House of Commons Hansard #256 of the 35th Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was cmhc.

Topics

National Housing ActGovernment Orders

12:40 p.m.

The Deputy Speaker

All those opposed will please say nay.

National Housing ActGovernment Orders

12:40 p.m.

Some hon. members

Nay.

National Housing ActGovernment Orders

12:40 p.m.

The Deputy Speaker

In my opinion the yeas have it.

And more than five members having risen:

National Housing ActGovernment Orders

12:40 p.m.

The Deputy Speaker

Call in the members.

And the bells having rung:

National Housing ActGovernment Orders

12:40 p.m.

The Deputy Speaker

The chief government whip has indicated that the vote will be deferred until tomorrow at 5 p.m.

The House resumed from November 6 consideration of the motion that Bill C-95, an act to establish the Department of Health and to amend and repeal certain acts, be read the second time and referred to a committee.

Department Of Health ActGovernment Orders

12:40 p.m.

Reform

Randy White Reform Fraser Valley West, BC

Mr. Speaker, I take the opportunity to speak to Bill C-95 and to discuss the health care system.

There are several issues to be talked about. The most important is that the bill is only a name change. It transfers responsibilities and we accept that. However overriding the bill is what we will do with health care.

Department Of Health ActGovernment Orders

12:40 p.m.

Liberal

Dennis Mills Liberal Broadview—Greenwood, ON

Scrap it.

Department Of Health ActGovernment Orders

12:40 p.m.

Reform

Randy White Reform Fraser Valley West, BC

The hon. member says scrap it. We do not agree with that.

We need the highest quality of health care for all Canadians while not increasing the pressures of finances on the public. If we look at where many people come from today, the health care system in communities is an ever increasing cost. The disappointing part is the federal government has not increased its costs. It has

actually decreased its expenditures toward the health care system over the years, thereby putting pressure on the provinces to come up with more and more money.

I have had occasion in the province of British Columbia to work in one of the municipal organizations. I know full well what rising costs are due to in part. Labour negotiations, for instance, over the years have produced increases that are extraordinarily high. Communities had difficulty trying to pay as the costs of labour increased. We know the cost of equipment in hospitals is high and necessarily so, because it has to be state of the art.

On top of all this we have a government saying that we must have universal health care which it relates to medicare. I will talk about the differences in a moment. The government wants it to be universal but is not prepared to pay 50 per cent or a higher percentage than it is today. It has been ever decreasing.

Many people are not happy with the health care system. They have to wait in line for operations, and services are ever decreasing. There are bed shortages, not enough nurses at times and so on.

I have been attending the Royal Columbian Hospital in Vancouver where my niece has been in neurosurgery for the last nine weeks. She was in a very serious car accident. I must say that I have been totally impressed with the health care system in that regard.

I am sure many people have gone through hospitals, have spoken to doctors and have been completely impressed. However, the fact remains that the services are decreasing. I see it when I visit the hospital. There are not as many nurses as we would like to see on staff and so on. The demands and the expectations which people have for health care today are perhaps more than what the provinces can afford. Therein lies a good part of the battle.

Some myths have been promoted across the country. I believe they are more political myths than reality. We hear from the other side that Canada's health care system is the best in the world and that any changes would be detrimental. I do not subscribe to that thesis. The fact is that the health care system in Canada is very good. I cannot from my experience determine whether it is the best in the world, but I am sure it is very high up there.

The Liberals are saying that any changes would be detrimental. I disagree with that. In this day and age what is truly required, because of the costs and the limitations on the resources, is a core set of services that would be provided throughout Canada on a cost shared basis. It could be called a core medical service. Over and above that, we have to allow the provinces to innovate and provide other services. That only stands to reason unless the federal government is prepared to provide more funding into its shared responsibility.

The government cannot have it both ways. It cannot say: "The rules are going to go our way, but we are not going to give you enough money to operate". It is unrealistic to think that way.

If you are looking for changes in health care, we have offered a program for change with a core medical service. Organizations such as the Canadian College of Health Service Executives are coming to the conclusion that there has to be some kind of core service. Trying to provide all things to all people within a very limited finite budget will not work.

Some myths about health care are attached to this party. They are political myths. I can understand when we are campaigning or when we are debating in the House that statements are made to promote one side or the other. Some of the myths are that the Reform Party will dismantle medicare; that it wants a U.S. style of medical system; the Reform Party is in favour of a cash register medical system; it favours private insurance; it is in cahoots with insurance companies; it is a proponent of a two-tier health care system.

The fact is that the Reform Party is a lot more realistic than the government. Unless the government is prepared to look at the funding it provides to the provinces, I do not see how the provinces can expect to live by the standards which have been set by the federal government. It is not realistic.

The biggest burden of cost is on the provinces. The government cannot stand by and promote such things as block funding without eventually finding out what the problems are. I have had a lot of experience with block funding. It is just another way of saying: "You have the same amount of money. You can spend it on whatever you like. If you want more money for health care you can spend the bulk of it but that will take away from welfare transfer payments or post-secondary education". It is still the same amount of money. The government has not really resolved anything other than to change the name and provide the money which has been decreasing over the years.

We have to define medicare today. I do not believe medicare and health care are necessarily synonymous. Medicare to me is a comprehensive set of core national health standards, publicly funded, portable across Canada and universally accessible to all. Canadians regardless of ability to pay should be able to use and access the health care system.

If we get to defining the problem we will be better off. However, if the Liberal government merely says: "The rules are this and we are only going to give you a finite set of dollars to live within", the provinces are not going to take that any more. That is what the debate is on constantly in this House.

We have to remove-

Department Of Health ActGovernment Orders

12:50 p.m.

The Deputy Speaker

You have one minute left.

Department Of Health ActGovernment Orders

12:50 p.m.

Reform

Randy White Reform Fraser Valley West, BC

So soon? I cannot even get into the report from the Canadian College of Health Care Executives but if possible in a minute I would like to read some of the conclusions which illustrate where its members are coming from today.

One of their concerns is with the political concerns of this country. The report says: "With the increased importance of health care to the public, main issues have become campaign issues for many elections. There is concern that pledges to balance budgets will result in reduction in the quality of health care provided".

They are really saying that politics are limiting this, and that politics are part of the problem in the health care system. I agree. The Liberal government has to open up on the issue of health care and get away from the idea that we have a traditional system, there is no other way to do it and that it is finite.

Department Of Health ActGovernment Orders

12:50 p.m.

Liberal

Paul Szabo Liberal Mississauga South, ON

Mr. Speaker, I am pleased to speak in support of Bill C-95 because I believe in the importance of a federal department of health. I am among those Canadians who value their health care system as one of those things that tie us together as a nation.

This system for which you and I share responsibility is central to our identity as Canadians. More than any other program of government it reflects our belief that we are mutually responsible for each other's well-being. We exist as a nation and will continue to exist as a nation precisely because we do care for one another.

However, if we are to preserve what we value we must be aware of the changing times. The budget signalled a new era of fiscal responsibility and smaller government. We cannot escape the financial facts of life which mean we will have to abandon some old ways of thinking and some old expectations of government.

I hardly need to emphasize how far we have come together. We know that Canadian health care is second to none in the world. Everyone in Canada has reasonable access to health care. We establish our priorities for treatment based on medical necessity and not on how much money we have. No Canadian need fear now or in the future that a catastrophic illness will result in financial disaster.

As we approach the 21st century there is a new fiscal reality. The government has recognized it and is acting responsibly to deal with it. We are committed to protecting social programs. Indeed, the government's budget was about taking the fiscal steps necessary to do so.

Our national health care system is rooted in our common Canadian values of equity, fairness, compassion and respect for the fundamental dignity of all. The goal of the new Department of Health is to preserve medicare and put our fiscal house in order.

Many of the values that make up Canada's social fabric are reflected in the five principles of the Canada Health Act. They reflect the Canadian concern for justice and equity in our health care system and they are not going to disappear. Canadians will not allow that to happen. The Canada Health Act and its five principles of universality, accessibility, portability, comprehensiveness and public administration will be maintained. The principles of the Canada Health Act are not just words. Their meaning has stood the test of time. In their totality they assure both the provision of quality health services to all and the containment of costs.

As Canadians, we believe all must have access to services. People cannot be de-insured because they might be too costly for the system to cover. They cannot be turned away at a hospital door because they have not paid their quarterly tax bill or their provincial premium. If we need health care, we will be treated the same as anyone else. That is what Canadians mean by equity. This recognizes our dignity as human beings and thus demonstrates that we are a fair and compassionate people.

Of course, new realities require new thinking about how we will do things. That thinking must be pragmatic and stand the test of both fairness and fiscal reality.

This fiscal year the federal government is transferring $15.5 billion to the provinces and territories for health services. The total federal health, post-secondary education and social contributions for 1995-96 will be about $29.7 billion under the established programs financing and the Canada assistance plan.

With the introduction of the Canada health and social transfer in 1996-97, total transfers will be $26.9 billion. The transfer reduction for 1996-97 represents, and I stress, less than 3 per cent of the estimated provincial-territorial expenditures for health, post-secondary education and social programs. It is also less than 2 per cent of provincial government revenues.

What is important to highlight is that the federal cash contributions under the Canada health and social transfer will not disappear. In fact, when you take into account the economies that provincial governments are putting in place, the federal proportion of funding in most provinces will remain steady or even increase. Make no mistake about it, the federal government is in medicare to stay. There will be stable, ongoing cash in the system to ensure that it is sustained.

Sustaining the health system does not mean spending more; it means spending better. Research demonstrates that there is no direct relationship between increased health spending and improved health outcomes. It is not the amount of money we dedicate to our health care system that will ensure a healthy population. Rather, it is the way we spend it.

We can do more with less, without in any way jeopardizing universal access to quality health care on uniform terms and conditions for all residents of Canada. In fact, we are doing more with less, as comparisons with the United States continue to demonstrate.

Traditionally, the split between public and private spending has been about 75-25. Currently, the private share is rising and is now over 28 per cent. This is a trend that must be examined as we look at ways to keep health care affordable to all residents.

We are doing this for several reasons. One of the most important is that the threat facility fees pose to the public system's ability to continue to deliver the efficient results that we have come to expect. By billing both the patients and the taxpayers private clinics does not take pressure off the system. They take resources away from the system. Facility fees fracture a system whose greatest strength is cohesion.

Look at the issue from the point of view of efficiencies and economies. Encouraging the growth of private clinics with partial public funding takes all of the strengths and efficiencies of our health system and turns them on their head. It reduces economies of scale. It undermines our bargaining power.

Like the U.S. system, a movement toward publicly funded private clinics could shift more of the Canadian economy's resources to health care at the expense of other areas that could provide greater benefit to the health of Canadians. It could very well end up costing more while providing less. It would be hard to think of a better example of counterproductivity. Moreover, it threatens to create an under supply of services to the majority of Canadians and an over supply to the wealthier minority. It would be difficult to think of a better definition of inefficiency.

Medicare is based on fundamental principles, but they are not abstract principles. They are pragmatic. They were designed to make it possible to provide every Canadian with the level of health care he or she truly needs. We must do so at a cost we can genuinely afford.

I will comment briefly on the Reform Party position on Canada's health care system. It is advocating a two tier system of core services in which Canadians have to pay and in which the rich can jump the lines and get ahead. This demonstrates a lack of vision. It demonstrates a sincere lack of understanding of the fundamental principles of the Canadian health care system.

We will not transfer our Canadian system into a U.S. style system. Canadians know full well the quality of health care in the United States and it certainly is not the kind of health care system Canadians want.

Canadians look on their health care system with pride. We have an overwhelming degree of satisfaction with what we have created. They expect governments to work hard to adapt to changing times and to priorities. They understand the need for cost effectiveness in what we do. They expect governments to work as a team to meet goals they set years ago, goals such as access and universal coverage. They are still valuable and still appropriate.

The new federal Department of Health is ready to take up this challenge. I am proud to add my support to the bill. I indicate most emphatically that the Reform Party is seeking to undermine the fundamental principles of the Canada Health Act, which Canadians have come to rely on and which they deserve.

Department Of Health ActGovernment Orders

1 p.m.

Bloc

Paul Crête Bloc Kamouraska—Rivière-Du-Loup, QC

Mr. Speaker, at a time when we are considering the act to establish the Department of Health, the first question we could ask is: Why have a federal Department of Health? British North America Act says in section 92.7 and section 16 that health and social services are a provincial jurisdiction. So why did the federal government get involved in the health care sector?

To refresh our memory, I may recall that during the Second World War, the federal government obtained the right to collect income tax on a temporary basis, as they said at the time, to pay the country's war debts. However, by the end of the war, since people were now used to it and considering spending powers under the Canadian constitution, the federal government felt it would be useful to to continue to be involved in this area.

This led to the creation of several white elephants, to take action in areas for which the federal government had no responsibility. Today, the Department of Health is an interesting case in point. Quebecers and Canadians should know that for 1996-97, the annual cost of the federal Department of Health will be more than one billion dollars, which includes $347 million in salaries for staff and $703 million for goods and services, this in addition to administering $7.4 billion in transfer payments to the provinces.

We can see the insidious effect of what happened at the end of the Second World War, when the federal government, having obtained the right to collect taxes, returned this money to the provinces in the form of transfer payments. On the other hand, if every province had kept the right to look after health care, it would have been able to raise taxes so that citizens would know exactly what amount is spent on the health care sector and whether it is well spent. Unfortunately, that is not the model we developed in Canada. Today, we have a rather extraordinary situation where the federal government, while reducing its contribution to health care from year to year, nevertheless maintains national standards and

thus puts the provinces, with their responsibility for the day to day administration of health care, in an impossible situation.

The federal government says emphatically: no extra billing, but at the same time it denies the provinces the funding they need, and there is no reduction in the tax points the federal government collects.

The provincial governments are unanimously opposed to this state of affairs and are trying to do something about it. The federal government wants to create a Department of Health that would be a continuation of previous departments, but at the same time the government assumes the right to intervene in a number of sectors, and that is why we think this does not augur well for the future of Canada. In the months and years to come, important budgetary decisions will have to be made.

I repeat that if we have two bureaucracies looking after health care in Canada-and in fact there are not two, there are more, as many as ten or eleven, because each province can have its own department of health-there will be unnecessary spending, unavoidably. When they say: "The government has no more money, where could it cut spending, how will we determine our social options for the future?", the first place to look is where we have duplication.

Are there not areas in this sector that should not be the responsibility of the federal government? Should the federal government not withdraw and give the provinces the right to take care of a sector that is theirs under the constitution?

I would like to give a few examples of this encroachment. For instance, for the strategy for the integration of persons with disabilities, funding will be $46 million over five years, $46 million to be spent on the integration of persons with disabilities. If we consider the situation in Quebec, the province already has its Office des personnes handicapées which does the job, and here we see two governments involved in the same sector. Of course the whole $46 million will not be wasted. There is money that goes directly to people, to the client. But say this amount includes $5 million for administration costs. If only one intervener was involved, we could save that much and relieve some of the pressure on the federal budget, while services could be maintained quite adequately.

Another sector is family violence. A program was set up that would cost $136 million over four years. Again, this is a valid activity and government action is desirable, but the fact that two governments are involved undermines the effectiveness of these programs.

Say that in this case 10 per cent goes to administration costs, we could save $13 million. In the end, the same taxpayer pays the taxes. Whether he is paying municipally, provincially or federally, he always pays his taxes. So it is not surprising that those advocating decentralization so areas of jurisdiction may be recognized are critical of this sort of legislation by which the central government wants to impose its decisions on the provinces in areas where it has no responsibility, in areas where the provinces have constitutional responsibility.

Let us continue down the list of programs duplicating the action of the provincial governments. The new horizons program for seniors is another example of duplicate administration and duplicate bureaucracy. Members should see the forms the senior citizens clubs have to fill in to obtain these receipts. Often the administration costs for these programs equal what is paid out to senior citizens' clubs. This sort of thing is unacceptable, and people are rebelling. They want elected officials to clarify the situations.

Other examples include the seniors secretariat, the fight against smoking, the anti drug campaign, the national AIDS strategy, the children's bureau and, the best example of all, the national health forum.

Imagine. The federal government gave a team of experts a mandate to look at health management in Canada assessing the relevance of maintaining existing programs and of making change, but without the provinces taking part in the forum on health. This, for me, is the height of federal interventionism. From within an area of federal jurisdiction, a decision is made to interfere in an area of provincial jurisdiction, the provinces do not participate in the forum on health and no one has the patience or wants to do the negotiating necessary to have them there.

This means that, in the end, when the Prime Minister receives the report from the committee responsible for the forum on health, as its chair, he will be also be handed a total rejection by all the provinces of the report's conclusions.

We cannot ask people we have not included in the process to accept the conclusions reached. First of all, a determination should have been made of who ought to take part in the forum-was participation by the federal government really appropriate. Then, steps should have been taken to ensure that the provinces had a strong and appropriate voice that would have allowed them to address actual situations, because all the institutional networks are provincial.

These include hospitals, community health centres, shelters. Practical decisions are needed: reforms in individual provinces, the need to strike a balance between active treatment beds and extended care beds. At the moment, the provincial governments are bearing all the weight of the difficult decisions in this area, while the federal government, washing its hands of it, is reducing the funds it gives to this sector annually.

I will conclude on this point. When, in upcoming months it is looking for a place to save some money, one of the first could be the federal government bureaucracy enshrined in the Department of Health. How much can it save of the $347 million used to pay the salaries of officials working in the same area of activity as the provinces?

Department Of Health ActGovernment Orders

November 7th, 1995 / 1:10 p.m.

Liberal

Jean Payne Liberal St. John's West, NL

Mr. Speaker, I rise today to speak in support of Bill C-95 not only because it provides a framework for Health Canada, not only because Canadians are renowned worldwide because of their health care system, but because today more than ever we need the support of a vigorous health care system.

There are those who condemn the cost of uniform health care to all Canadians. These individuals fear that a changing economy and a fast moving society will make it more difficult to maintain the current system.

As technology improves and surgical breakthroughs evolve, expenses increase. Transplants and bypasses are becoming more common and the therapy and equipment associated with these operations are more costly.

We are moving from an industrial age to an information era. Associated with this transformation are economic and social disruptions which bring greater demands to the system.

Our current system though stressed is simply reflecting the pressures associated with change. We already have a system that has provided a foundation stable enough to support change and we now maintain that system as the cornerstone of our society.

In my riding of St. John's West unemployment rates are some of the highest in the country. Every rise in the unemployment rate brings a greater increase in stress related diseases.

Our country represents a nation united. This could be seen in the strong support that Quebecers received, including support from those in my riding.

As our nation experiences change, we see fluctuations of high and low points in the economy of each province. What we need is stability. We need stable variables to rely on. One variable must be our health care system. This system must serve to maintain stability and unity within and between the provinces, a symbol of what it means to be Canadian.

Increases in stress related diseases produce associated afflictions such as increase in spousal abuse, alcoholism, drug addiction, high blood pressure and cardiac problems. The stress of not having the stability of a uniform health care system to rely on will certainly generate increases in stress and stress related diseases.

Members opposite have from time to time criticized the Department of Health because they say it spends too much money. I say it is money well spent, and not more than its responsibilities require.

The Department of Health is the department of defence against disease, the common enemy of all Canadians. Health allows no fiscal restraint. It is the challenge of the Department of Health to maintain an infrastructure that guarantees quality health care to Canadians in good times and in bad regardless of their economic position.

The health system I see is one that does not represent a net cost to the country, but a benefit. It is not an expense but an investment. Every element of economic and social life in Canada gains from medicare. Canadian patients are freed from the extra burden of health spending when the trauma of illness weighs heavily. Physicians are assured of payment for their services, while retaining professional freedom. Hospitals have more financial security and can better serve Canadians.

Most important and least obvious is the fact that Canadian medicare provides many economic benefits to the country as a whole. To take one example, more than $7 out of every $10 that is spent on health care in Canada is paid out of a provincially administered insurance plan. This single payer system in each province has built in efficiencies that allow considerable control over total expenditures. This efficiency is what holds per capita health costs in Canada well below comparable costs in the United States. Because of this control over spending, personal resources are freed for other priorities, such as education, housing, and nutrition, all of which enhance the well-being of Canadians.

There are aspects of medicare that provide Canadian business with competitive advantages in the global market. Some international firms have established plants here because the cost of providing employee benefits in Canada is significantly lower than in the United States. Medicare enhances labour force mobility, and access to quality health care helps to ensure a healthy and productive workforce.

In St. John's West the labour force mobility is currently essential to long term sustenance, and the maintenance of our health care system is vital to ensuring the people of Newfoundland have a fighting chance in terms of labour mobility. Healthy business means economic growth, which in turn results in jobs, less unemployment, a healthier population, less stress related disease due to undue stress in the workplace, fewer demands on the health care system, and lower health care costs.

Health must be everyone's top priority. We must commit a large percentage of resources to maintaining health. It is our right and responsibility to do so. At the same time, we must be vigilant and

innovative to ensure that what we are spending is done with economy in mind.

Among the areas the Department of Health is investing in is health intelligence. This initiative, which will include participation in a new global network designed to detect emerging diseases, is endorsed by provincial governments. The provinces know that national leadership in this area is essential if we are to make the most cost effective choices among all available health technologies and options.

Inevitably, there will be an increase in movement toward international standards or international processes. This department on Canada's behalf is very much in the forefront of this trend and will lead, not follow, other countries in establishing health standards.

The minister has spoken about maintaining traditional values and at the same time getting value for money. In St. John's West and throughout Canada tradition is what has made our country so unique. Health Canada promises to work closely with the provinces and territories in order to avoid duplication of programs and services, contrary to the comments made previously by my colleague in the Bloc.

All in all, I have confidence that the department that will be brought formally into being by this bill has its priorities straight. It will serve Canadians. It will guard our health and our health care system. It will do this with regard for efficiency and for getting at least $1.10 of value for every $1 it spends. Above all, it will continue to provide assurance that our national life and economy will stay vital at the domestic level and competitive abroad based on a healthy and vigorous Canadian population.

I have no hesitation in supporting the passage of this bill to create the new Department of Health. I urge my colleagues across the floor to do the same.

Department Of Health ActGovernment Orders

1:15 p.m.

Reform

Jim Silye Reform Calgary Centre, AB

Mr. Speaker, I rise today to try to get a point clarified.

I do not know why we are debating the creation of a Department of Health. Do we not have a Department of Health? Do we not have a Minister of Health? Is this the kind of legislation we should be debating in this House, talking about things that already exist? Did not Kim Campbell set it up two years ago and it has already been operating? Is this the best this government can offer? I cannot believe we are taking up two hours voting for the creation of a Department of Health that already exists.

Why does this government not get on with governing the country and providing the provinces with some leadership? Government members know very well that all the provinces are angry that we almost lost one province and this country almost broke up. Why do they not do something about the promises they made during the referendum campaign and get on with some serious legislation that would help this country?

Mr. Speaker, do you really think that debating this bill and creating the Department of Health will now make the province of Quebec want to vote to stay in Canada, that it is going to convince the yes voters to vote no because this is exactly what they were looking for from the Government of Canada? The Prime Minister is now off on another trip. I do not understand what this government is all about.

Where does the member for Mississauga South get off attacking the Reform Party on its health care position in an aside from his scripted speech that was written by the department, as if our health care position is out to destroy health care in Canada. Either the member does not understand our platform or the issue, which is more likely the case, or he has nothing better to do.

Our party has put forth some concrete suggestions to reform health care in this country. I find it ironic that this government prides itself in introducing the health care act, that it is proud of the health care act to the degree it keeps preaching about some of the fundamentals, that it will protect health care for Canadians in terms of accessibility, portability, affordability, and equal access to all, unlike the Reform Party which favours a two tier system and would kill health care. What is the government afraid of in terms of the Reform Party?

We also want to preserve all of the items in the Canada Health Act. However, the one element the government conveniently forgets and the one principle the Liberal government conveniently leaves out of this equation is that in the Canada Health Act it promised to pay for 50 per cent of the services, 50 per cent of the cost of the program. It has now reduced it to 27 per cent.

This wonderful new Minister of Finance who cannot balance a budget and this new wonderful Minister of Human Resources Development are now going to further reduce what they give to the provinces for health care; they are going to further reduce what they give the provinces for education. They are saying to the provinces: "You must stick by these principles; you have to retain this level of services and we are going to give you less money to do it".

If by chance the provincial governments decide to be creative enough to come up with a method of delivering the same level of service with less money, of reducing the line ups at no cost to the federal government, they cannot do it because that is the American style. The government says: "Listen to us. We know best because we are the federal government".

This is a stubborn headed type of attitude that is tearing this country apart at the seams. It makes me mad to come here as an Albertan and see those people sit on that side of the House and not

listen to concrete suggestions, to always put them down and say we are destroying everything. We are here to offer constructive alternatives.

When it comes to health care, we want and need to recognize that the level of support and the level of funding for the various social programs we have are of such a high level that we can no longer afford to sustain spending at these levels. Therefore we must all look at ways and means of reducing the costs while delivering an effective service, ways and means of getting people in and through the system who really need attention rather than preventing them from moving forward.

Let me talk about the principle this government will not talk about. It is out of money; it is broke. Yet it still talks about all the wonderful things it can do for the people of Canada. Mr. Speaker, I know we are not supposed to use certain words, so I will try to get the word right. That is a gross misrepresentation and a lack of intellectual honesty in terms of the Canadian public. Here we have people who are supposed to be responsible, who are supposed to be giving Canadians what they need, yet they play politics rather than play with the facts and the reality of the situation.

Why not have a good debate and a discussion about issues like topping up a health care system that badly needs topping up with a system of an insurance policy in place in provinces if a person wants to do that to have access and pay for certain operations? If somebody's life is saved, what is really wrong with that? Why not? Do the rich not deserve as much as the poor?

I do not understand the debate the Liberals always use. Anything that we suggest always favours the rich and is against the poor. We are talking about lives. Anybody in this country who needs attention should get that attention. We are trying to suggest ways and means by which they can get it quicker, so they can get at the point of service in a way that saves them, that reduces the line ups and the pressures, a complete overhaul of the system itself, the inefficiencies in hospitals, the inefficiencies of visiting doctors and how they go through their check-ups.

If this government really wants to do its job and do it well, why does it not just stop collecting money for health care, impose the rules and regulations by which the services must be delivered in all the provinces, and get back to doing what a government should do? Why does it not get into the area of regulations on behalf of all Canadians coast to coast so that it is standard, portable, accessible, all these things, but leave the collection of the funds and cancel this stupid Department of Health and leave the raising of the moneys for the services to the provinces? This government takes $2 out of every $5 it collects for health care and blows it on a bureaucracy that is ill-prepared to deliver the services in all the regions of Canada.

Let us stop this mismanagement of government programs. The federal government has to get out of certain areas. These guys and

gals are too proud to recognize that the federal government is intruding into a lot of people's lives. It is intruding in such a way that its members are imposing their perceived-

Department Of Health ActGovernment Orders

1:25 p.m.

Liberal

Dennis Mills Liberal Broadview—Greenwood, ON

What are you going to do with the weaker provinces?

Department Of Health ActGovernment Orders

1:25 p.m.

Reform

Jim Silye Reform Calgary Centre, AB

It is obvious that I have the government listening to me, but those members really do not want to listen, they just want to interject. That is all right, I am used to that.

Department Of Health ActGovernment Orders

1:25 p.m.

Reform

Jan Brown Reform Calgary Southeast, AB

Such a nerve. All they do is babble.

Department Of Health ActGovernment Orders

1:25 p.m.

Reform

Jim Silye Reform Calgary Centre, AB

I am used to that.

Department Of Health ActGovernment Orders

1:25 p.m.

Liberal

Dennis Mills Liberal Broadview—Greenwood, ON

Say what you believe.

Department Of Health ActGovernment Orders

1:25 p.m.

Liberal

Bob Nault Liberal Kenora—Rainy River, ON

Come on. We know you do not believe any of that nonsense. That is Reform rhetoric.

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1:25 p.m.

Reform

Jim Silye Reform Calgary Centre, AB

I know what sexual harassment is, but I have never really felt verbal harassment.

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1:25 p.m.

Reform

Randy White Reform Fraser Valley West, BC

We will help.

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1:25 p.m.

Reform

Jim Silye Reform Calgary Centre, AB

I have my troops here now. One for one. You guys go at it and I will just talk to the Speaker.

Seriously, we have a major problem in health care. We have a solution called medicare plus. We have a solution that will allow people to have access to the health care they need at the lowest possible cost and the maximum level of service possible. Unlike this government, which just keeps harping about giving them less and they should do with less, we have something to offer.

If the member for Mississauga South really wants to understand before the next time he gets up and points a finger at the Reform Party and says they want to do this, they want to do that, let me tell him two things.

One, the Reform Party has a plan. He would be well advised to read it, because members in his constituency are going to get a copy of it. He had better be able to answer why it is not good and why it will not work for the people who are sick in his riding and are in line ups and are dying, rather than taking cheap political shots in this House.

Two, let me tell him another thing. The time of putting people down the way he does, as he has done for two years, every time I speak about remuneration, salaries, or any time I talk about health care-

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1:25 p.m.

Liberal

Paul Szabo Liberal Mississauga South, ON

Mr. Speaker, I rise on a point of order. I take exception to the indictment that I am putting people down. I am here to speak on behalf of the Canadian health care system.