My friend from Wild Rose is informed, as usual.
I say to him and others that this bill will create the new Department of Health. The old department was called national health and welfare and this bill together with the one dealt with the other day affects the change.
This bill confirms the mandate of the minister regarding the promotion and preservation of the health of Canadians. Health is a matter that affects Canadians very deeply. Our medicare system has come to be part of the way in which we see our country. We
believe that the federal government has an essential role in medicare and in safeguarding the overall health of the Canadian population.
In this time of change to our health system, many people want to know where the federal government stands on health issues. Canada's health system will continue to rely on the interlocking responsibilities of federal, provincial and territorial governments. That is why in the recent budget of March, the government went a long way toward providing provincial and territorial governments with stability and predictability in health funding and other social services of $25.1 billion each year over a five-year period, comprising a tax floor that had been requested by the provinces and tax transfer points.
Health Canada bears the overall responsibility for protecting and encouraging the health and safety of Canadians through promotion and prevention activities at the national level. It assesses the safety of drugs and medical devices. It deals with issues such as the potential impact on Canadians of exotic viruses or the re-emergence of public health threats such as tuberculosis. It encourages healthier lifestyles and active living.
The federal health department also supports the health system through funding for research as well as financial and technical contributions to provincial health systems. The federal health department arranges health care programs and services only for specific categories or groups of people who are a federal responsibility such as status Indians and the Canadian Armed Forces. Otherwise, the federal department is not a delivery agent for health care. That lies with the provincial and territorial governments. They have the primary responsibility in the area of health care delivery. They design and manage the system that most of us as Canadians use. However, the federal department does play an important national leadership role in health that Canadians see as essential.
Health issues figured very prominently in the Liberal Party's red book in the last federal election campaign. For example, a head start program for children of aboriginal families living in urban centres and large northern communities was promised. A number of projects under that program have already been funded.
Action on prenatal nutrition programs was also promised in the red book. They are being delivered through the community action program for children.
There are other commitments on which the government is acting but I will talk about them a little later. What is common to all of those initiatives is their national scope and the value of national action on each of them.
Of course this work also involves financial support for the health care system for the provinces and the territories, as I said a moment ago.
Federal health contributions have evolved over the last four decades from cost sharing arrangements to block funding transfers to the provinces and territories. Since 1984 the Canada Health Act has set out the five criteria that provincial and territorial medical insurance plans have to meet to qualify for federal support.
These five criteria are worth repeating here today. The first principle is universality. The Canada Health Act supports provincial health insurance systems that cover all eligible residents.
The second principle is accessibility. Services must be available without financial barriers. People must be given health care on the basis of need, not on the basis of how much they can afford to pay.
The third important principle is comprehensiveness. If a province defines a service as medically necessary, that service must be covered completely.
The fourth principle is portability. Canadians with coverage in their home province or territory maintain that health plan coverage when they travel or when they move. This is a very important principle, like the others, given the mobility in this country at this time, the number of people who move from jurisdiction to jurisdiction, from province to province and from province to territory.
The fifth principle, together with the ones I have mentioned, universality, accessibility, comprehensiveness and portability, is public administration. It means that the health insurance plans of a province must be administered and operated on a non-profit basis by a public authority. That, to me, is the one some of the provinces either have difficulty understanding or difficulty wanting to live with. That is one of the five principles that we on this side of the House are committed to continue to enforce, the principle of public administration.
The government takes these five principles very seriously. It has resisted the false claims that watering down the act is the only way forward. Canadians want the health insurance system they have built during our lifetime to continue. They do not want to see a two-tier system and I do not want to see a two-tier system either.
Canadians understand that medicare has been a great social benefit. It has been one with very strong economic benefits as well. It is an efficient, effective program for providers, hospitals and for
Canadians. In fact, the average man or woman knows this reliability better than some commentators. We are better off thanks to medicare. That is why the federal government has defended the Canadian system of health insurance so strongly.
The government has been equally clear that it believes the health system needs to be reviewed. Canadians know the economic issues facing the health system. Make no mistake, they are the same issues in the United States and in other developed countries around the world. Many countries face issues such as rising costs of care, the emergence of new health needs, aging populations, the appearance of new medical technologies, drugs and other factors. We are all asking where the money goes.
As a country we face more challenging health issues. For example, all Canadians agree that tobacco is a major health issue. The Supreme Court of Canada has affirmed that smoking consumption in this country causes deaths of the order of nearly 40,000 each year. Remember that smoking is a costly exercise to the Canadian economy. The estimated cost to the Canadian economy is $11 billion a year. This figure incudes the costs to the health care system and the overall loss of productivity for Canadians as a whole.
The federal government is determined to work with its provincial counterparts as stakeholders to bring forward a comprehensive and focused package to address the tobacco issue.
There are other concerns. I have mentioned the tobacco issue. There are women's health issues for example. It is an important priority for the government and I am sure it is for provincial governments and stakeholders alike. It is time to address key issues surrounding women's health.
There is the issue of new reproductive technologies. Some who may have followed this issue will recall that the previous administration sponsored a Royal Commission on New Reproductive Technologies which contained numerous recommendations. This administration is now considering these recommendations. The government hopes to be able soon to move on a number of those recommendations in a substantive way. Members from all parties in the House have called for action on the issues of new reproductive technologies, of women's health, of tobacco. There have been calls from all over and the government is acting on those issues.
We must begin to consider what will become of the health system down the road. We know that spending more on the status quo is unlikely and that direction would not give us much better health outcomes than we now have.
The international evidence is clear that spending more on health care does not mean better health results by itself. Why? Health care is not the same as health and people often wrongly equate the two.
The status of a person's health is determined by many factors which are in place long before he or she sees a doctor or is admitted to a hospital. Some are as basic as genetics. Others involve the economic, the social or the environmental conditions in which we live. Still others are grounded in lifestyle choices. All these are determinants of health.
Progress in improving health may owe far more to living in an economy which produces good jobs or programs that help people live in proper housing surrounded by a clean environment. They are reasons for us to invest in effective health protection and promotion measures, ones that result in people making better health choices.
Health care is not enough, but it is important. Our question is how to achieve the best health results possible with the money that we have. This renewal process has been under way now for a few years. The challenge for all of us is to break out of the traditional box of health thinking. It will mean change. Community based health service centres and multidisciplinary team approaches to health care are changing the landscape of health care delivery.
The increased awareness that good health begins long before a visit to a doctor will mean an increased emphasis on the education of health consumers and preventive medicine. People will need to learn what physicians can and cannot do for them. People will need to learn how much they can take charge of their own lives. These steps are each part of a broader evolution of our health care system.
Canadians trust their health care system. They expect the federal government to support and defend that system, especially the fundamental principles on which medicare is based. That is why we need a strong federal Department of Health and why I am encouraging members of this House to support the bill before us today.
I mentioned a moment ago the issue of determinants of health. We in the Standing Committee on Health which I have the honour to chair are doing a study on the determinants of health as they relate to younger children. It is an important issue.
We in this Chamber and elsewhere are aware that poverty for example is a real determinant of health for people. We have direct correlations between poverty levels and such matters as the rate of suicide among people. Poverty levels and achievement in school are two areas where poverty impacts on other outcomes. The all-party health committee of the House is now undertaking a rather in depth study of this issue to see what needs to be done and is not currently being done in the area of children's health.
The bill before us is not one that is terribly earth shattering but Bill C-18 is an important piece of legislation. In the jargon of the House it is considered only a housekeeping bill to put in place the necessary statute to allow the department to function.
I am rather delighted that the current Minister of Health is my good friend from Cape Breton. Already in the short time he has been in the portfolio I have watched with some satisfaction his commitment to the serious challenges we face in health care and his determination to do something about those issues. He is a good spokesperson for the issues. I certainly wish him well, together with his parliamentary secretary from Eglinton who has just taken on that responsibility.