Debates of May 18th, 2000

Supply

[Janko Peric, Liberal, Cambridge, ON]

Mr. Speaker, I have high respect for the hon. member for Macleod as a professional. I am glad to hear that the hon. member, as a professional, is not in favour of a two tier system.

Early in his speech he mentioned brain drain, but I am not sure if the hon. member is aware of brain gain.

In the Waterloo region there are probably close to 40 medical, highly qualified and experienced doctors from all over the world. As he knows, there is a quota in Ontario. I believe that there are quotas all over the country. Would the hon. member encourage the provincial ministers to leave those quotas and to give those opportunities to newcomers to practise medicine in the country, as well as nurses?

[Grant Hill, Reform, Macleod, AB]

Mr. Speaker, I thank the hon. member for that sensible question. The issue of brain drain could not be made more clear than to recognize that one-third of the current medical graduates from our 16 medical schools in Canada do not set up practice in Canada. They leave this country and never set up practice. That is a tragedy. We, as taxpayers, have a lot to say in terms of their training.

On the issue of foreign graduates and other individuals, some of them are driving taxis while their medical credentials are left unused. That is another tragedy.

We have a closed shop mentality in our country. We have an idea that the only training that is good is North American training, and that is not accurate. Those individuals should be able to pass an examination. I would open my arms and my heart to their experience, their thoughts, their ideas and their talents. Many of them go to far-flung spots to practise in areas that have difficulty getting practitioners. They will go anywhere to practise their skills.

The sad thing is that governments bought the idea that physicians were driving health care costs and if we restricted the number of physicians we would drive down costs. It would be wrong for me to talk so much about physicians. There is a shortage of nurses now due to the same issue.

It is a very sensible suggestion and I appreciate the hon. member's input.

[Réal Ménard, Bloc, Hochelaga—Maisonneuve, QC]

Mr. Speaker, I generally pretty much agree with NDP proposals. This morning, however, I must say that, unfortunately, we will be unable to support the motion proposed by the NDP on this opposition day. I would like to recall the terms of it in order to explain our concerns. Our colleague, the leader of the NDP, moved the following:

That this House call upon the government to act on the words of the Health Minister when he said, “we have grave reservations about investing public funds in private for-profit facilities”, by immediately amending the Canada Health Act to provide that provinces be financially penalized if they allow public funds to be used for the provision of insured services by private, for-profit hospitals.

I submit to the members of the House that there is a trap in this motion. First, and I say this right off, our party believes that health care must be the most important of all public responsibilities. We believe in a system of universal, accessible and public health care for our fellow citizens.

Happily—and I will have the opportunity to return to this—the Government of Quebec is miles away from considering privatization, which of course does not prevent some of our fellow citizens from having private health insurance plans.

The trap in the motion by the NDP lies in its inviting the government to intervene in the way the provinces organize health care.

Favourable as we on this side of the House may be—the Bloc Quebecois is, as a party, highly favourable to this idea and believes without any shadow of a doubt in the appropriateness of using public funds to put in place a health system that must also be public—we nevertheless believe that the way the provinces organize their use of the health system does not concern the federal government.

We believe that the Canada Health Act in fact constitutes an overstepping of boundaries, because according to the Constitution of 1867 and its revision of 1982, there are just two areas of the health sector in which the federal government is concerned. These are the health of aboriginal people and of military personnel. Perhaps there might be a third, the whole matter of epidemics and quarantine. The rest of the health system does not concern the federal government. Nevertheless, over the years, the federal government has come to adopt a Canada Health Act, which proposes five principles.

We are not opposed to those five principles, but we do believe that their implementation must be provincial. What are these principles?

Section 8 of the act is, of course, where it is stated that the health insurance system must be administered and operated on a non-profit basis by a public authority.

There is also the principle of comprehensiveness, which provides, under the terms of section 9, that the plan must cover all the services provided by hospitals, medical practitioners or dentists and, where permitted, services provided by other health care practitioners.

The third principle is universality. Section 10 provides that 100% of the insured persons of a province are entitled to the insured health services provided for by the plan.

There is also the principle of portability, and section 11 provides that a person leaving their province must also be eligible for coverage under the health care system of the province they move to.

Finally, section 12 provides for accessibility. This refers to the ability of our fellow citizens to receive treatment.

An important distinction has to be made: we are not addressing the right question when we say that provinces tempted to privatize should be penalized.

I repeat once again that we do not believe in privatizing the health care system. Those of you who have doubts as to the merits of a public health care system need only look to the United States.

There, last year—so this is recent—53% of Americans' spending on health care was private. With this high percentage of use of the private system, we must remember that 16% of Americans are excluded from health care systems and have no form of protection. This means 44 million people who, as we are speaking, are excluded, because they do not have the protection that is often associated with the workplace and must therefore pay when they go to a hospital, or when they require health services.

The real debate that we must have in this House is the one that we were reminded of by the premiers. The federal government has money. Let us not forget that the budget surpluses for the coming years have been estimated at around $95 billion. Yet, the federal government backed out of its responsibilities toward the provinces.

When the Canada Assistance Plan and medicare were created, the federal government pledged, as with the other major joint programs that existed at the time, to pay 50% of the costs of health care services, just like it had pledged to pay 50% of the costs of post-secondary education.

But, as we speak, what is the federal government's contribution to health care services? How much money does it give to the provinces? In Quebec, for example, for each dollar spent on health by the provincial government, the federal government invests 12 cents.

Let us be clear: it takes a lot of nerve on the part of the Minister of Health to rise in the House and, with his smooth voice, tell us that the federal government cares about health services in this country. If the federal government cares about health services, there is a solution. Its only option is to restore transfer payments to their 1994-95 level.

There is nothing partisan about asking that transfer payments be restored to their 1994-95 level, when it is what all the premiers did. The most vocal was Newfoundland's premier, Brian Tobin, a former cabinet minister.

It is what the Progressive Conservative premier of New Brunswick did; it is what the premier of Nova Scotia did; and it is what the premier of Ontario did. All the premiers called on the federal government to restore transfer payments to their 1994-95 level.

We submit to the NDP that the real issue here is transfer payments. Why is this important? We know very well that there is not one health care system in Canada but several, and that health care is first and foremost a provincial jurisdiction. All the provinces must cope with new realities affecting how they must deliver health care.

The first reality that should be pointed out to the House is that people are living increasingly longer. We no longer talk about the elderly but about the very elderly.

If the parliamentarians here pay a bit of attention to their health, to the determinants of health, if they eat well, do not smoke or drink too much, and take part in a moderate amount of physical activity, they stand a chance of living to be 79, in the case of men, and 81, in the case of women. This means that people are living longer and longer. But that means pressure on the various components of the health care system.

One of the things that is happening in Quebec, in particular, is that the population is aging. It will take less time for a significant proportion of our fellow Quebecers to reach age 65 than will be the case in other provinces.

In 35 years, 25% of the population of Quebec will be over 65. I say this to the pages, who will take our place, especially those who come from Quebec. In 35 years, in Quebec, there will be more people aged 65 and over than there will be aged 15 and under.

This has all sorts of ramifications in social terms. It will significantly affect our ability as taxpayers to provide public services. It is mostly the people in the labour force who pay for public services. There will be pressure on the system as well in the provision of services.

Not only will people live longer, but they will be wanting very specific services. They will also want to remain in their natural surroundings longer, which will mean home care. There are pressures in demographic terms, but also in terms of specialities. I will give a few examples.

When people live increasingly longer, when the population is aging, it means people are more likely to end up in hospital emergency rooms. I have a few statistics on this point.

As far as Quebec's emergency departments are concerned, in 1998-99, in other words one year ago, there were 50,000 more patients in emergency department beds than the figure for 1994-95. Of that number, 56% were over the age of 75. More and more people are going to emergency departments and half of them are aged 75 or more. This means that system administrators need to plan for additional care.

Taking the sector of radiation oncology, which has to do with the treatment of cancers, the demand is increasing, particularly for people aged 50 and over. The baby boomers, born between the second world war and 1966 or 1967, have reached the age to require such services. There is a 3% increase in cancer cases every year.

As for cardiology, demand for services is increasing, particularly in the 50-plus age group. Once again, health determinants are important. The better a person eats, the more physically active he is, the less he smokes or drinks, the better his chances of not having heart problems. There is an undeniable statistical correlation between lifestyle and the probability of using public health services.

The community has only recently become aware of this connection. A whole generation of us grew up with a positive picture of smoking. It was connected with sex appeal. We can all remember the images televised until very recently of attractive young girls with their cigarettes.

Let me digress for a moment to say that, five years ago, 29% of Canadians aged 15 and over smoked daily and were addicted to tobacco. Today, that percentage is 25%.

We hope that in five years it will be down to 20%. However, the heaviest smokers are found among young people and in Quebec in particular, with 38% of young Quebecers being smokers, compared to 23% of young British Columbians. As a society, we must make sure that all the information is available to young people so that they never start to smoke.

It is not a coincidence that, for years, tobacco companies targeted that clientele. Just remember that picture of a race car driver. Mr. Speaker, you know what I am talking about, because you were a young man once, some years ago. I do not dare say many years ago, because I know that you are a very dynamic person, you are really very alert physically. I had the opportunity to go up some stairs with you and you were not even out of breath. You have a good cardiovascular system. You could work a little on your muscle mass, but I know that your days are very full.

All this to say that it was just recently that our society realized the importance of having winning conditions, from a health point of view, to be in good shape. Until very recently, tobacco companies were looking for young consumers.

I can explain why. If we conducted a survey among parliamentarians, we would see that 95% of smokers do not change brands of cigarettes. The only opportunity for tobacco manufacturers to increase their share of the market is to reach young people. These new entrants on the market will, of course, adopt new brands of cigarettes.

This is why I support any measure suggested by either government—Quebec has done a lot in that area—to tell people that tobacco is the primary cause of avoidable deaths in Canada. Every year, 45,000 people die as a result of smoking and this could be avoided if we made it socially unacceptable to start in the first place, and helped people stop.

I will close by saying that there are two ways to end the health debate in the House. The first is to restore transfer payments to their 1994-95 level. Quebec alone is out $6.5 billion, or $1.2 billion annually, of which $500 million would go to health and another $500 million to income security and post-secondary education.

If Quebec had 500 million additional health dollars, it would not be tempted to consider privatization. It is not tempted to consider privatization but let us not be hypocritical. The government cannot be surprised that some provinces are considering privatization when it is the reason they are cash-strapped.

As long as I am the Bloc Quebecois health critic, I will never stop calling on the government to restore transfer payments. The government has literally robbed the provinces; it has slashed their budgets and misappropriated funds. We cannot sit still for this.

Do I have the time to point out to the House what the Quebec government could do with the 500 additional millions that are its due? That is almost one-quarter of the budget of all Montreal's hospitals.

I will close by saying that I hope government members will be extremely vigilant and bring pressure to bear on the government so that it will restore transfer payments.

[Ethel Blondin-Andrew, Liberal, Secretary of State (Children and Youth)]

Mr. Speaker, I would like to thank my hon. colleague for his comments. I note that I too have a very great concern, as the Secretary of State for Children and Youth, and being an aboriginal woman, about the rate of consumption of tobacco products by different sectors of society.

In particular, it should be noted that Quebec has a 30% higher intake of tobacco products than the rest of the country. It is an extremely huge problem. Inuit women also have a very high rate of lung cancer and very high intake.

There is a pervasive influence on young people across the country.

In recent months it has been stated that Quebec has $500 million in a bank account in Ontario. Would it not be wise or at least appropriate for it to make use of that money for such purposes? Would that not make sense? I am sure that all Canadians watching us today would want to know how we could tolerate this situation, with that surplus or money not being used for these means.

I would like to hear the explanation the member would give, not to me but to Canadians on this issue.

[Réal Ménard, Bloc, Hochelaga—Maisonneuve, QC]

Mr. Speaker, I would expect our hon. colleague, with the responsibilities that she has, to be a little better informed and a little less of a grandstander.

Quebec's finance minister, Bernard Landry, an excellent finance minister, who has no equal in this House, may I point out, has clearly indicated that Quebec put the money the hon. member refers to in trust in order to protect itself from Treasury Board accounting practices that would not, had he included it in Quebec's operating revenues, have guaranteed the National Assembly that this money would be used for health.

The finance minister, with the agreement of the health minister, wanted to significantly increase the funding allocated to health care in Quebec. I want to reassure all my fellow Quebecers that, if there is a government in recent years that has fully assumed its health care responsibilities, it is the government of Lucien Bouchard.

I ask the hon. member if we can count on her as a committed voice in her caucus to make it known to the Minister of Finance and the Minister of Health that we want transfer payments to be returned to their 1994-95 level.

How can she remain silent? We are waiting for the government caucus to provide something other than the sorry spectacle of silent lambs with the government's cuts simply being confirmed uncritically.

I ask her to join with the members for Rosemont, Hochelaga—Maisonneuve and our colleagues in the New Democratic Party to say that the real crisis in the provinces' public health care system can be laid at the federal government's doorstep. Unilaterally, as of 1994, the federal government made cuts in transfer payments. Since 1994, these cuts have totalled $33 billion, $6.5 billion for Quebec alone.

If transfers were to be restored tomorrow morning, Quebec's share would be $1.2 billion. It would use half of this amount, or almost $500 million, for health, and the other half for income security and postsecondary education.

I therefore call on the Liberal members to rise out of their stupor, to take matters into their own hands and to stand up and be counted with opposition members when we call on the government to restore transfer payments to the 1994-95 level.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Mr. Speaker, this is certainly an interesting debate and I am very pleased to take part.

Health care is the number one issue in the country. There is no question about it. The reason, of course, is that we fear for the future of health care if the present government continues the way it has since its election in 1993. It has been in power for seven years. In that seven years we have seen the erosion of health care. What is even more frightening is that it has no plan.

Most of us would take a little comfort in action being taken by the government, in any action it might take. What we have basically said all along is that without a plan nobody knows. Without a plan we cannot predict the future of health care.

The difficulty in Canada, in the eyes of most Canadians, when they compare our health care system with others, is that we see what is happening in the United States. People in the country south of us do not have a health care system which is universal and managed by the federal government. Basically they have a health care system which is managed by, run by and controlled by litigation lawyers and insurance companies. We have all heard the horrendous stories in the United States of families going bankrupt because of the burden of health care forced upon them because they are sick. In other words, there is no one there to help them. We do not want to see that happen in this country.

In this country about 9.5% of our gross national product is spent on health care. In the United States that percentage is around 14.5%, the difference being that in Canada everyone is included. In the United States about 40% of the population is excluded from any health care coverage at all.

What this boils down to is that the health care system we have in Canada, in terms of the percentage of our GNP, is actually a good deal for Canadians. We want to see it preserved, but there is no evidence on the part of the government that it intends to pay attention to it to ensure that we will have a system down the road.

I have with me a couple of documents which I thought most Canadians would enjoy. I have the two red books. I will be quoting from both of them, red book one and red book two. Incidentally, one of the books was written in preparation for the 1993 election, the infamous red book one, which has a section on health care.

In the 1993 election members of the now federal government, then the opposition Liberals under the leadership of the present Prime Minister, promised some things in terms of health care. I want to show how the Liberals have deviated from what they said they would do to what they have actually done.

If we are unfortunate enough to have these people in office in the year 2004, by that date they will have effectively taken $30 billion out of health care. That $30 billion represents the crisis we are experiencing today. They have simply taken too much money out of the system.

None of us would stand in our place to argue that money alone would solve the problem, because it is about more than money. We are talking about a plan. We are talking about everyone getting together in the same room and talking about a strategy, a game plan, which will take us through the next 15 to 20 years.

I will read from red book one, which was the Liberal policy platform going into the election, which incidentally brought a lot of Liberal members into the House in 1993. We are going to hear some grumbling on the other side because I am getting into something that is very painful for them. I am reciting, line and verse, what they ran on in 1993. Here is the promise which is found at page 77, under the title “Canada's Health Care System”:

A Liberal government will face these challenges squarely, thoughtfully, and with confidence. Our approach will be based on our values. Our solutions will be predicated on our commitment to the five fundamental principles of our medicare system...

A Liberal government will not withdraw from or abandon the health care field.

Those are the very principles which we are debating today. Quoting again from the same book:

Liberals cannot and will not accept a health care system that offers a higher quality of care for the rich than for the poor.

In other words, according to the Liberals in 1993 we would not have a two tier system. We know what happened.

I am going to table this document. We will at least send it upstairs for Hansard to use in getting the correct quotes, the page references and that sort of thing, because we want it squarely on the record.

What did the Liberals do between 1993 and the election of 1997? They extracted over $17 billion from health care. Why were they able to do that so easily, so effectively and without a lot of criticism?

At that time just about every province in the country was Liberal. The Liberal premiers of Nova Scotia, New Brunswick, Newfoundland and Prince Edward Island nodded in agreement. All of the Liberal members of parliament nodded in silent agreement as money was hacked and cut out of health care.

On this side of the House the Bloc Quebecois was the official opposition. It was focused on one thing: leaving Canada. Those members had one thing on their minds: a new country. They were not focused on health care. They did not care.

The other major party in the House at that time was the Reform Party, now known as the united alternative. No matter what the government did to health care, the reformers would not stand to protect it. Nothing could be too draconian for the Reform Party. If the government had simply massacred the system completely, taken it down to ground zero, the Reform Party would have been pleased with that. Basically there was no intelligent debate in this House on health care between 1993 and 1997.

To make matters worse, the Liberals went into the 1997 election looking for a deathbed reprieve. They had put some money back into health care, but not enough. They knew they were in trouble. They had taken out $17 billion and they had replaced $1 billion or so, thinking that would do the trick leading into the election.

They did not do it, of course. They did not fix health care. The sad thing about this whole story is that in the 1997 election they went on to promise more. Let us read what they said in the 1997 red book.

The 1997 red book was their policy book for that election. We just heard in red book one what they promised. They completely reneged on that. I guess most parties would have abandoned their position, knowing that they had misrepresented the Canadian people in the election. No, they did not. They had the gall to stand and say the same thing all over again. On page 72 of red book two it states:

Medicare is a cherished legacy that we will never abandon. The Liberal government remains firmly committed to the five fundamental principles of health care in Canada: it must be universal, accessible, comprehensive, portable, and publicly administered.

However, they simply abandoned us again. They went on the same—

[An hon. member]

Tired old track.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Mr. Speaker, I was going to say burn and destroy mission; a scorched earth policy in terms of health care.

Thinking that might not be enough, given their record between 1993 and 1997, they went on to promise even more. They went on to promise a home care program in red book two, on which they were elected. They promised home care and more money for health care. Not to end it there, they promised a pharmacare program, which they knew they could not afford, but they promised it anyway. Apparently the Liberal philosophy is: the bigger the promise, the more votes. I suppose we could say: the bigger the promise, the bigger the votes.

Again they were successful. Since 1997 they have gone on with no plan and things are getting worse. Approximately $90 billion will be spent in Canada on health care this year. That $90 billion will be made up of the federal government share, the provincial share and the private sector. I want to remind Canadians that there is a private sector. Our system is not totally funded by the federal government.

My party's concern is that more of our health care system is becoming private. We have to be very careful of the direction we go in. That is what the NDP motion today is about. The NDP is suggesting that the federal government take strong action against the province of Alberta because of the introduction of bill 11.

I would like to give an example of how difficult it is for the provinces to manage given the set of circumstances that the federal government created. In my home province of New Brunswick spending in support of health care is the single largest expenditure. It even overshadows debt charges, believe it or not.

In 1998-99 the Department of Health and Community Services in New Brunswick expected to spend $1.3 billion, approximately 30% of its total provincial budget, on health care. About half of that total was spent on hospitals; 17% on medicare, which is predominately payment to physicians; 8% on nursing homes; nearly 5% on the prescription drug program; 12% on social services; and nearly 8% on other things, including mental health services and public health. Mental health services and public health received 1.7% of the total budget.

The situation in Newfoundland is worse. What is so hypocritical is that the present premier of Newfoundland, Mr. Tobin, sat in the House of Commons and supported the federal Liberal government at the time. He sat in the front row as the minister of fisheries. Mr. Tobin voted for all of the cuts that affected every province, including his home province of Newfoundland, of which he is now premier.

In the province of Newfoundland 42% of all spending is on health care. Per capita health care costs are now $2,037, compared to approximately $1,700 four years ago. Ironically, Newfoundland's population is decreasing, but health care costs are going up. That is the worst of all worlds. A lot of this was created by the federal government, of which Mr. Tobin was a member. He is starting to pay the price back home in terms of his government's ability to manage the system. The system cannot be managed without money.

The province of Saskatchewan is going through the same set of difficulties. Saskatchewan's population is declining as well.

[Dick Proctor, NDP, Palliser, SK]

It is not.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Let me speak. If members are opposed to what I am saying they can get on their feet and debate. But while I am on my feet I expect them to listen, as good children normally do.

In the next few weeks Roy Romanow will take a look at Saskatchewan's health care system. He will have a public review of what we would consider to be the holy of holies if we were members of the NDP, health care, and will define what services are essential.

This is almost parallel to what Mr. Klein is doing in Alberta, the province next door. The difference is that Alberta has taken measures on its own to deal with the shortfall coming from Ottawa in terms of funding. It is looking at privatization.

Saskatchewan will take a slightly different view. It will determine what services are essential. I hope hon. members are listening to this because it is quite important. It is important for members of the NDP because medicare is the holy of holies when it comes to their party. That is great, because we have to have more people in the House defending health care.

Instead of going down the Ralph Klein road in terms of privatization, with the aid of the stroke of a pen the premier of Saskatchewan will actually take procedures off the list of those that today are considered to be essential. Why? To cope with the shortfall in funding which hurts the poor provinces. Mr. Romanow knows that Saskatchewan cannot keep on paying to the degree it has. It has gone beyond its capacity to pay. The point I am attempting to make is simply that the federal government has created the problem.

I am sure Canadians get confused when they hear us debating this issue in the House ad nauseam. They want this sorted out because once we get into the numbers it gets so confusing.

Under the Canada Health Act primary care delivery is the responsibility of the provinces. This is where the equation has gone wrong. Primary care is the responsibility of the provinces and the 50:50 cost share which we originally entered into back in the 1970s has been abandoned. The provinces started out in a situation where the federal government would share the costs. The equation was that the federal government would pay half of all the costs. Now it is down to about 15%, 15 cents on the dollar being taken care of by the federal government.

It is imperative that we get all the players into one room. The federal government poisoned the atmosphere a few years ago when it unilaterally took $17 billion out of the system. We have to get all the players, the premiers, the health ministers, the federal health minister and the Prime Minister along with the health care leaders in the country, in the same room to debate where we are going and to come up with a plan. If there is anything missing in Canada today, it is a national health care plan to let the Canadian people know where we are going.

We do not want to see the Americanization of a system that is capable of being saved. We have a good system. Let us work to preserve it. It is up to the federal government to come up with a plan that will work.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Mr. Speaker, I commend the hon. member from the Conservative Party for his fight when it came to the hepatitis C battles and his efforts in his province to fight for medicare as well. But there is a contradiction when the Tories talk about health care.

Recently at a byelection in St. John's West, which the NDP came very close to winning, the Conservative member said that one of the greatest things he will do is fight for health care. He will fight for the universal, not for profit health care system in this country. Yet his leader, Joe Clark, said that he supports bill 11 in Alberta. The problem is, does the member not agree there may be a contradiction in that? The member for St. John's West said he would fight for health care, yet the leader of the Conservative Party said he supports some sort of tinkering with the private system.

I believe that is some form of contradiction. I would like the member to comment on that.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Mr. Speaker, I am glad the hon. member asked that question. That is an issue on which I have spoken a number of times, as has our leader Joe Clark.

I want to set the record straight. This is why I talked about Roy Romanow, the NDP premier of Saskatchewan and the radical measures he will have to take as an NDP premier to deal with the shortfall in funding in health care. Let us start with Mr. Klein who said that this is something he would prefer not to have to do. He is on the record as having said that. He did not want to do it, in other words, bring in bill 11. If we talk with Roy Romanow, Saskatchewan is reconstructing the list of essential services. In other words, some of the services deemed to be essential will be taken off as a cost saving measure in the province of Saskatchewan.

The two premiers are next door to each other. One is a Conservative premier and one is a socialist premier, and I am not saying that in a derogatory way, but our position on the issue has been much the same as Mr. Klein's. This is something we would not want any government to have to do nor would we want Premier Romanow to have to strike off essential services, those that are deemed essential today, eliminate the list and make the list shorter. Unfortunately he is being forced to do it. That is exactly what Ralph Klein was forced to do. Our position and Mr. Clark's is simply that we support his right to introduce that bill in the legislature. We understand why he did it. It is a question of survival.

It comes down to what province will be next. We already know which one it is. It is Roy Romanow in the province of Saskatchewan. It will be a raging debate in his province, as it will be in my province and every other province until we come up with a plan that is sustainable and which will work. That is why our leader, Mr. Clark, has suggested in addition to the five principles which I mentioned in the House, there has to be one more principle and that is sustainable, predictable funding.

That is not to say funding in itself will do it because it will not. Throwing huge gobs of money at the problem will not solve it. That is one of the points John Crosbie, the former fisheries minister who is from Newfoundland made this week at our policy conference. We agree with that. We have to have honest debate and dialogue on where we are going.

For the NDP to point at us or any other party in terms of where we are going and what we want to do, that is not what Canadians want to see. We want to see honest dialogue with honest solutions.

The federal government has not engaged in honest dialogue. On bill 11 it has not. It has sent out mixed signals to the premier of Alberta and every other premier in the country because it wants the best of two worlds. It wants to be able to balance its books on the backs of every province. The finance minister wants to be able to stand in this place on his hind legs and brag about how he balanced the books. He repeats that day in and day out in the House. He has been successful, but let us examine why he has been so successful.

He has done it at the expense of every single living Canadian. The government has taken it out of health care. That is not a lot to be proud of. The truth will be in the next election. That is why I am very supportive of our leader Mr. Clark. There is no national leader who is more respected than Mr. Clark when it comes to dealing with the provinces and premiers from one end of the country to the other.

We need honest dialogue in an attempt to come up with solutions. We do not have all the solutions. We want to engage Canadians in the debate so that at the end of the day they will say, “ We can see where this is going. We do not want Americanization of our health care system. We know it will cost us some money but this is where it is going. This is a plan we can live with. It is an honest plan, a sustainable plan and one that will do the trick”. That is what Canadians want. Pointing fingers back and forth is not going to work. The Liberals have done that for the last seven years.

In fact, when I concluded my speech, I mentioned that the Liberals poisoned the atmosphere. When we talk about bringing the premiers and health care ministers together, they holler across that they will not do it. They will not do it because they have poisoned the atmosphere. Only by having an honest dialogue and having a broker come in to solve it will the problem get solved.

The present government cannot do it. It has been scrambling for the last seven years. We can measure its approach to every single problem that has besieged Canadians in the last number of years. Those problems exist today because of the lack of leadership. In other words, it has not honestly addressed them. The Liberals have been coasting for a number of years.

If any other members would like to ask a question, I would be more than happy to answer them. Maybe some Liberal members have a question or two for me.

[Dick Proctor, NDP, Palliser, SK]

Mr. Speaker, I am sharing my time with the member for Bras d'Or—Cape Breton.

I want to say how pleased I am to take part in this debate as a member for parliament from Saskatchewan, the birthplace of our cherished medicare system. I also want to acknowledge all of the hard work that has been done by our leader, the member for Halifax, and our health critic, the member for Winnipeg Centre, to keep this issue first and foremost in parliament over the last several months.

I would like to begin by picking up to some extent where the previous speaker ended in terms of setting the history of what has happened over the last 40 years. As many Canadians know, this is our most cherished and most important social program. It started in Saskatchewan where it was finally brought in by former Premier Tommy Douglas and his successor Woodrow Lloyd in 1962. It was a program that took 18 years to deliver because the Government of Saskatchewan at that time was adamant that it was not going to bring in the program until it could fund it for the long haul. It took from 1944 until 1962 for the program to come in.

Five years later it was extended to the rest of Canada by the then Prime Minister Lester Pearson on the basis of 50:50 funding. I remember well that premiers like John Robarts of Ontario and Ernest Charles Manning of Alberta wanted nothing to do with socialized medicine, but they could not resist the 50 cent dollars that were on the table so everybody joined in. In 1967 we got a national medicare program.

As I said, it has been a cherished program. Until the last few years, medicare has been something Canadians have been justifiably proud of. They have talked about it as they have travelled throughout the world and visited other countries.

The question before us today is what has happened in recent years to the program, which we were so proud of in 1990, 1991 and 1992, that we are anxiety ridden as to whether we will have a national medicare program in the next short while? There are a number of reasons.

There have been cutbacks. I would submit that the principal problem we have today happened in 1995 with the Canada health and social transfer and the end of the Canada assistance plan and established programs financing. At that point the government, on its mantra for balancing the books and eliminating the deficit as quickly as possible, took more than $24 billion out of our health care system.

When we talk about the problems the provinces are having, whether it is Alberta, Saskatchewan or another province, they are problems driven by the lack of cash in recent years from the federal government. Provinces have had to resort to backfilling. Notwithstanding the comments of previous hon. member, the province of Saskatchewan has backfilled 100% on the cutbacks to federal funding for medicare. I worked in the department of health of that province for a brief period of time before I was elected.

I would also submit that many other provinces have done the same. The modern day John Robarts, Ernest Mannings, Mike Harrises and Ralph Kleins have basically no commitment to medicare, especially when there are only 11 cents, 13 cents or 15 cents of funding instead of the 50:50 funding they once enjoyed.

At some point in time, sooner rather than later I would submit, one of those provinces will tell the government to forget its 11 cents or 13 cents and have its own health care system. That will be the end of the national medicare program, which concerns us a great deal.

The government has taken billions out of health care. We have an aging population, as the Minister of Health said earlier in the debate. We have a number of new technologies. Health care is not getting less expensive. We have more demand and less money. There is simply not enough money in the system but the culprit is across the aisle.

I urge members of parliament to concentrate on that issue and not get too bogged down in the backbiting of which province is doing what. Although, having said that, I want to come back at some point before I close to what is specifically happening in the province of Alberta.

I have tried to suggest that there is an end to the partnership and that 1995 was a watershed in that regard. We now have a government of a province with very little commitment to health care, to medicare. I do not think that is reflected accurately by the people of the province of Alberta, but bill 11 would set up a legislative framework for surgical facilities offering overnight stays as far as we are concerned. It would also offer diagnostic and treatment services, services for both medically necessary surgeries as required under the CHA and elective surgeries.

I have been involved in various organizations that have been fighting privatization for decades. The pattern is always the same. Privatization occurs where there is a fast return on profits and the more expensive long term care is left to the public. When we talk about tonsillectomies, cataract surgery and hip and knee replacements, we are talking generally about relatively minor short stays in hospital, quick release in 24 hours or less. People are back home and recovering and not a burden on the health care system. That is what people interested in privatizing our health care system want to do. They will leave long term care for the public system and we will quickly end up with two tiers. That is the heart of what the bill and bill 11 are all about.

By way of conclusion, the initial announcement back in 1995 was that cash transfers would be cut by 40% and for most provinces the cash portion of the transfer would ultimately phase out. In future under the CHST it would be up to the provinces to decide how to allocate their much reduced cash transfer.

I should like to make mention of one point that has not been talked about in the debate. It caught my eye last week that five of the largest pharmaceutical industries in the world have now decided in their benevolence to do something about the horrific problems with the outbreak of AIDS in Africa. They have agreed under an umbrella agreement that they would provide AIDS related drugs to Africa at a much reduced cost. I guess we would say that is a very noble endeavour on the part of the pharmaceutical industry.

We can think about what is driving the cost of medicare and pharmacare in Canada, the high cost of drugs, and the fact that we had to comply with Bill C-92, the 20 year patent protection and the inability to use generic drugs. How is it that the pharmaceutical industry can arbitrarily say that it will provide these drugs as a noble endeavour to the continent of Africa? We in Canada are prohibited from saying that we would like reduced pharmaceutical costs to benefit our population from coast to coast to coast and keep the costs of our health system down.

As I indicated I am sharing my time with the member for Bras D'Or—Cape Breton, but I am pleased to have had the opportunity to participate in this important debate today. I look forward to hearing from members of all parties on the issue.

[Bev Desjarlais, NDP, Churchill, MB]

Mr. Speaker, I thank my colleague for his excellent remarks. He certainly gave the real reasons for being in the situation we are today in terms of the health care service in Canada.

A good number of members and I are from a generation in Canada that has never had to fight for the benefits in our health care system. We have never had to truly experience the horrendous situation that went on prior to medicare.

I will mention an incident that I heard about from the Canadian Alliance member for Selkirk—Interlake. I happened to meet a constituent in his riding last week. He recognized that his own member of parliament was not on the right side of the issue, so he mentioned to me that he recalls the years when his brother on the farm had an appendicitis attack. They called a doctor who came out to the farm. Before seeing his ailing brother in the house, the doctor went out to barn to check out the cow he was to receive by way of payment. That was the state of health care in Canada. That was our health care system prior to medicare.

I find it absolutely unconscionable that the government would not put enough funding into our health care system nationwide to ensure that we have those services for all Canadians. Has my colleague heard of any of such instances?

[Dick Proctor, NDP, Palliser, SK]

Mr. Speaker, the member for Churchill is saying that there was a time and there may be a time again soon when the medical profession will be checking our purse first and our pulse second.

It might help to elaborate on the answer by recalling why Tommy Douglas, the founder of medicare, became so passionate and committed to it. It went back to a time when he was growing up and had a problem with his leg. He was living with his family in the United States. He was an ironmonger's son, as I recall. He was in a hospital and they were getting ready to amputate his leg when a surgeon came along, looked at him, and said that he could fix it without the amputation and did so. Tommy Douglas thought from that day until his death why it was that we would have a two tier system. If his parents had the money the possibility of the amputation would never have been an issue. It was only the generosity and kind services of the surgeon in the Chicago area that actually saved his leg.

This kind of thing has been at the forefront of medicare throughout the years since it was introduced in 1962 in Saskatchewan and in 1967 nationally. It is what we want not just to look back on fondly but to look forward to for coming generations.

[Nelson Riis, NDP, Kamloops, BC]

Mr. Speaker, I listened to my hon. colleague who spoke eloquently about the need to support the motion. I have a question for him. Was he delighted this morning when he found out that the federal government surplus was now in excess of $14 billion?

It is clear that money ought not to be an issue. The money is there if the government has the will to provide the financial support. Could he tell us whether he too was delighted to get this news?

[Dick Proctor, NDP, Palliser, SK]

Mr. Speaker, I was delighted to hear the news. If I heard it correctly it was $14 billion more than the projected surplus which is considerable.

What the member is suggesting in his question and what I will suggest by way of response is that there is money. Despite the dripping sincerity of the Minister of Health, one more time as he did this morning, we have the money in the system. What we do not have so far is the will to dispense it in this very necessary program.

[Michelle Dockrill, NDP, Bras D'Or, NS]

Mr. Speaker, I am pleased to participate in the debate but somewhat disappointed given that my first speech in the House in 1997 was with respect to the deplorable health care system from which the constituents of Bras d'Or—Cape Breton were suffering. Here we find ourselves three years later and the only change has been that the health care system has become progressively worse and we are very close to a two tier private health care system.

The Canada Health Act is under attack and the government continues to do nothing. A recent poll showed that nine out of 10 Canadians clearly stated that they believed there should be equal access to medical treatment for everyone regardless of income. What else does private for profit health care do but prevent equal access? This is the essence of the motion we are debating today.

One reason the government has had to backtrack and sidestep Alberta's bill 11 is that the Canada Health Act is not clear. The Canada Health Act needs its own clarity bill and the motion begins the process of ensuring that the government is accountable for what it says.

We hear members of the government talk about health care. They continue to talk about the cost of maintaining a public health care system. I do not think there is anyone, certainly not in the New Democratic Party, who would dispute that public health care is costly. However, as we have heard from my hon. colleague from Kamloops, we just found out this morning that the government has $11 billion more than it had projected. It is not about not having money. The reality is that Canadians have paid for the services and the government is denying them the money to allow for those services.

We are here because the government is still not providing the leadership Canadians want. For months the government waited and waited and continued to tell those of us in the House and Canadians that it would intervene if the health act were violated.

When I talk about health care I cannot help but worry and concern myself about the importance of health care to women. It is not that men do not use the health care system, but it is certainly true that women tend to be greater users of health care services because we live longer and are unfortunately more often in poorer economic circumstances than men. The effect a privatized for profit health care system would have on women also concerns me. Profit means that people will have to pay for services rendered. The percentage of women who live in poverty in Canada is 18.2%. How will they be able to pay for private services? Will they be able to access the same quality of health care that their richer neighbours have access to? I think not.

We have a poverty rate of 25% in my regional municipality. The child poverty rate, I am ashamed to say, is quite a bit higher than 25%.

Eighty-eight percent of Canadians recently polled think it is very important that everybody be able to access the same level of health care no matter what their income. Canadians do not want a two tier system. Why does the government continue to stand by the tiresome excuse that bill 11 does not violate the Canada Health Act?

We are all aware of the link between poverty and access to quality health care. This is only one of the concerns Canadian women have about these possible changes to our health care system. Women will bear the brunt of a privatized for profit, two tier health care system.

Women already fill in where the government has failed to provide the assistance to its citizens that they expect. More and more women are adding the burden of caring for elderly relatives as the system becomes overburdened because of all the cuts to funding. This will not change if bill 11 becomes law and sets the precedent for private for profit health care in Canada. In fact, the burden will probably increase even more. Women already perform two-thirds of the unpaid work in Canada. How much more are Canadian women expected to do?

The government changed the Canada Health Act in 1996. Why not change it again now? Why not make sure that there are more incentives to provide accessible, quality health care than incentives to make a profit? Why has the government not increased transfer payments and earmarked them specifically for health care services to make sure that there is no market or room for foreign companies to come in and begin competing with the health care system that the overwhelming majority of Canadians want us to maintain?

The reason is because the government continues to be influenced by a powerful lobby group that would love to see for profit health care that they could benefit from.

In 1995 the Prime Minister sent a clear message to the provinces that they were basically on their own in their provision of health care because of the steady cutbacks to cash transfers over the years.

When health transfers were folded into the CHST, this government had to make changes to the act. First it had to get rid of the then health minister who wanted to stop the cuts in funding and ensure that the federal government played a leadership role in the enforcement of the Canada Health Act. The government made sure it appointed a successor by the name of David Dingwall who made nine major changes to the Canada Health Act which paved the way for the existence of bill 11.

The NDP is not standing here today saying that there is no work to be done in our health care system. I, as a health care worker, know that changes need to be made within the system. What we are here to tell the Minister of Health and the government is that we are all sick and tired of hearing the government say that we should just sit and wait.

Canadians do not want the government to wait. The government's excuses are wearing pretty thin these days as we see its inability or unwillingness to jump in and show the leadership necessary to protect the Canada Health Act.

Canadians want the Liberals to act now. They do not want the government to pass off the responsibility to the provinces. Canadians are sick of this juvenile game of tug of war.

Nobody should ever make the mistake of thinking that the Canada Health Act is or should be a finished document. It should be open to debate and open to change. Canadians are telling us that there are some basic principles that, in their opinion, are not open to change. Highest on their list is accessibility regardless of income.

The government should act now. It should change the Canada Health Act and do what Canadians want it to do. The government should make sure that bill 11 is stopped and that no other province tries to introduce legislation that so clearly violates the principles, the morals and the ethics behind what Canadians believe their health care system should be.

I urge all my colleagues in the House to support this motion which sends the clear message that private for profit health care is not the kind of health care Canadians want and it is not the kind of health care that we are going to give them.

[Nelson Riis, NDP, Kamloops, BC]

Mr. Speaker, once again I listened with much interest to my hon. colleague from Cape Breton who spoke so eloquently about the crisis in which health care finds itself, particularly as a result of the lack of adequate federal financing.

The question I have for the member has to do with the situation south of the border in the United States where it does have a for profit health care system. A report came out last week indicating that the reason for the lion's share of personal bankruptcies filed in the United States was as a result of the horrendous health care costs that families were required to provide and that once those health care costs were provided it bankrupted the family operation and they had to declare personal bankruptcy as a result.

Based on the United States experience, would the member share the concern that this may threaten us here in Canada?

[Michelle Dockrill, NDP, Bras D'Or, NS]

Mr. Speaker, fortunately, I have relatives who have been living in the United States for approximately 45 years. I have talked about standing here today and being disappointed at having to fight for health care. One of the interesting discussions that I continue to have with my relatives is that they do not understand what this government is doing. They have been south of the border for 45 years looking at Canada and saying “My God, we wish we had what you have”. I have an uncle who fortunately was not seriously ill but who had to be hospitalized for three days. I think the bill totalled something like $8,000. It does concern me and it should concern all Canadians.

Unfortunately, we recently had a medical crisis in my family. My mother-in-law had three heart attacks in three days. The doctors put her on a nitroglycerine intravenous so they could hold her over for the Easter weekend before they did a triple bypass because of the shortage of staff, the shortage of surgeons and the cost to do the surgery. We sat around for four days and prayed that she would not take that one massive heart attack and not make it to the surgery table. That is a reality every day in this country.

As my colleague indicated, what will happen to a single mother if she has to pay for health care? I had a case in my riding where a single mother went to a pharmacy with her two young children who were sick but, fortunately, not seriously sick. As any mother knows, when our kids are sick we are worried and concerned. The pharmacist called me because he was so disturbed. The single mother asked him if he could tell her which one of her children was the sickest because she only had enough money for the medicine for one. The pharmacist told me that he gave her enough medication for two and that he did not care if he lost his licence because he was able to sleep well with himself. Imagine a mother having to decide which one of her kids would get the medication.

We are at the tip of the iceberg if this government does not stand up and act now to give Canadians what Canadians are clearly telling this government and this House that they want. They are saying clearly that they do not want two tier for profit health care.

[Nelson Riis, NDP, Kamloops, BC]

Mr. Speaker, I have a supplementary question for the member. After having given a presentation that will help people to understand the crisis nature of our health care issue, could the member confirm two things? Does the average American family in the United States that is actually able to pay the premiums to get some kind of health coverage, all of which is deductible I might add, pay an average payment per family of between $5,000 U.S. and $7,000 U.S. annually, which is a tremendous cost for every household? As a matter of fact, as my hon. friend from northern Manitoba has told me, that is one of the major reasons that people enter the American Armed Forces. It is an easy way to get good personal and family health coverage.

Would the member confirm that the annual family cost ranges between $5,000 U.S. and $7,000 U.S.? Would she also confirm from the information that she has that in terms of a cost effective system the actual cost of health care in the United States, albeit there are millions of people without any coverage, actually costs more than it does in Canada on a GDP per capita basis?

[Michelle Dockrill, NDP, Bras D'Or, NS]

Mr. Speaker, I do agree with my hon. colleague in terms of what the cost is of guaranteeing medical coverage for our neighbours to the south. As I said, I have had firsthand experience with those costs. Even the cost of small needle for a fly bite is absolutely astronomical.

With regard to the second part of my colleague's question, the figure I saw, and I would not want to be quoted, but the overall cost of the American system is something like 40% more than a publicly funded system. Our friends south of the border want what we have and our system is going to where they are at.

[Alex Shepherd, Liberal, Durham, ON]

Mr. Speaker, it is interesting that the member for Kamloops, Thompson and Highland Valleys has a problem with his memory today. Indeed, he has probably forgotten the fact that it was the Liberal Party that brought forward medicare in the first place.

Mr. Speaker, I will be sharing my time today with the member for York West.

I am very honoured to take part in the debate about health care. As I observed and listened to the New Democratic Party bring forward this issue once again in the House, I think forward to what its campaign will be like in the next election. I know it will be able to save a lot of money on stationery presenting public policy documents because, quite simply, its whole public policy is based on two words, and that is, more money.

In the last couple of days we have heard the NDP members talk about the problems at CBC. It simply needs more money. When they speak about unemployment insurance, it simply needs more money. Today, on health care, it is more of the same, more money for health care.

Canada spends close to 10% of its gross domestic product on health care. Canada is one of the highest spenders in the western world on health care.

It is only reasonable that policymakers would sit down and ask themselves how much money they would need to spend on health care and what is applicable to our population. Does that mean that we are discriminating and getting a poorer quality of health care? Of course not. The problem with our health care system is clear to me: We are not getting value for our money. It is not about spending on health care.

We have had this constant debate that the federal government is not carrying its share of the health care issue. We contribute 33 cents on every dollar to health care. It is not as high as it was when it was originally brought in but we cannot ignore the whole issue of tax points, even though everyone wants to forget they exist.

Tax points occurred when the premiers and the federal government sat down and decided that rather than the federal government taxing people, collecting the money and then turning around and giving it to the provinces in transfer payments, that it would allow the provinces more tax room to tax directly and collect that money and spend it on health care. Today, provinces, like the province of Ontario, choose to ignore that part of our history.

I am not making these things up. Anyone can go down to the archives and get various documents and agreements that were signed at the time when provinces agreed to this kind of formula. Today they want to ignore that. Mr. Harris in my province has caused the spending of something like $6 million to carry on an ongoing battle with the federal government for no particular purpose at all, as far as I can see.

The fact is that we continue to spend significant amounts of money on health care. I did my own analysis to show that the province of Ontario was not even spending the money we gave it for health care.

We hear from members of the New Democratic Party that it is simply more money that is needed. They do not have any ideas about how they want to change the health care system. The health care system is important to Canadians.

Since we are giving anecdotal information, my commitment to a publicly funded health care system is also based on a bit of a life experience. I remember being on a dock down in Key West. The next door neighbour of a friend of ours who was a retired doctor from Illinois had been out fishing with a friend. His friend collapsed with cardiac arrest on the dock. His friend said to the doctor, “Do not take me to a doctor. I cannot afford it”. I thought that was such a great statement, because he was saying it to his friend who was a doctor.

Most of us in this Chamber would agree that we do not want that situation in Canada. It is important to maintain a publicly funded system.

Having said that, there are things we have to fix. The problem with this whole file is that the federal government is seen by many of the provinces as a dispenser of cheques. That is not the answer to the problem. That is not the answer to this file. We should look at the way the country is changing, its demographics. Our population is aging.

Many, many governments before us of all stripes had problems with health care. I would like to reiterate that the New Democratic Party was in control of the government in the province of Ontario during a significant period of time and our health care system eroded during its watch as well. If we are honest to the public, we should say that yes, we think there are some problems with the health care system but we have to have a comprehensive plan to make it better. It is not just those two words the New Democratic Party constantly uses, more money. It is not about more money.

There are problems in our primary care service. There are people who are not receiving adequate medical care from their GPs because the provinces have developed systems of remunerating doctors which quite frankly such as in my own province discriminate against the doctors for working certain long hours. It is hard for people to get 24 hour health care in the province of Ontario. It is because of the way governments have structured the payment system for doctors.

We have heard in the House that we have to have a publicly funded health care system. Let us be honest with ourselves. The reality is that what most people think of health care will probably have a broader definition than that of a good number of politicians. They probably think of chiropractic medicine. They may think of pharmaceuticals. They may even think of naturopathic medicine. If we actually looked at the total expenditures on what people think is health care in this country, 50% of it is probably privately funded already.

I think we are talking about the elements and the aspects of a health care system which includes health care workers, nurses and doctors and institutions we still feel should be controlled by the public because of some of the very reasons that are enshrined in the Canada Health Act, accessibility. That is the basic principle which I want to address today.

We need to change the way we do health care, primary and permanent care. We have not developed as a nation a full appreciation of how to deal with permanent care. Indeed, Mr. Harris in my province said, “Gee, we have all of these beds and we have too many people using them. Really what we need is a home care system so we will close the hospitals”. He forgot the other side of the argument. The other side of the argument is that we have to enforce a home care system. We have to have places where people can go, whether they are geriatric cases or otherwise, nursing homes or other facilities.

Constant studies have been done. An empirical study was done by going to people who were either in nursing homes or in acute care in their own homes. They were asked the very fundamental question would they rather be there or would they rather be in an institution like a hospital. The majority of the people said, “We would rather be in a home care facility where we have loved ones around us assisting us. And when it comes to dying, heaven forbid that we can die with dignity and respect”. Lo and behold when we take those figures and start extrapolating, it is $2,500 more costly to get this service in an institution. It costs the hospital.

Those are the kinds of changes that are needed and the federal government is not in the position to do that. The only position we have is to tell the provinces, with our money in our back pocket, that we have to move in the area of home care. I do not hear members of the NDP talking about this. I hear them saying to just give them more money and that will solve the problem. It is not going to happen that way.

We have not put the investment in technology. We should be able to track patients across the country. We cannot even do something simple, use the technology that is available to us today, to simply track patient records. We cannot even do that. We talk about investments in MRI equipment and all kinds of other new technology. We have not done that. We have not put our money in those areas.

We need to restructure the health care system. I would be the first to agree with that but we cannot simply talk about more money. We have to talk about the real things that matter to people.

That is why I am having a health care forum. The provincial members of parliament in Ontario do not care about this area. That is why I am having a health care forum in my riding and bringing in a former assistant deputy minister of health. It is to talk with the people and ask them how they want the health care system to change. It is not about giving us more money. It is about making the thing work so it protects our health.

[Michelle Dockrill, NDP, Bras D'Or, NS]

Mr. Speaker, I have to say it is sometimes very frustrating on this side of the House when we hear some of the comments from the government that clearly indicate it is clearly not in touch with Canadians. Canadians have clearly said that they want the guarantee of a publicly funded health care system.

My question is very simple. Canadians have said the problem with the health care system is the lack of money. We know the government has the money. Why does the government not want to use money from Canadians to guarantee them the services for which they pay?

[Alex Shepherd, Liberal, Durham, ON]

Mr. Speaker, that is very simple. The people of Canada are not asking for more money. It is the members of New Democratic Party because they cannot think themselves beyond dollars and cents.

The people in my riding are asking us for better quality health care. That is the issue, better quality health care, not more money. Let us talk about money.

I heard these comments today, that now we have $14 billion more in surplus. But we forget about the $890 billion in debt that the country still has and the $44 billion we spend every year in servicing that debt. The members over there would walk away from it; to heck with money, money is not important.