Mr. Speaker, I will share my time with the hon. member for Winnipeg North.
It is a great pleasure for me to participate in the debate on health care today. There are few issues which we speak of here which touch as many Canadians as health care. It is a central issue to the people of my riding, as it is to all Canadians. They appreciate the security which our health care system gives them and they firmly believe that commitment must be continued.
As we are in a time when there are questions about the commitment, some in the House favour steps which I believe would move us down the road to a two tier system, one for those with money, another for those without. Some in the House favour the balkanization of health care with a withdrawal of federal government from any real role in the health care field. How much support is there really for either of these perspectives? From what I hear from my constituents, not very much. They support the leadership which the federal government has taken on health care issues.
Leadership does not mean rigid centralization. In my remarks today I want to emphasize the flexible nature of federal co-operation in health care. More specifically, I want to talk about the Canada Health Act. This law is not a straight-jacket on the provinces; not now, nor has it been, nor will it be in the future.
The Canada Health Act is a very short piece of legislation. At its heart are five principles grounded in common values which we hold as Canadians, values very close to the hearts of every Canadian. They represent the essential ground rules that most Canadians expect the provincial and territorial governments to respect when it comes to guiding principles of the Canada Health Act. Let me talk about each one of them and the reasons for which every one still matters to the federal government and to every single Canadian.
The first principle is universality. Quite simply, the federal government provides financial support to provincial health insurance plans, plans that cover all citizens. People cannot lose their health insurance because they might be too costly for the system to cover or because they may be unemployed or because their health may be a high risk.
The second principle is accessibility. This means we should not face any financial barriers in receiving necessary health care: no extra billing, no user fees, no facility fees. If the service is medically necessary it will be delivered on the basis of medical considerations, not financial considerations.
The third principle is comprehensiveness. It recognizes Canadians have a range of health care needs and that those needs should be met. The Canada Health Act requires that all medically necessary services be covered.
The fourth principle is portability. This means Canadians should maintain their health coverage when they travel.
The fifth principle is public administration. Our health insurance plans must be operated by a public authority accountable to provincial governments and operated on a non-profit basis.
At various times since the act was passed in 1984 there have been issues that have brought these principles into focus. Between 1984 and 1987 extra billing and user charge penalties were levied against several provinces.
More recently, extra billing has occurred in British Columbia and we have acted by making deductions to the transfer payments. We now see other questions emerging, for example, as the Government of Alberta pushes its agenda of private, for profit health care.
These principles do not extend to dictating how provinces should run their system or what they should cover. Since the beginning of federal support for health care in 1957, decisions regarding what is a medically necessary service have been up to each of the provinces to determine. After all, they manage the system. They have the constitutional authority. They work with the appropriate medical experts and also pay a substantial portion of the cost. It is not for Ottawa to say this procedure or that procedure must or should be covered.
It is better to leave the responsibility of determining medical necessity to the provinces and to physicians who deliver services and are aware of the circumstances under which they are delivered.
The Canada Health Act also leaves much to the discretion of provinces; ensuring the services of health care professionals other than physicians, charging for semi-private or private room accommodations requiring prior consent for elective health services provided out of province, and financing for a variety of methods not including those that require point of service charges.
Remember, the Canada Health Act does not force a province to comply to its requirements. The provinces can accept the cash penalties and allow the non-compliant situation to persist.
These facts alone show that any claims of rigid centralization are simply not founded. That will continue to be the case as we renew the health system.
The federal government and the provinces recognize the health system has to change. Provincial authorities are trying many different ideas in their efforts at renewal. They will continue to experiment but as long as they adhere to the five principles of the Canada Health Act it is unlikely there will be any disputes.
Not one of the principles in the Canada Health Act prevents us from looking at innovative solutions to health care issues. They simply define the limits of the system in a way that Canadians who rely on the system want it to continue. It is not a free for all. Canadians believe some limits are necessary and useful to preserve our accessible and comprehensive health care system which is available to all Canadians.
The federal government is equally committed to finding better ways to achieve our health goals. The most high profile element in that approach is the National Forum on Health. This was a red book commitment and it is a commitment that we have met.
The forum was created to help us adapt our health care system to the new social and economic realities of today. It will create a vision for health in the 21st century. It is made up of 24 Canadians, health care professionals, volunteers and health care consumers from across the country. It is chaired by our Prime Minister, with the Minister of Health acting as vice-chair.
Canadians understand these issues, as does the forum. They want to spark a frank and open dialogue with each citizen about the challenges that will influence the kind of health care we will receive in the future.
There is the impact of technology, the impact of new drugs, of aging and emerging possibilities thanks to research and great technological innovations. Our challenge is to deal with them in a thorough, comprehensive and sensitive way.
We anticipate an open process of consultation that reflects the attachment Canadians feel toward health issues and the commitment to finding real solutions. The government believes the National Forum on Health represents an excellent opportunity to address the future of health of all Canadians in a comprehensive and open way.
The forum is not going back to square one. It is working within the principles of the Canada Health Act quite simply because those are fundamental values that every Canadian has asked the government to respect, to maintain and to deliver on.
I want to end my remarks by saying that despite the ill informed critics, the Canada Health Act is still a valuable piece of legislation, one that enjoys the greatest support of the public. It is probably the greatest factor that binds Canadians together today. It is the underpinning of a system based on universal access to high quality, efficiently run health care. It is not a monument and our task is to find new and efficient ways to achieve better health goals for all Canadians.
As we undertake this process the federal government will continue to be an important source of the funding that keeps the system going. It will continue to be a staunch defender of the Canada Health Act. It will still work with medical practitioners and professionals, but we will protect the system.
The federal government intends to play the national role in health care that Canadians have asked us to do and that Canadians expect we will do. The Canada Health Act will be an important and flexible part in the role of health care in the future.