Health Act.
The Department of Health has played a key role in the development, protection and preservation of medicare. Bill C-95 will ensure the Department of Health continues this valuable role.