Madam Speaker, the gist of the hon. member's question is concerned about the issue of universality which actually has nothing to do with cost.
Universality means that we are all eligible for health care services regardless of what is our status in terms of employability or whether we have chronic illness, chronic diseases or not. Accessibility is the one that talks about ability to pay.
I understand the hon. member's question which is how can we continue to support the kind of medicare system that we know, based on the five principles of health care, if we do not put enough money into it.
As he so wisely pointed out, the United States spends 14 per cent of its gross national product on health care. Canada spends about 10 per cent and Japan spends about 6 per cent. Japan has the highest outcomes in health care in the world today. Canada ranks third. The United States ranks somewhere between Cuba and Czechoslovakia.
If we talk about money spent on medical services being the only determinant of outcome of health care, we are barking up the wrong tree. Money does not equate to outcomes and good health status. Many other things drive health status, such as poverty, environmental issues and many other issues with which we have to concern ourselves.
We are committed to health care. Studies have shown, especially the recent one from the University of Ottawa, that we can have an affordable, much more efficient health care system with better outcomes if we make some very real changes. We should look at such changes as moving from acute care to community care, looking at care closer to home; looking at providing core services for continuing care for seniors, looking at prevention and health promotion. Many of these things will give us better outcomes. This study has shown that we can save $7 billion a year on health care payments as a federal government and still come up with very good results.
We are talking about a time for looking at how we renew our system and how we make our system more effective and more efficient. We now know of so many ways to manage our system. That is what we are talking about in the renewal of health care. Those are the changes we want to see.