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.