Debates of April 27th, 1995

Supply

[Reg Alcock, Liberal, Winnipeg South, MB]

Mr. Speaker, I was interested in the last few remarks made by the member opposite when she said: "Let the doctors decide. Let the physicians decide. Let the people who are responsible for delivering the care decide".

That is exactly what we do. That is exactly what the Canada Health Act does. Her proposal would put a bureaucrat in their place. There would be a schedule or a list decided by someone other than the physician, someone other than the person who is providing the care. That is one reason why we do not support the proposal that party brought forward today.

I want to step back a little bit and look at exactly what the Reform Party is saying today. The members sat down, thought this out and put it into their political planning that they would have this debate today. They stood up and put forward a motion which states:

That this House recognize that since the inception of our national health care system the federal share of funding for health care in Canada has fallen from 50 per cent to 23 per cent and therefore the House urges the government to consult with the provinces and other stakeholders to determine core services to be completely funded by the federal and provincial governments and non-core services where private insurance and the benefactors of the services might play a supplementary role.

[Some hon. members]

Hear, hear.

[Reg Alcock, Liberal, Winnipeg South, MB]

I am pleased that the members recognize that I can read.

I would like to balance what members opposite talked so strongly about, of putting greater control in the hands of the province, against a statement made not too long ago by another Reform member in the human resources committee. The statement made was: "Well, I come from a have province. We contribute money to Confederation. Should we not be able to dictate the kinds of services those people in the poor provinces get?" At the root of my feelings about this debate is what it says about us as a country.

We made a decision a long time ago that we were going to provide health care. We were going to see that every person no matter where they lived in the country, no matter what their income level, would be entitled to basic health care. We made that decision as a country. We have followed through on that promise.

Reform members talk so loudly about supporting the wishes of their constituents. There is no other service government delivers that the people value as much as their health care system.

The Reform Party reminds me of the old story about the doctor whose only answer to a query was: "Take two aspirins and call me in the morning". On every policy issue that is debated its members say one thing: "We have a deficit. We do not have the money for it so we have to cut somewhere. We have to get out of it". It strikes me that a party that has been around here for a while which has some intelligent, thoughtful people in it, could think a little harder about what they are really saying.

We spend between 4 and 4.5 per cent of the federal budget on health care. In doing so, we buy ourselves one of the finest health care systems in the world. This is the point of attack

Reformers have chosen to solve the deficit problem. It is not funny. It is tragic that they would attack a service that is so valuable to so many people who have so few options.

It is fine to talk about the wealthy individual who can walk into any place in the world and buy what he or she needs. However we also have to think about the person who cannot do that. It is something that has been a part of our values for all my working life, and hopefully will be for all my life.

There is another aspect to this. I think we have to ask the Reform Party to be a little more intellectually honest. In the proposal put forward it talks about the fall from 50 per cent to 23 per cent. I suppose it is done to heighten the fears it might engender in people or to heighten the arguments that can be made about the role of the federal government and what the federal government has or has not done. However, that is simply not true. It is false information, which the party has put on the record in order to strengthen its debate.

The fact is that the first number refers to the federal government's share of spending on hospital and physician services, our contribution to medicare. The second number refers to the federal share of total health spending, things like non-prescription drugs, cough drops, et cetera. The Reform Party knows this, and its researchers should know this, and to bring it forward simply discredits the debate it wishes to have.

Reform members talk about creating a list of services, which presumably some bureaucrats in Ottawa would manage, having consulted with doctors, and they would tell us what medical services we could have and what medical services we could not have.

The Reform Party has been accused on occasion of looking south for its policy initiatives. I do not want to spend all of my time walking through that particular model, but I would like to note a couple of things.

I had a recent experience in the United States. I lived there for a few years. I met a man in Los Angeles, quite a wealthy man, who had a very serious cancer of the jaw. He received very good medical service. Following a technique that is available here in Canada, they replaced his jawbone with a piece of bone taken from his thigh. It was marvellous. It was truly a wonderful piece of work.

He walked out of that hospital and was told that was it, his insurance was now cancelled. Despite the fact that he is wealthy and despite the fact that he has the resources, he cannot at any price buy service. In the system the Reform Party promotes, he cannot buy service for the rest of his life.

I would like to give another example. This happened to my nephew, who lives in Los Angeles. He drove to another state on a vacation and he fell and cut the palm of his hand on a piece of glass. He cut a tendon, so it was a little more serious than just a cut in his hand. He was rushed to the local hospital and they looked at it and put a compress on it and said: "Your insurance only covers this immediate service. To get the tendon repaired you have to go back to a health jurisdiction that your insurance respects". He had to drive some 500 miles to get a fairly serious repair. He could have lost the function of his finger.

When we talk about letting the provinces decide and when we talk about letting individual hospitals decide, are we not talking about a system that says that a person may not be able to get service because the level of coverage in their province does not cover them for all of those things? Is that not exactly the kind of divisive force that the Reform Party promotes when it talks about the have provinces being able to dictate the level of services in the have not provinces? I reject that.

Frankly, in this country we have a very serious problem. We are seeing an increasing polarization between those who are well to do, who can take care of themselves and live a comfortable life, and those who are not so fortunate. We are fast building a community not unlike those we see around large cities in the U.S., walled cities, walled communities, which have a wall built around them to keep the bad folks out. We are building a society that is less inclusive, less caring, less Canadian than the one I believe in. The Reform Party needs to consider very carefully what it is promoting when it talks about the destruction of our health care system.

One of the discussions the Reform Party brought forward in its motion is the idea that we would have a matrix of services or a list of services. It is interesting that the provinces and the federal government do not want to impose a list of services. They do not want it because they want to do what the member for Beaver River said in her closing remarks: they want the decisions about care to be decided between the doctor and the person who needs the care. The federal government believes that. It is enshrined in the principles. The provinces also want that.

The member who spoke just before the member for Beaver River made a comment about universality. It is odd to me that the Reform Party finds universality such a difficult concept to understand. All universality means is that everyone has access. If they do not want to have universality, as they have been stating, despite the agreement, who are they going to exclude? If they are not going to have universality, who then is outside of that universal range?

[John Williams, Reform, St. Albert, AB]

Nobody.

[Reg Alcock, Liberal, Winnipeg South, MB]

They cannot have it both ways. They cannot say they are opposed to universality and they are not going to put

anybody outside. That is all universality means: that we are going to cover everybody, we are going to give everybody access to the services.

The leader of the Reform Party made a speech on medicare not too long ago. I would like to talk a bit about it. Perhaps the members can get ready to jump up and down, as they do.

There was a suggestion that we might want to ask the member for Beaver River to try to define where facelifts are free.

The leader of the Reform Party, in his speech not so long ago, said that the real long run threat to medicare is the financial threat caused by deficits, debts, and skyrocketing interest payments. Skyrocketing interest payments on the national debt eat up the federal government's ability to finance any and all social programs, including medicare.

[Deborah Grey, Reform, Beaver River, AB]

Hear, hear.

[Reg Alcock, Liberal, Winnipeg South, MB]

Mr. Speaker, I thank the hon. member for Beaver River, once again, for giving me a standing ovation.

Take two aspirins and call me in the morning.

We have a problem so cut the deficit. That is their only solution. Do not look at what is happening within the services that are being provided, do not call upon the medical community to find more efficient and more effective ways to deliver services. Cut the deficit. Cut the funding.

The member for Beaver River called upon me to talk a bit about the Liberal approach to this. The leader of the Reform Party talks about cutting the deficit. In fact, total savings from our Liberal budget will be $29 billion over the next three years. This budget represents, by everyone's criteria, the strongest fiscal action taken by a government, certainly since the war years.

I was on a local radio show with a fellow by the name Peter Warren back home, who has been on the air for 25 years. I asked him if he had ever seen a tougher budget, and he said no.

This government is living up to its promises to be fiscally responsible, but it is being fiscally responsible in a morally responsible way. It is not throwing the weakest people out of the boat. It is not saying let those folks who can afford it go off on their own and do what they want and forget about the others. It is saying we are all in this together, we are all part of the same family, we are all part of the same country, and we will solve these problems.

One of the issues the Minister of Finance talked about over and over again was fairness, that we would do this, we would swallow the tough medicine, we would make the tough decisions, but we would do it fairly.

In the speech of the leader of the Reform Party he talked about how the Prime Minister's speech contained no workable framework or plan whatsoever for the reform of medicare.

I do not know where the leader has been. He has not been in the House that much, but certainly has people who can read, who can talk about the council, who can look at the work the minister has been undertaking to work with the provinces, to work with people to find solutions for what are some very difficult, very complex issues that confront all of us.

The federal government is already engaged in discussions with all the key players. A number of provinces, the conference of the Ministers of Health, the federal-provincial advisory committees, bilateral meetings with health organizations, and consultations with Canadians through the National Forum on Health, ensure that all parties are informed and working together to ensure that Canadians have access to a responsive, effective, and affordable health system.

There is another aspect to this. If the member for Beaver River wants to talk about the cost, there is a very significant cost to poor health. There is a very significant cost to poor children. There is a very significant cost to unhealthy children.

The fact is that universal access means, yes, that my children get coverage, which I can afford to pay for, but it also means that those who cannot afford it get coverage. It means that we also care about their public health needs. It means that kids go to school stronger, more fit, more physically active and more ready to learn. It also means that people are able to pursue careers. It means that people are more able to be productive, working and contributing to society. Good health care is a foundation of a healthy community. To risk destroying that in the cavalier way the Reform Party does is irresponsible.

The Reform Party has been accused at times of speaking in code. I want to add a bit more code to the discussion. The leader of the Reform Party said: "Reform therefore favours the decentralization, localization, and personalization of health care delivery", and to amend the Canada Health Act to provide this kind of flexibility.

Is it not interesting that mere minutes ago, when I talked about the problem that my nephew had in a different state trying to access health care, the members opposite said: "Oh no, we do not mean that". Then what does decentralization mean? What does localization mean, except specific services in a specific area? What does that do if I do not come from that area, if they are not insured in my area?

Do we really build a system where certain Canadians have certain kinds of services and other Canadians have different kinds of services when it comes to our health? Is that really what we are promoting?

What does personalization mean? Does it mean user pay? Does it mean the ability of those who can pay will pay? Does that not just promote a greater fracturing of the community?

[The Acting Speaker (Mr. Kilger)]

I have been somewhat generous with the time. I have taken into consideration the applauses and so on and so forth. I would ask the member for Winnipeg South to summarize in the next minute and a half.

[Reg Alcock, Liberal, Winnipeg South, MB]

Mr. Speaker, I appreciate your alerting me to the time.

I would simply like to say that I want to thank the members opposite for bringing forward this resolution. I reject its intention absolutely and completely. I am saddened by the position that they have taken on so vital a service to this country. I do appreciate the opportunity they have provided me to stand up and say how strongly I and my party support health care and medicare in this country and reject the position taken by the party opposite.

[Ghislain Lebel, Bloc, Chambly, QC]

Mr. Speaker, I listened with great interest to the member's speech. His views are diametrically opposed to those of the Reform Party.

However, some of the issues raised by the Reform Party are not totally erroneous. I do not agree with the hon. member when he says that the Reform Party's views are irresponsible. I do think that, unfortunately, our debt ratio will force us to make some hard choices, as is already the case with the UI program, for example.

We learned today that the number of welfare recipients in Quebec climbed to 808,000, with a more or less corresponding decrease in the number of UI beneficiaries. It is pretty easy to figure out that those are UI exhaustees who have now joined the welfare rolls. If the Liberals continue to close their eyes, as they have a tendency to do, instead of tackling the issue of the national debt, we will have to make even harder choices in the future. We will have to cut our social programs, including medicare.

This Liberal government set aside a tidy sum for things such as the purchase, by the Department of National Defence, of four secondhand submarines, which will of course have to be upgraded with state-of-the-art detection systems, the very best enemy detection systems. Given what is happening with the frigates that have to be refitted, we can expect this government to once again spend billions of dollars. If the government stopped spending uselessly, it might be able to delay cutting into social programs.

But this is not what the government does. Consequently, I do not agree with the hon. member's comments on the Reform Party vision. I am not a Reform member either, but I do think that our debt ratio is dangerously high. This is the real threat for our society and, without going as far as the Reform Party, I do believe that the provinces, which are closer to the taxpayers, are in the best position to assess their needs, and should therefore be the only ones to decide which medical services to provide.

The other day, in Quebec, we had-

[The Acting Speaker (Mr. Kilger)]

Order, please. I hesitate to interrupt at any time, but particularly during the period of questions and comments. When I called the question and comment period, I noted that a number of members wanted to ask questions of or make comments to the member for Winnipeg South.

This is the period that permits an exchange of viewpoints between members from both sides of the House. In noting the number of members wishing to debate the hon. member for Winnipeg South, I would ask the hon. member to ask his question and conclude his remarks so that I may give the same opportunity to others who have indicated their desire to speak. I hope you will trust in my being as reasonable and fair all the time.

[Ghislain Lebel, Bloc, Chambly, QC]

Mr. Speaker, I understand very clearly and I will be quick. I would ask the member for Winnipeg South if the solution, which would not be entirely that of the Reform Party or, at the other extreme, the Liberal Party, if it could not be a joint one with respect to expenditure cuts, particularly in the area of defence, that might satisfy everyone?

[The Acting Speaker (Mr. Kilger)]

I thank the hon. member for Chambly for his co-operation.

[Reg Alcock, Liberal, Winnipeg South, MB]

Mr. Speaker, I thank the member for his question.

I absolutely agree with the member. All sorts of areas have to be looked at, evaluated and tough decisions have to be made. That is what we are doing. That is what the budget which was tabled here not so long ago was all about. That is why people in every constituency across the country are feeling the pinch. It is because we have made some of the toughest fiscal decisions made by a government, at least in the last quarter century.

The difference comes in this way. I was in a provincial legislature that supported health reform. We said that we have to get costs down in health care. We advocated very strongly and the health care professionals worked very hard to do exactly that.

Procedures which used to cause a week or 10-day stay in the local hospital near me are now done in one night. Many are done on an out patient basis. All sorts of reorganizations have been undertaken in order to reduce costs, be more efficient, deliver better service, faster and cheaper. However, we have not made the reform of saying one person can have health care but another cannot. That is the difference in the Reform approach and what we are doing.

Change is a fact of life. There can always be change. There can always be improvement. We can always do things differently. But as Canadians we made a commitment that we would be in this together. That is the difference.

[Lee Morrison, Reform, Swift Current—Maple Creek—Assiniboia, SK]

Mr. Speaker, I wish the hon. member for Winnipeg South were the minister of fisheries because I have never seen so many red herrings dragged through this Chamber in the brief year and one-half I have been here.

[John Williams, Reform, St. Albert, AB]

Call them turbot.

[Lee Morrison, Reform, Swift Current—Maple Creek—Assiniboia, SK]

Yes, perhaps turbot. We were supposed to be debating the Reform Party's motion on the reform of the Canadian health care system. We heard a dissection of the American health care system which is totally irrelevant to the discussion being held here today.

We heard the hon. member saying that we must have good health, that good health is so valuable. Who is arguing? Let us get down to basics and talk about the motion instead of dragging in these straw men, setting them up and kicking them down.

I wish I had the hon. member's gift of eloquence but I thank heaven I do not have his gift of logic. He will not stick to the issue. He wants to know what local administration of health means. I can give him a good example.

I was born and raised near Swift Current, Saskatchewan in what was known when it was first formed 50 years ago as health region number one. It was the first medicare system in Canada. It was an experiment. My family helped to create it. They worked hard for it. It was a great success and do you know why? Because it was run by a bunch of country doctors and municipal reeves. It did not have a giant bureaucracy leaning over its shoulder telling people what should or should not be done. It was a wonderful system.

When the Canadian medicare system was finally set up some 20 years later the results of that experiment were ignored. It was thrown out the window. A massive federal bureaucracy was set up to oversee the medicare system we had worked so hard for. Our system was efficient, it was effective and by God it was cheap. Nobody went without medical care. If we did not have the specialists available in our rural area to do certain procedures, we sent them somewhere and we paid the bills. That is what local control means.

In this day of marvellous communications we do not have to go that small. However surely to heaven we can put it at the provincial level where politicians have to respond directly to the people who elected them, where the system is run by the people who are most directly concerned. That is what local control means. That is anathema to the Liberals because they are the great centralizers, the great controllers.

[Reg Alcock, Liberal, Winnipeg South, MB]

Mr. Speaker, I will only take a minute to respond.

I would urge the member to get a copy of the Canada Health Act. There is nothing in the Canada Health Act that prevents local involvement, local control. We have medical regions in my province. The hospitals have boards. There are some restrictions. The Canada Health Act states that the provinces will pay for any service that is medically necessary. We cannot decide in a local region to de-insure somebody for a medically necessary service. We cannot make that decision because we as Canadians made a decision that everybody in all parts of the country would have access to medically necessary services.

The member raises the spectre of a huge bureaucracy centralized in Ottawa that makes all these decisions. Does the member know how many people it takes to administer the Canada Health Act? Has the member ever bothered to check the size of this huge bureaucracy? There are 25 people who make the decisions about the Canada Health Act.

I have nothing against local control and local involvement. That is something we promote. We went around designing a series of health regions with elected boards and everything else. It was done in British Columbia and Manitoba. However, that is very different from saying that we will have a two-tier system where the rich get one kind of help and others do not, or that rich provinces will have a particular kind of health care system and poor provinces will not. We are all Canadians who want to see a country that includes and brings everybody into the Canadian family, not one that kicks a few out.

[John Williams, Reform, St. Albert, AB]

Mr. Speaker, I am glad to participate in the debate on the Reform's motion on health care today. I would like to try to put to rest some of the misconceptions and untruths by our friends on the other side of the House.

We have heard so much about the two-tier system. The two-tier system has already been created.

Someone who has money can get something fixed today. He can go south to the United States and get any medical treatment

he wants. It alleviates the necessity of the Canadian taxpayer to pay for it. It costs, but the person can have it right away.

The other is our Canadian health care system which will deliver non-emergency services sometime down the road in maybe a year or more. That is the health care system we have today. It is the one which is eroding and deteriorating significantly. It is being starved for cash by this government.

The government clings to its five universal principles that it cannot ensure and guarantee any more. That is the two-tier system which exists under this Liberal government and the two-tier system we are opposed to.

Now we are in a financial crunch. The system is broke and is falling apart. People are in desperate need of surgery and are having to wait a long time. One per cent of Canadians are waiting for elective surgery. This is not 1 per cent of those who are sick. According to the Fraser Institute, today 1 per cent of Canadians are waiting for the health care system to deliver and it cannot.

Those who have money can go across the line and spend money in another country. This is equivalent to importing which is detrimental to our economy. They can buy any service they want. Therefore, we have a two-tier system. It is not the one we would propose or that we even like. In fact it is the one we are totally opposed to.

However we are saying that there is a guaranteed need. The Reform Party is absolutely committed to ensuring that all Canadians have access to medical services and they should be able to have it now.

Someone may want more than the basic minimum and may want to pay for a longer hospital stay or a private nurse at their bedside. I say be my guest, at your cost.

There are many ways that we can resolve the problem. However, before we talk about resolutions let us continue to look at the problem.

I have a letter from the Sturgeon Health Unit in my riding. It is dated September 9, 1994. It is a generic letter to its patients:

Dear Home Care Client:

As you may be aware, the increased demand for home care services has far exceeded the available resources. There is decreasing access to acute hospital care. Increasing numbers of people in the community need high levels of support to compensate for disabilities.

In order to continue to provide essential, basic service to those in greatest need, we have asked home care co-ordinators to review their caseloads and reduce services where possible.

We recognize that assistance with homemaking enables many clients to remain at home longer. Currently, however, homemaking will be limited to those people who would face an immediate move without the service. This means that families may have to provide more assistance or purchase the service. The Home Care Program recognizes the significant contribution family caregivers make to home care clients and regrets the increasing expectations placed on families. It is hoped that increased funding will soon follow the demand for community based care.

Sincerely,

Carol Sims, R.N.,BScN.

Director, Home Care

The letter says there is decreasing access to acute hospital care. That is not Reform policy. That is not because of Reform Party actions. That was happening in 1994 and it is happening in 1995. It is happening in the country now under the government and it accuses us of proposing a two tier system. The letter says: "In order to continue to provide essential, basic service to those in greatest need, we have asked home care co-ordinators to review their caseloads and reduce services where possible". Only those in serious need will be looked after. The rest will be passed over to the families to look after because the government does not have any money.

This is not a letter from someone who is peripheral to health care. It is not a letter from someone being denied health care. It is a letter from the very heart of our health care operation where decisions are being made to deny health care services except to those most in need.

We have a two tier health care system today. We have it in the worst possible way. That is exactly why the Reform Party put forward this motion which says things must change. It is not because we simply want to change things; we recognize the health care industry is sick and needs to be revitalized. We are asking questions about how that should be done.

I said earlier the Liberal Party seems to be stuck with its head in the sand on the five principles: universal, affordable, comprehensive, publicly funded and publicly administered. The Liberal Party says that is it, the debate is finished and there will be no more discussion. In the meantime the government is cutting back the money it is prepared to put into the health care system by the billions. In the last budget the Minister of Finance cut it back again and said: "Provinces, it is all yours. Remember that you must abide by our five principles that we refuse to let you off the hook on".

In Alberta the Minister of Finance gave a severe warning. He said unless it stops these practices that do not meet the definition of the five basic principles, Alberta will be cut back on its funding.

We all know that every province is providing these same types of services where doctors, hospitals and clinics are charging additional fees. For some reason Alberta was singled out as the big bad ogre and was told to toe the line or it would be cut back. The Minister of Health said nothing, not a word, about the other provinces.

Alberta is wrestling with reduced budgets and less money to resolve the problems. It is being innovative. It has reorganized its system. I will not say I think it has resolved every problem the best way it should but it is trying and it is doing its best to grapple with a system with less money to ensure the services are there for those who need it.

With respect to the two tier system in order to reduce the cost of health care, we must introduce that dreaded word competition. That is deemed the code word for the American style of health care but I say there is no competition in the United States. That is a closed shop. It may be privatized but it is a closed shop and there is no competition.

If we are to control the cost of health care we must introduce competition. Competition can show up in many different ways. Competition means that we have a choice. If we have a choice between A or B and we decide to always choose B, then A disappears through lack of funding.

We find our health care costs are 50 per cent higher than those in Europe. In the last few days they have made some references in the Liberal camp to the fact that we are trying to bring health care costs down because Europe has a wonderful system and it only consumes 5 per cent or 6 per cent of GDP, but we are up closer to 10 per cent of GDP. Why is that?

I was in the UK last summer. To give an anecdote, my sister who lives over there had surgery a year ago and had to attend the outpatient department in a large hospital. When I say a large hospital, I mean a large hospital. It serves .5 million people.

We had to be at the outpatient department at 11.10 a.m. and after we had been there my wife and my sister and I were to go shopping and so on. I thought: The day will be gone before we get out of the hospital; an appointment at 11.10, they will see us at 1 p.m and by the time we get out of the doctor's office it is 2 p.m and it is time to go home.

I could not believe it. My sister had seen the doctor and we were back out on the street at 11.30 a.m., 20 minutes after her appointment time. I was amazed. How did this happen? I investigated to find out.

Medicare is free there. What has changed since I had last seen medicare there is the UK has introduced a couple of things. One is internal markets and the other is called social charter.

The social charter basically says any government organization that deals with the public in a monopolistic environment has to publish minimum standards. These minimum standards are not enforced on them but they have to decide their own minimum standards and publish them.

In the outpatient department of this hospital the minimum standard that the hospital had published was to see its patients within 30 minutes of their appointment time. It sounds good to me. It went a little further. It said that if the hospital cannot see the patient within 30 minutes, fill out this card, pop it in the mail and the hospital will not get paid for providing the service.

All of a sudden we have accountability. Right there we have accountability. If it cannot meet its minimum service standards it does not get paid. Now it has a challenge to provide service. Two out of five principles, publicly funded and publicly administered, which the Liberal government has, totally and absolutely fall down.

Until one provides competition there will never be service. That is why we have to wait a year or more for surgery. Competition ensures it looks after its patients. That is the type of thing we are trying to start a debate about in this country, that provided accessibility.

I talked about the concept of internal markets. Every hospital is required to get on to a true and proper cost accounting basis, just like business. That is all; we are not asking them to do something impossible. We are asking them to do their accounting by the same rules as business. Then when the regional health units have a budget to look after their clients, they have to spend money. Let us take something quite expensive such as bypass surgery.

They will choose the hospital that meets and exceeds standards, that can provide the service and also does it for a lower fee. Now we have hospitals competing on price. That ensures that each hospital keeps its costs down. That is how we introduce cost savings and bring health back into the medicare system.

Health care in the UK to the consumer is still free but the UK has introduced internal markets, social charters and it has competition. The health care system in the UK is costing a half to two-thirds of what it does in this country.

The Liberals cling to the idea that only publicly administered and publicly funded hospitalization and medicare is the way to go as we watch it crumble before our eyes. The UK was the pioneer of socialized medicine. Fifteen or twenty years ago it was in the turmoil we are in today as far as trying to afford health care services. It introduced these new ideas and has been able to improve the service, improve the quality and ensure competition. By allowing competition it has also allowed private funding to come into health care.

When I say private money, is that such a dirty word? We all say we cannot have profit in medicare. I defy anyone to find anybody in the health care industry to say they will continue to do what they are doing for nothing.

Everybody is in for the paycheque, the profit they make on the sale of the equipment, on the hospital they build, and so on. That is why the other thing we have to introduce is a real and true market. Market makes the right decisions.

We have seen it time and again. My riding is a perfect example. Health care built a brand new hospital four or five years ago at a capital cost of $50 million. It sat empty for a couple of years before the operating money could be found to open the doors. Now it has been downgraded from a hospital to a health care unit. This is in the city of St. Albert. All these were political decisions. They were not market decisions. We have wasted millions and millions of dollars on these kinds of decisions.

Access to health care is not available today, even though universality is talked about. The definition of universality does not mean access because people are waiting up to a year and sometimes longer for elective surgery.

Affordable? Yes, we want to ensure that all Canadians in any part of the country have access to health care. That can be basic health care. There can be a deductible charge of 5 per cent or $5 or $10 to make people think because as soon as it is free, there is abuse.

Yes, we want to ensure that health care is available for all. However, we totally disagree that publicly funded, publicly administered, non-competitive, political decisions by bureaucrats, politicians and committees are the only way to run a health care system.

There are all kinds of situations in the private sector. From the food we grow to the vehicles we drive and the buildings we live in are all provided at standard or above standard by the private sector. It is done on a competitive basis. It ensures the highest quality and a variety of choices for the consumer.

In conclusion, I strongly endorse the Reform Party proposal. I would like to see a national debate on health care. I would strongly ask my Liberal colleagues to re-examine, and I have to say it again, their heads in the sand approach to publicly funded, publicly administered health care that has proven it does not work.

[The Acting Speaker (Mr. Kilger)]

We will go to questions and comments. I would ask you to keep your questions and comments brief so that I might recognize as many members as possible.

[Dan McTeague, Liberal, Ontario, ON]

Mr. Speaker, I am pleased to have the opportunity to question my learned colleague from St. Albert.

Where are these great waiting lists the member talked about? Who are the thousands of people who have gone to the United States in search of services? I have one of the largest ridings in the country. I do not have these large numbers telling me about this. On the contrary, I hear a lot of people complaining about the provincial government and the way it administers services.

It is interesting that the hon. member used the Fraser Institute to support some of his information. Really, that is the Pravda of the political right in this country.

While I agree with some of the comments the hon. member made with respect to the home care issue, I would hope he would take the time to read the Canada Health Act. Under the Canada Health Act our requirement is only to deal with hospital services and MD services. If we want to talk about the home care issue, we have to go beyond the act. Therefore, he is really speaking out of context.

All the provinces, including Alberta where the member comes from, support the five principles. It is interesting that the comment has been made that the province is not in agreement and in particular that the member is not in agreement with the five principles. Could he tell us which part of the five principles he or the Reform Party is prepared to abandon? I presume he is speaking on behalf of the Reform Party since he is a member of that party.

I also want to point out to the hon. member that when we compare ourselves to the United States where competition and market forces exist, 39 million people in the U.S. have absolutely no protection and are in no position to get sick. Another 39 million in that same jurisdiction where this great aura of competition exists are also underinsured.

Does the position the member has taken here today really deal with whether or not members of his party are prepared to understand the full implication of what they are lamenting here today? Before the hon. member answers that question, there are some other examples which I think have to be taken into account.

Dental services are not covered in Canada. Most people will not go to a dentist to get necessary treatment because they are concerned about the possible costs being assigned to them.

[Herb Grubel, Reform, Capilano—Howe Sound, BC]

How do you know that?

[Dan McTeague, Liberal, Ontario, ON]

I know that for a fact because my wife is a dentist. That is the evidence I am prepared to support because I am speaking from truth, unlike my hon. colleague's friends over there.

My concern is with the hon. member. I would like-

[The Acting Speaker (Mr. Kilger)]

Order. I hope I am not overreacting. I know members feel very strongly about each and every issue we debate. I think there would be unanimous agreement in the House that the issue being debated today is of critical interest to all Canadians and all parliamentarians here in the House, particularly those taking part in this debate.

As to the matter of truth and who has the best ownership of truth, there is certainly no sole ownership and I will leave it to all of us to debate. I would ask members to be very judicious in their selection of words. Would the hon. member for Ontario please conclude and ask his question to the hon. member.

[Dan McTeague, Liberal, Ontario, ON]

Mr. Speaker, I take that under advisement. Can the hon. member tell me what he really means when he talks about competition and its full implications on Canadians given that we have a universal, acceptable system that is working for the benefit of all Canadians?