Debates of Dec. 12th, 1995

Protection Of Personal Information Obtained By Certain Corporations Act

[The Deputy Speaker]

In my opinion the yeas have it.

And more than five members having risen:

[The Deputy Speaker]

According to the order made earlier today, the vote stands stands deferred until tomorrow at 5.15 p.m.

A motion to adjourn the House under Standing Order 38 deemed to have been moved.

[Svend Robinson, NDP, Burnaby—Kingsway, BC]

Mr. Speaker, it was on February 16 of last year, four days after the death of Sue Rodriguez, that the Minister of Justice promised Canadians that this House of Commons would have an opportunity to vote in a free vote on the important issue of possible changes to section 241 of the Criminal Code.

The Minister of Justice said that he would be meeting with the government House leader as soon as possible to find out when he could arrange a debate and he said that they were not going to sit on it. He went on to say: "We will find a way to put the question before the House so that it is not academic. It will be meaningful and if that involves a proposal for changing legislation with a free vote, then that is exactly what we will do".

He pointed out that the Supreme Court of Canada had unanimously agreed, although it was divided on the substance of changes

to section 241, that this was a matter that elected representatives must deal with. The Minister of Justice said on February 16 that he would make sure this House had an opportunity at an early date to deal with this matter. Some months later at the national convention of the Liberal Party of Canada, delegates voted overwhelmingly in favour of a resolution urging the government to allow for a free vote on the issue of euthanasia and physician assisted suicide.

In September of last year the Parliamentary Secretary to the Minister of Justice, who will be responding today on behalf of the government, said during the course of a debate on my private member's bill to change the Criminal Code: "We have been assured by the Minister of Justice that all parliamentarians will be given the opportunity to consider these issues in a meaningful way. I am confident that in due course we will be presented with the opportunity to do so".

On February 16 of last year the Minister of Justice said: "In emphasizing the urgency of this question, I am sure doctors could tell us there are a number of people right now facing terminal illness who want to have clarification". He was right then and he is right now.

It is unconscionable that the government, almost two years after having promised to allow the House to seriously deliberate on this issue, to vote in a free vote, is still not prepared to allow that decision.

One of those who is seeking a change in the law is Austin Bastable. Mr. Bastable has written twice to all members of the House. He wrote in late September and again at the end of last month, pointing out that the quality of his life is continuing to decline. He does not wish to endure the prolonged natural death that awaits him.

Mr. Bastable points out that palliative care is not a meaningful option for him. He pleads with the House and he pleads with the government to honour the commitment made to allow a free vote, to allow debate on this issue of fundamental conscience.

The member for Vancouver Centre also assured Canadians and her own constituents there would be a free vote. I call on her to honour the commitment made by the Prime Minister, by the Minister of Justice and by the parliamentary secretary to ensure Canadians have a voice in this fundamental issue of life and death.

[Russell MacLellan, Liberal, Parliamentary Secretary to Minister of Justice and Attorney General of Canada]

Mr. Speaker, the hon. member for Burnaby-Kingsway has not said anything which I would contest with respect to me or Minister of Justice. It is still the intention of the Minister of Justice to allow this debate.

The hon. member has requested that the Minister of Justice advise the House when members will have the opportunity to review the issue of physician assisted suicide, including the provisions of section 241 of the Criminal Code.

Both the hon. member and the Minister of Justice have referred to the important work undertaken by the special committee on euthanasia and assisted suicide which tabled its report in June of last year. The terms of reference provided that it examine and report on the legal, social and ethical issues regarding euthanasia and assisted suicide.

The report is lengthy and contains recommendations concerning palliative care, pain control, sedation practices, withholding and withdrawal of life sustaining treatment, advanced directives, assisted suicide and euthanasia.

Of the recommendations presented in the report, there are a number of legal implications unanimously agreed on by committee members. This was not the case with respect to their recommendations concerning assisted suicide.

While the senators were unanimous in their view that counselling suicide, subsection 241(a), should remain an offence, they were not unanimous in respect of the provision of subsection 241(b). As the Minister of Justice has indicated, there was difficulty in achieving consensus with respect to some of the most fundamental questions that arose in the course of the committee's study.

Specifically, with respect to the issue of assisted suicide, a majority of the committee recommended that subsection 241(b) of-

[The Deputy Speaker]

The hon. member for Edmonton East.

[Judy Bethel, Liberal, Edmonton East, AB]

Mr. Speaker, in discussions with people in Edmonton East over the past number of months, one concern keeps coming up with increasing regularity: where is medicare headed in Canada?

Canadians value the system of universal health care. Medicare is one of the fundamental elements of our Canadian identity and of our shared commitment to fairness, equity and compassion.

However, Canadians recognize that the health care system must adapt and evolve within the guiding principles of the Canada Health Act. It is not enough to say that we spend $72 billion on health care without knowing whether we are spending it in those areas where it makes the most difference to Canadians.

Residents of Edmonton East want the government at the national and provincial levels to work together to ensure accessibility and quality in health care and to sustain a health care system that respects the five principles of the Canada Health Act: universality, accessibility, comprehensiveness, portability and public administration.

How do we renew our health care system to meet the needs of consumers in a cost effective and efficient manner? What are the implications of allowing greater private funding in our health care system?

There is concern in Edmonton East that private funding competing with a public system will create a two-tier system where access and quality will be based on ability to pay rather than medical need.

To the ideologically driven in Alberta, an increased private presence in the funding and delivery of health care is the answer to controlling costs and improving accessibility. But is it? In the industrialized world, the United States is the best example of a health care system which relies extensively on private funding.

Let us examine the U.S. health care experience in more detail. More private money in the U.S health care system should result in a better standard of health care for Americans but clearly that is a myth. A significant amount of health care spending in the United States is to support an extensive bureaucracy that has evolved under a multiple player system. The average American under a private insurance scheme pays $150 a year in administrative costs alone, compared to $23 for the average Canadian.

Respected Canadian health care economist, Robert Evans, put it most succinctly when he stated: "Canadians provide care. Americans shuffle paper". Not only is the U.S. health care system plagued by skyrocketing administrative costs and a bureaucratic jungle, it is also plagued by inequities and lack of access.

For older Americans, 65 years and over, out of pocket costs consume 23 per cent of their household incomes. For older Americans with family incomes below the poverty line, out of pocket expenses consume 37 per cent of their incomes. Most telling, the number of Americans who are uninsured continues to grow at an alarming rate. Nearly 40 million Americans or 15.3 per cent of the population had no health insurance coverage at all. The total number of uninsured American children under the age of 18 is 9.5 million or 24 per cent of all American children under the age of 18. The total number of uninsured Americans earning an average family income of $15,700 is nearly 15 million.

This leads me to a second element that private funding components have failed to address adequately: the ability to control health care costs. Cost containment is a necessity if health care is to be sustained and preserved in today's fiscal climate but cost containment in health care is not achieved by shifting the cost burden on the Canadian consumer through de-insurance, de-listing or user fees.

[The Deputy Speaker]

The member's time has expired.

[Hedy Fry, Liberal, Parliamentary Secretary to Minister of Health]

Mr. Speaker, I am very pleased that the hon. member asked this question. As she said before, medicare is a defining value of Canadians. Eight-nine per cent of Canadians support medicare. All the ministers of health in every province support medicare, with the exception of Alberta.

Medicare is unique to this country because it is based on clinical need and not on the size of your wallet. It is a Liberal value. Medicare was brought in by a Liberal prime minister. A Liberal minister of health, Monique Bégin, brought in the Canada Health Act which defined the five principles and set a series of limits on how they are used.

One of the important things about medicare is that the government, being a Liberal government, is committed to medicare. We are committed to a predictable funding of medicare in the new Canada health and social transfer. We are committed to working with provinces to ensure that we find innovation and creativity in dealing with some of the pressures that are now facing medicare.

We will work in a consistent, cohesive and coherent manner to find all of the answers within the Canada Health Act.

I want the hon. member to know that this government is the first since the enactment of the Canada Health Act that actually has taken non-refundable deductions from provinces: British Columbia, Manitoba, Nova Scotia, Newfoundland and finally, Alberta.

We have a concern about the growth of two-tier medicine. User fees are not on for this government. The program is based on clinical need. If we are going to continue to make medicare important, we are going to have to look at issues such as evidence based medicine such as moving from prevention, from life style based diseases and-

[The Deputy Speaker]

The motion to adjourn the House is now deemed to have been adopted. Accordingly the House is adjourned until tomorrow at 2 p.m.

(The House adjourned at 8.04 p.m.)