Mr. Speaker, I an indeed pleased to be able to participate in this debate. I personally believe very strongly in the principles of medicare and I know that they are also of great importance to people not only in my own riding but across the country.
The Canada Health Act is a brief, simple act. It sets out the five principles: public administration, universality, accessibility, portability, and comprehensiveness. It has a few definitions and deals briefly with penalties for failure to achieve these principles. It does not, could not, and should not set out how provinces operate their systems.
The preamble of the Canada Health Act is clear on this. Provinces are free to build their own systems within the broad framework of the Canada Health Act.
The guiding principle of medicare has long been that Canadians' health and access to quality care should not depend upon their financial means. In 1984 the Canada Health Act was introduced by a Liberal government and passed unanimously. The preamble of the Canada Health Act recognizes that "Continued access to quality health care without financial or other barriers will be critical to maintaining and improving the health and well-being of Canadians". This concept is also brought out as the primary objective in Canadian health care policy: "to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers, as described in section 3 of the act". It is within this framework that I wish to address the motion before us today.
Contrary to what some members in the House would have us believe, the government does not have a rigid view of how health care should be organized in Canada. The provinces already have a large degree of flexibility in the organization and provision of health insurance and health services. They have had this flexibility for many years. The only conditions the federal government assigns are that the provinces respect the requirements of the Canada Health Act.
Within the requirements provinces can experiment and change the way they deliver care, and many have been doing so. Nothing in the Canada Health Act limits the flexibility of provinces to realign the delivery and organization of their health care systems. Almost all provinces have embarked over the last few years on major reforms of their health systems.
The public administration criterion of the Canada Health Act presents a good example of the flexibility inherent in the act both in the provision of health insurance and in the delivery of health services by the provinces. The criterion applies to provincial health insurance plans and not to the administration of individual components of the health care system such as hospitals. This means, for instance, that private sector management of publicly owned hospitals is permitted. In addition the criterion allows administration authority of a provincial health insurance plan to be delegated to an agency if that is the wish.
Another example of flexibility inherent within the Canada Health Act relates to hospital services. These services are not directly tied to an institutional setting. Thus it is permissible for acute care to be provided in the community in a patient's home, for instance. It is always the provinces, not the federal government, that determine which services will be given in which setting.
The extramural hospital in New Brunswick is an example of provincial use of the flexibility. Under the program the patient is formally admitted to the acute care program. However, all required services are brought to the patient's home and not to the most expensive operating unit within the hospital structure called the emergency ward.
I emphasize, however, that the government recognizes the need for flexibility. On other hand it will not compromise on the fundamental values upon which the Canada Health Act and medicare in Canada are based. We are and we will continue to be flexible in our approach to health care, but we will not permit financial barriers to impede access to health services. If flexibility means turning our health care system into a private one that profits from the misfortunes of Canadians, the government
wants no part in it. We will not tolerate direct charges to patients for medically necessary care.
During this period of constraint creative processes are being produced by creative individuals in every province in handling these fiscal problems. There are solutions and money can be managed much more effectively than it is at the present time.
One of the most cherished services enjoyed by Canadians is the health care system. Health care issues constantly rank as number one across a variety of polls. The federal government is the ultimate torch bearer of the one of the last truly national programs. The central government, therefore, is morally obliged to defend the Canada Health Act against policies that seek to destroy it.
I believe as do many Canadians that the Canada Health Act should be kept as it is. Undoubtedly any changes to the fundamental principles upon which health insurance is founded would cripple the most notable gains attained by the Canadian health care system.
We need only look south of the border to realize how fortunate we are to enjoy the health services we do. In the United States approximately 35 million people are without adequate health coverage. Health care horror stories abound south of the 49th parallel. Even Americans who have medical insurance can be hit by very high medical bills. In some cases, because of poor family coverage, if a family member has a serious illness or an accident the extra bills can be financially devastating. Moreover American company medical insurance plans lock many Americans into their jobs. This is because once a person develops a chronic illness no other insurance company will provide insurance at reasonably affordable rates.
Certainly wealthy Americans can receive the finest possible health care. However this is certainly not the case for the middle and lower socioeconomic classes. It is interesting that the opposition in the House is advocating a very similar system to that of the Americans.
Some detractors of our health care system indicate that we can no longer afford medicare in its present form as a result of our fiscal situation. However most health economists agree that it is not our medicare policy in and of itself we can no longer afford, but the inefficiencies in the manner in which medicare is implemented and delivered.
Significant improvements could be made in a number of areas without compromising national standards. For example, the unbridled growth of unproven and costly new medical technology has ballooned health care costs without any apparent return on the money spent. Another problem pertains to the manner in which drug prices have skyrocketed over the recent past. As well it appears supply and distribution of our medical manpower need improvement.
These are but a few of the areas where efficiencies, if introduced, could reduce the cost of delivering health care in Canada. Above all, provinces must listen to those who deliver and maintain health care services as well as those who receive the services. Although some problems exist we must do what we can to improve the system without destroying it. In a nutshell, the difficulties facing our health care system are the result of unlimited demands upon a limited pool of resources.
I feel compelled to rise today before the House to speak against a motion that would ultimately lead to the dismantling of the health care system that is dear to the hearts of many Canadians. In sum, Canadians demand and expect direction from the federal government for the preservation of our most sacred national program. The government has a moral right and the legal authority to ensure that this is the case. That is why we must vote against the motion before us today.