Mr. Speaker, it is my pleasure to speak to the opposition motion regarding Alberta's bill 11. This is a very important topic and of concern to all Canadians.
At the outset, I must say that on May 5 the Alberta legislature passed bill 11. The bill will create the regulatory framework for contracting services to private for profit facilities. The federal health minister has relayed his concerns about this bill. Prior to the passage of the bill, and contrary to the remarks made by the opposition, time and time again the minister has voiced his concerns about the bill. He has said that the federal government was really concerned about some of the views expressed.
The government is committed to ensuring that our health care system will not be put in jeopardy. We wish to make sure that the opportunity exists to detail these concerns and commitments.
There are some disturbing trends happening with medicare. I share the views of my fellow Canadians about what is happening in Alberta. These trends do not speak to the values of Canadians. Indeed, we need to know how people are looking at medicare. On one hand, Alberta will have the medically necessary services. On the other hand, it will also provide enhanced medical services. I believe that is a contradiction. Time and time again when we have compared services provided by the private sector, double billings have occurred and it has not worked.
Our medicare system is one of the best in the world. Like many medicare systems, things are changing. MRIs and various other things are causing this change. Adopting new technology does not mean that Canada should end up with a two tier medical system.
In a policy statement in November 1999, the Alberta government announced its intention to have private delivery of some surgical services. At the same time, the federal health minister raised some important issues related to the sustainability and integrity of the public health care system, including the consistency of the proposed measures with the spirit and intent of the Canada Health Act. He conveyed these views publicly not just in one province but across the country.
In November we asked how private for profit delivery of health services would reduce waiting lines for services in a way that would contain costs and maintain quality, but these questions were not answered. On the contrary, based on the opinions of experts, and actual experience in Alberta, the waiting period for services had increased. In areas where private for profit clinics were used, these lists exceeded those of the public sector.
On the subject of costs, our minister asked if we could expect private for profit hospitals to save money. Would they be more cost effective? Again, the Alberta Consumers Association of Canada found that a shift in cataract surgery from the public sector to the private sector resulted in increased costs for consumers not only in the actual cost of the operation, but in administrative costs as well as transaction costs.
The health minister asked how pressure from private investors to de-insure more services, so services can be charged for privately and their profits will balloon, would be addressed. He also asked how pressure from private investors to purchase medical goods or services patients do not require would be addressed. He asked how the tendering process for contracting would be open and transparent.
The bill was passed. It contains a commitment to preserve the principles of the Canada Health Act as the foundation of the health system in Alberta. However, the sincerity of this commitment is suspect given that the question is still outstanding.
Earlier this year the Prime Minister and the Alberta premier asked all Canadian health ministers to compare the bill to similar provincial legislation. There are important differences in the way Alberta intends to proceed. In particular, the sale of enhanced or extra services in combination with medical goods and services insured in the public system, unlike in other provinces, represents a serious concern in relation to the principles of accessibility in the Canada Health Act.
How serious is this? The day the bill was passed, the Saskatchewan premier, Mr. Roy Romanow, answered. He said “When we released our legislation our press release was entitled a bill to prevent two tiered health care”. He continued “We are at odds with bill 11 in Alberta”.
Back in Alberta the legislation bans queue-jumping, where supposedly people who could afford to pay for these enhanced services get quicker access to insured services but concerns remain about how this ban will be monitored and reported on.
The health minister respectfully suggested that the bill be amended to prevent this, as does the legislation in Ontario and Saskatchewan, but it was not.
Another key concern, specifically and clearly expressed by our government, relates to private for profit facilities accommodating overnight stays for patients. This too represents another important difference between the approach of the Alberta government, going far beyond what is in place in other provinces. The health minister suggested that the bill be changed to prohibit services involving overnight stays until the full implications for Canada's health care system are understood.
On April 7 the health minister put the Alberta government on notice that these types of facilities that would be regulated under this legislation would be considered hospitals under the Canada Health Act. This means that all hospital services provided by these facilities must be fully insured and, like hospitals, these facilities are prohibited from selling any insured service to an insured person on a private basis. As the federal health minister said “This is in keeping with the fundamental principle of our single tiered health care system, care based on need not on the ability to pay”, or the size of their pocket book or credit card.
On the day after bill 11 was passed, the federal health minister reiterated these concerns noting how the Alberta government did not respond to any of his recommendations. He said “Bill 11 is not the direction in which we should be heading to strengthen our publicly funded health care system. We have grave reservations about investing public funds in private-for-profit facilities”. He also announced that the federal government would be strengthening its capacity to detect violations under the act, should they occur.
We will act. The strengthening means that the minister has now committed some $5.5 million to improve administration of the Canada Health Act. With additional staff distributed across the country our health care monitoring capabilities will be enhanced and will ensure compliance with the act.
I want to say categorically that the health care system reflects one of the basic values of Canadians. I am not animated too often in the House, but I will be right behind the minister to make sure that there is not a two tier system. Let us imagine for a minute that somebody thinks he or she could make money from somebody who is ill. I rest my case.
We will be monitoring the legislation. The government is committed to make sure that Canadians get the care they desire, that it is not two tiered, and that it is not based on someone's pocketbook.