Debates of June 15th, 2000

Supply

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

Mr. Speaker, I have to say that we on this side of the House have had it with watching this minister rise and ask the provinces to work with him, when the minister and the government have unilaterally cut transfers the provinces were entitled to expect in the health care sector.

I have to say that a person has to be a real hypocrite to rise in this House and call for co-operation when, last week, the provinces tabled a report in which they unanimously—I hope the minister will have the decency to rise in this House and acknowledge it—asked the minister to reinstate the transfer payments at their 1994-95 levels.

In 1968, the government established a social contract in 1968 in which health care programs, in terms of transfer payments and funding, were to be shared 50-50, that is, 50% by the federal government and 50% by the provinces. However, the government did not honour its part of the bargain, because it contributes 12%, that is 12 cents on the dollar. The federal government's contribution has shrunk to 12%, and the provinces have to assume the rest.

The best thing this minister could do to establish his credibility in the House is not give us fine speeches for the leadership campaign, but exert pressure for the reinstatement of the transfer payments at the 1994-95 level, as Brian Tobin, Bernard Lord, Pauline Marois and all the health ministers have asked him to do. He must stop his fine speeches and do something. That is what we want from him.

[Allan Rock, Liberal, Etobicoke Centre, ON]

Mr. Speaker, it is unfortunate that the hon. member only talks about money. But if this is what he wants to do, I am perfectly comfortable with that.

I would like to quote Bernard Landry, Quebec's finance minister. Some weeks ago, it was discovered that Mr. Landry, in his capacity as Quebec's Minister of Finance, had left untouched, in a Toronto bank, an amount of $850 million paid to Quebec by the Government of Canada, for health.

When Mr. Landry was confronted with these facts, he said “Health is not just a money issue, it is also about how our health care system is run and structured. This is where the real answers are”. That is what Mr. Landry said.

Therefore, I am really disappointed to hear the hon. member focus exclusively on money. This is clearly not just a money issue. Innovative methods and changes in the delivery of services are also required.

I am prepared to work with my counterparts in that regard. I have received and read the report. It is an excellent report. I intend to discuss it in detail this afternoon during a conference call with the provincial and territorial health ministers. I hope the hon. member will recognize that this will require us to work together, in a co-ordinated fashion, to improve service delivery.

[Louise Hardy, NDP, Yukon, YT]

Mr. Speaker, I thank the minister for his commitment to social medicine in Canada. Unfortunately I think he discredits himself when he acts like the problems have not arisen from the serious cuts made by this government.

What plans does he have for dealing with access in remote areas such at the north and Yukon? The fact that people have to travel thousands of miles to obtain treatment such as dialysis means complete isolation from families. It is a serious problem for isolated areas, which means most of the country.

[Allan Rock, Liberal, Etobicoke Centre, ON]

Mr. Speaker, the member is quite right. Monday morning last in Chesterville, Ontario, I had occasion to speak to this subject in the presence of rural members of the government caucus. I said at that time that after becoming Minister of Health, travelling the country and looking at the situation on the ground, I came to the conclusion the real threat of two tier medicare in Canada was not so much between the rich and the poor but between the urban and the rural.

Access to services in rural areas is a major issue. The one-third of Canadians who live in rural Canada or in the more remote regions are demographically older, have poorer health status, are more subject to accidents and injuries, and yet have less access to the whole range of services from ambulances to emergency rooms to diagnostic equipment and family physicians, let alone specialists.

The purpose of my appearance in Chesterville with members of the rural caucus of the government was to receive their report on recommendations for action the Government of Canada could take to address some of these issues. I accepted all their recommendations and I undertook to implement those that were within my sphere of authority as federal minister.

At the same time I announced $130 million for concrete steps which I will believe will help. First, there is a program devoted to pilot projects for rural and community health with money set aside specifically for innovative practices to be funded in rural communities and looking at new ways to overcome issues of access to services, whether it is training physicians and nurses or paying them differently.

Second, investing in telemedicine would enable us to take advantage of new technology to overcome the challenge of distance. In the member's riding and in rural Canada generally I believe telemedicine holds real promise for helping us overcome some of the problems the member has identified.

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

Mr. Speaker, before getting into the opposition motion from the Canadian Alliance members, I wish to point out that today is the last day of work of someone whose dedication in helping us with our parliamentary duties has been extraordinary.

I am referring to Pierre Ménard, who has worked with the Bloc Quebecois since 1993. I am sure that all members of the House will want to thank him, because we all have colleagues who work behind the scenes to help us to do a better job as parliamentarians.

Pierre Ménard is someone with a solid legal background, who is well versed in parliamentary procedure, who has a very keen sense of humour, and who is charming. I want to tell him that we will miss him very much.

I am sure that all my colleagues share these sentiments, particularly the members for Chambly, for Beauharnois—Salaberry and for Repentigny.

This tribute is not intended, however, to distract from the extremely serious and urgent business of debating in this House the federal government's responsibility in the crisis facing the provinces.

I would like to begin with two cautions. The first is that we believe that the provinces should be responsible for the health care system. We believe that the problems facing the provinces obviously have a lot to do with the question of money and transfer payments.

In no way does the Bloc Quebecois believe that we should cut corners in examining the re-organization of the system.

Before going into detail, I wish to tell hon. members that I met with some hospital administrators a few months ago, the ones for CHUM and for Maisonneuve-Rosemount. I understood clearly that the problem was not solely financial. It is mainly financial, however, because if the provinces do not have all the resources they should in order to be able to re-organize the health system, the debate will remain extremely theoretical.

That said, I will offer one example of how the network can be reorganized. Does it make sense that there can be 30, 40 or 50 different collective agreements within one health facility, and that the person who puts down salt when there is a winter storm is not the same one to shovel or clear the entrances to the hospital?

Does it make sense that there is such fragmentation in the health community that, when one person could perform two or three different jobs, at present this takes four, five or six people? We are able to figure out that service delivery needs to be re-organized along with the way the system operates.

The basic reality is that demographic and technological pressures and drug costs will confront all provinces, whether Quebec, Newfoundland, British Columbia or Saskatchewan, and despite their greatly different political leanings, with the same reality: that 4%, 5%, 6%, even 7% more will have to be invested yearly in order to provide exactly the same services.

I would like to show hon. members the factors that contribute to the pressure on the health system. Now we have not just seniors, but increasing numbers of older seniors. In French we call these the “fourth age” as opposed to the third.

It is not exception to run into people in our ridings who are 85, 90 or 95 and in relatively good health. These are the “old elderly”, those aged 80 and over.

Since people are living longer, they want to continue living in their own environment. This presents a challenge in terms of home care. This presents a challenge in the way society will organize itself to keep people in their natural surroundings, and I will come back to this.

Quebec has a larger population of people aged 65 and older than do other societies. I have some figures that will provide food for thought for the member for Repentigny, who has a good crop of grey hair himself.

In 2011, the number of people 65 years of age or older will have increased by 60% since 1991. The increase in the number of those 85 years of age or older is even more striking. Their numbers will increase by 84%. We might be tempted to think this is far off. We might think 2030 is beyond reach, but 2030 is just round the corner. In 2030, 25% of Quebecers will be 65 years of age or over.

My colleague, the member for Beauharnois—Salaberry, an eternal optimist, has just whispered a very relevant point to me. In 2030, Quebec will be sovereign, but that fact in no way changes the need to organize and consider how we can give our seniors the best services possible.

When we compare things in Quebec with the way they are in Germany, Canada, France and England, we realize that what sets Quebec apart is the rate at which its population is aging.

Proportionally, Quebec's population is aging twice as rapidly as the population of European countries. This means that the percentage of people turning 65 or more will be demographically greater here than in Europe. This will take place at an accelerated rate that is unknown in countries such as France, Germany and the Scandinavian countries.

I also want to mention another reality. The upward pressure on the health budget is around 4% to 5% annually. This means that, by the year 2002, if we want to provide exactly the same services, if Quebec wants to provide exactly the same range of services as it does in 2000-2001, the National Assembly will have to increase its health budget by 4% to 5%.

If we look at this figure, and my colleagues are anxious to do so, we realize that demographic growth accounts for 1.3%, technological change for 1% and inflation for about 2% annually.

But there is a natural growth of 4% to 5% in the health sector. Mr. Speaker, if I asked you, since you are mentally alert, to tell me the rate of Quebec's collective growth, you would have to say 2.5%. Therefore, if we do not restructure Quebec's health system, we will find ourselves in a situation where the National Assembly, the government of Quebecers, will have to allocate more money for health than it can, based on the collective wealth indicator. This is what is disturbing.

This is why the Premier of Quebec, one of the best ever to have held the position, said, in response to Jean Charest in oral question period, that it was not possible for Quebec's health care budget to be open-ended. It is not possible. No government in the world can operate that way and neither can Quebec.

I will return to what the Minister of Health erroneously said in a moment of what I would call confusion and delirium. I will come back to the money which is supposedly being held in trust and which Quebec has not used.

But I wish to say that there are structural pressures on the health system. We have the number: in 1999, last year, for example, emergency rooms saw 50,000 more cases than in 1994-95. Of these, 56% were people over the age of 75. This is where we begin to understand the demographic pressure. When emergency rooms are treating 50,000 more people and three-quarters of them are aged 75 and older, we can see why demographic pressure has an impact on health care.

I will give the example of radiation oncology. Oncology has to do with cancer. Well, the demand for radiation oncology, particularly for those aged 50 and up—baby boomers—is increasing. New cases of cancer are increasing by 3% annually.

The demand in cardiology is also increasing, particularly for those aged 50 and older. Obviously, more seniors are undergoing coronary bypass surgery. The number of heart surgeries is increasing by 3.6% a year.

Mr. Speaker, you are a good-hearted person. You are going to be very upset to hear that the number of angioplasties has increased by 260% over the past ten years. This has an impact on the health care system.

I was totally amazed to hear the Minister of Health, with his dulcet leadership-seeking tones, praising the health ministers' report.

A year ago, all of the ministers of health met together and came to exactly the same conclusion. What was that conclusion? That the federal government must return transfer payments to their 1995 level.

The ministers of health wanted to document what was going on in the various health systems, so they tabled a report. I would like all hon. members here in this House to understand that this report is over the signatures of Bernard Lord, Pauline Marois, the premier of British Columbia and Brian Tobin.

So the same conclusion is invariably reached, whether those involved be Liberals, Progressive Conservatives, New Democrats or Parti Quebecois: the federal government has literally robbed the provinces of their due. It has diverted funds. It has turned its back on its most basic of responsibilities.

I would like to share part of the report, beginning on page 16. I find the Minister of Health particularly hypocritical for praising this report without giving us any of its content. I feel obliged to share with hon. members the two main findings of this report, which are most critical of the government.

On page 16 we find:

Total provincial/territorial health expenditures in Canada increased from $11 billion in fiscal year 1997-98 to $55.6 billion in fiscal year 1999-2000, an average growth rate of seven per cent per year.

So, it is not just the provinces that failed to assume their responsibilities. It is not just the provinces that failed to put money into the health care system. From 1977, the year established program funding, EPF, was created, the cost increased from $11 billion to $55 billion.

There is a limit, however, to what the provinces can do. There is a lot of federal money and less provincial money.

At page 19 of this report, endorsed by all the provinces, by Brian Tobin, Bernard Lord and Pauline Marois, the figures are stunning. At page 19, the report by the health ministers reads:

Long before the CHST, years of federal transfer restrictions had significantly reduced the federal government's proportional share of provincial/territorial health care programming costs. The federal share, which stood at 26.9 per cent in 1977/78, had fallen to 16.3 percent in 1995/96 at the onset of the CHST.

The report indicates there was a 40% decrease. It went on to say:

The deep cuts accompanying the introduction of the CHST reduced this share considerably, so that it stood at just 10.2 per cent in 1998/99.

Over a period of 21 years, the percentage of health care funding assumed by the federal government dropped 62.1%. Is it acceptable that the federal government cut transfers to the provinces, especially transfers for the health care system, with impunity?

And then the Minister of Health rises in the House and says “In spite of all the harm that I have done to the health ministers and to the provincial health systems, I would like to act as if none of that had happened and invite my provincial counterparts to sit with me at the negotiating table, so that we can discuss together the changes that should be made to health and social services programs”.

The Bloc Quebecois believes that there is a prerequisite to the minister convening a meeting with his counterparts, namely the restoring of transfer payments for health.

If the government restored health transfer payments to their 1995 level, the provinces would receive $4.1 billion for health alone. Quebec's share should be $1 billion, including $500 million for health.

I will tell the members who are listening and the people who are watching the debates of the House of Commons what Quebec could do with this additional $500 million for health.

That amount is equivalent to more than one quarter of the budget for Montreal's hospitals.

The $500 million owed by the federal government to Quebec represents nearly half the budget for the whole CLSC network in the province.

The $500 million owed by this government to Quebec is almost the equivalent of the budget allocated to home support.

The $500 million is four times the annual budget of Sainte-Justine hospital for children. It is three times the budget of the Royal Victoria Hospital, and it represents one quarter of the cost of the prescription drug insurance plan.

I will conclude by saying that if this government is serious, if it really wants to take its responsibilities and help the provinces meet their obligation to maintain the health system and preserve its integrity, it has no choice but to immediately state its intention to restore transfer payments to their 1994-95 levels. Otherwise, it will mean—and voters will remember it at the next election—that this government is a hypocrite and talks from both sides of its mouth. It will mean that the government does not want to help the provinces with their problems in the area of health and social services. And Quebecers will remember that.

[Yvon Charbonneau, Liberal, Parliamentary Secretary to Minister of Health]

Mr. Speaker, we have listened to the Bloc Quebecois health critic give an overview of health issues and try to paint a negative picture of what the federal government is doing. At the end of his speech, I heard him say that Quebec was ill-served and underfunded.

I wish to remind the hon. member and all Canadians that Quebec is getting its fair share of the 2000 budget.

With 24% or 25% of Canada's population, Quebec is getting approximately 28% of transfer payments. It is getting 28% of transfer payments with 24% or 25% of the population. I do not think that it can cry wolf and complain about being underfunded compared to other regions in Canada and other provinces. The record must be set straight.

Second, I hear the hon. member basing his arguments on a lack of funding from the federal government. We have before us a motion by the Canadian Alliance members, who talk about a system in crisis, and would have us agree that Canada's health care system is in crisis and vote in favour of their motion.

We have a report before us from the provinces. They are asking for more money. That was already understood. We have known that for some time. In this report, the provinces are saying that Canada's system is not in crisis. There are pressures, problems, challenges, but it is the provinces, not the federal government, saying this. It is not the Liberal Party saying it. The provinces are saying “The Canadian health care system is not in crisis”. That is the actual conclusion of their report.

I would like to ask my colleague from the Bloc Quebecois what comment he has to make on the opinion recently expressed by Claude Castonguay, the father of health reform in the 1970s, and a man with a reputation for wisdom.

All political parties and all consultations defer to Mr. Castonguay. People like to get his point of view. On May 6 he was quoted in Le Devoir as follows “In backing the race toward a zero deficit, Quebec won the bet on taxation, but lost the one on health. Quebec has lost its shirt on that one”.

Not only has it not managed to reform the system, it has even lost its shirt. Mr. Castonguay also pointed out that there are a number of reforms that need to be looked at. He pointed out that, not only is the health system inefficient, but also there is absolutely no way to gauge its productivity, its performance.

These are, to my mind, severe criticisms and I would ask the hon. member for Hochelaga—Maisonneuve to consider that there is work to be done in all of the provinces as far as service organization and delivery are concerned. This was also said by the Quebec Minister of Finance, Bernard Landry, a month and a half ago, when it was reported that there were hundreds of millions of dollars, $850 million at that time, available to finance services for the people of Quebec.

Some Quebec patients are having to go the United States for cancer treatment, and for other treatments, at the present time. There are waiting lists, as everyone is well aware, and there is also $850 million which could be used. The Quebec Minister of Health was very surprised when this amount became known.

According to the Quebec Minister of Finance, “Our problem in Quebec is not just money, but also the use, the administration of that money”. The minister got that message clearly, because she is commissioning an in depth study, and then of course there is last year's study, which led to the Arpin report. The Minister of Health and the Government of Quebec are therefore well aware that service delivery and organization must be re-examined, as Mr. Castonguay has also suggested. We must, therefore, focus on a concerted effort to solve these problems.

I would like to know what our colleague thinks of Mr. Castonguay's diagnosis.

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

Mr. Speaker, no one is denying in the House that the various health care networks have to look at the delivery of their services and that there is room for reorganization.

I myself provided the example of the meeting I had with the head of the emergency hospital centre. He explained that, in a winter storm, the person cleaning the entranceways is not the person doing the salting. These are examples of illogical working arrangements we have to reconsider. Situations we see now that are not logical, and not the best way to deliver the service.

My colleague has to agree, however, that the provinces, in their report said unanimously—and this includes Brian Tobin as well—that the federal government did not assume its funding responsibilities.

For every dollar the provinces invest in health care, the federal government, under its commitment, must set aside 50 cents. For every dollar spent, the federal government gives the provinces only 12 cents. We think something has to be done before we talk about co-operation.

Yes, the Minister of Health may want to meet his colleagues to find a way to reorganize the network. Yes, there are pressures that did not exist in the sixties. The so-called fourth age, the group made up of very old people, was not an issue. We did not have the same medical technologies. We can certainly understand that. Back then, people did not wish to remain in their community as long as they do now.

I hope the hon. member for Anjou—Rivière-des-Prairies, who is a Quebecer like me, will agree with the assessment made by the Quebec Minister of Health and Social Services, who is urging this government to assume its responsibilities.

Few stakeholders in the health sector do not agree that the federal government drastically reduced its financial support. I personally talked to Mr. Castonguay myself and I believe he acknowledged that the federal government had reduced its support.

I invite the government to co-operate. We will support its co-operative efforts. I also invite the parliamentary secretary to recognize that the federal government has reduced its support and that restoring transfer payments must be a prerequisite to any dialogue with the provinces. That is our conviction.

[Antoine Dubé, Bloc, Lévis, QC]

Mr. Speaker, my colleague, the hon. member for Hochelaga—Maisonneuve, is very enthusiastic. I am convinced that he still has a lot of things to say.

As regards transfer payments, and I anticipate his answer, would he agree with the suggestion that the federal government should make such a transfer by allocating additional tax points?

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

Mr. Speaker, our colleague no doubt wishes to remind the House that the Canada social transfer, as it now stands, takes two forms—cash payments and tax points.

I believe that he, like other stakeholders, has worked out that it would be more advantageous to receive tax points, given deflation and real value.

I know that our colleague, whose primary motivation has always been to defend Quebec's interests, which he considers non-negotiable, has put a great deal of effort in recent weeks into the argument that Quebec should collect all its taxes. That is a characteristic of sovereignty, or one step towards sovereignty.

I have no hesitation in giving him my support and I thank him for publicly pushing this idea, which is as generous as it is enlightened.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Mr. Speaker, I am very pleased to have the opportunity to participate in this debate and to begin the input in this discussion on the part of the New Democratic Party caucus.

It is fitting that we should end this parliamentary session with a full blown debate on the question of health care. I want to acknowledge the work of the Alliance in bringing this motion forward. However, in so doing I also want to say “Welcome to the debate” to members of the Canadian Alliance.

[Ken Epp, Reform, Elk Island, AB]

What about the Liberals?

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

An Alliance member just said “What about the Liberals?” I too want to say to the Liberals “Welcome to the debate”.

If there was any telling comment about the productiveness of this past parliamentary session it has been the lack of a clear discussion and debate on the future of our health care system. I hold the Liberals responsible for this lack of accountability to parliament and to the people of Canada.

I say to the Alliance members “Welcome to the debate”. This is something we have been trying to push to the top of the parliamentary agenda day in and day out for the past several months, from the day the federal budget was tabled and we were informed of just how serious this federal government took the crisis in our health care system. The government responded to the most critical situation facing health care in the history of this country by tabling a budget that gave two cents to health care for every dollar it spent on tax cuts.

At that moment there was no one else in this Chamber speaking up, joining us in calling on the government to act appropriately and responsibly in the face of the serious critical situation facing health care.

We were alone, day in and day out, week after week, raising this issue without any support, and we will continue to do so. We have not only used every question period available to put this question to the government, we have presented to the House two motions using our two opposition days on this very question. We have called for support from all sides of the House for an increase in transfer payments. Did we get the support of the Canadian Alliance? No, we did not. Of course we did not get the support of the Liberals. That seems to be a given.

We presented a second motion in the face of the most critical development in the history of medicare, that being the passage of bill 11 in the Alberta legislature. We put a motion calling upon the government to stand and either enforce the Canada Health Act, or, if that was not possible, to amend the Canada Health Act to prohibit private for profit hospitals.

Did the Canadian Alliance support us? No, it did not. It does not need to be said again that the Liberal government did not support us either.

No one supported us on those motions. We have stood alone, day in and day out, trying to hold the government to account and raising the number one issue facing Canadians today. Thank goodness, at least to this point in time, in the dying days of this parliamentary session, the Alliance has finally decided that perhaps there should be a discussion here in parliament.

We are pleased to participate in this debate. I also want to acknowledge though, because I do not want to issue total blanket statements about lack of involvement by the Alliance on this critical issue, the work of the health critic of the Canadian Alliance, who has tried along with others to have this matter addressed by the health committee.

Members will know that during the whole period that we were dealing with the fall-out of the abysmal federal budget and the rise of Ralph Klein's for profit private agenda the minister avoided the debate here in parliament. He avoided the health committee. In fact, he deliberately manipulated our agenda at the health committee so we could not have the debate.

Let it be absolutely clear that at the point when it was the most pressing time for all of us to come together to debate health care and deal with the serious threats to the future of medicare the Minister of Health took every measure he could to dictate to the Liberal members on the health committee to prevent us from having the debate.

Where is the debate taking place? Not in parliament. Not in the health committee. Except for the one or two days that we presented motions, there has been no ongoing, serious, long term discussion about this issue. Where is that taking place? In the other chamber. In the Senate.

This is the most pressing issue for Canadians. Surely to goodness it ought to be before parliament. Why did the Minister of Health, when he knew the concerns of all parties in the House, when he knew how Canadians felt, come to the committee and try to dictate what it should be studying? It certainly was not our universal public health care system. It certainly was not.

When confronted about why he did that he said “The committee is master of its own destiny. It can choose to do what it wants”. If we can choose, how is it that he tried to deliberately influence the agenda? How did he manage to get through to every Liberal member of the committee so that we did not have that opportunity?

This is the last day of the session. The health committee is not discussing this issue. Parliament is hardly discussing this issue, and the crisis continues.

Although this issue has not been thoroughly debated in parliament, the motion today gives us an opportunity to discuss the future of health care and put things into context.

The Alliance motion poses the challenges that we all have to deal with. However, we question what is really behind this motion, obviously. As we have noted in the debate today, time and time again the Canadian Alliance has stood in the House or outside the House to advocate private for profit health care. I mentioned in my remarks earlier that every single leadership candidate for the Canadian Alliance has in one way or another advocated this kind of private encroachment on our health care system. Just this past week Stockwell Day said that we should trim the health care budget. The month before, Stockwell Day said that we should stop the intrusive health transfers. The member for Esquimalt—Juan de Fuca is clearly on record as calling for a parallel private health care system. Today he is quoted in the London Free Press as saying “Establishing private clinics in hospitals in Canada is the key to aiding the country's health care system”.

It does not stop there. We know where Tom Long comes from. He is either the protege or the actual force behind Mike Harris.

[Lorne Nystrom, NDP, Qu'Appelle, SK]

The candidate from Bay Street.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Absolutely, the candidate from Bay Street. What do candidates from Bay Street want? They want to get their tentacles into the private health care market. They know that this is a lucrative market. It is an $82 billion golden egg and they want it. Tom Long wants it, not for the good of the public sector, but for commercial interests. As Dalton Camp said so well, when we are talking about Tom Long or Mike Harris, we are talking about the beginning of a concerted effort to change health care from a public interest to a commercial interest.

Then of course there is the other leadership candidate, the member for Calgary Southwest, who has said in this House, and I have no doubt he has said it along the campaign trail, that we should look at private sector health care. We can go right back and trace the whole history of that individual and members of the Canadian Alliance, and the Reform before it. All they ever talked about was opening up the Canada Health Act to allow private for profit health care. All they have talked about is the need for private interests to get their hands on the health care system, and my goodness, would it not be more efficient and would it not be better?

I do not need to quote all of that again. I have put those quotes on the record before. We have quotes from the member for Calgary Southwest. We also have quotes from the former health critic, and we have quotes from the present finance critic of the official opposition in response to the last budget. When we were leading the charge in terms of the weakness of the federal budget vis-a-vis the health care crisis, the finance critic of the Canadian Alliance said publicly on February 29, 2000 “Obviously we are going to have to look beyond the money and start to entertain some private sector solutions”.

There is no question that we need this debate in the House, but we are very suspicious of the motives behind the motion. What does this party mean when it talks about the system? What does it mean when it says the system is not sustainable? Is this party refuting everything that was ever studied in terms of our health care system?

Looking at the most in-depth review of our health care system in recent times, the National Forum on Health in its report “Canada Health Action” clearly states “We believe the health care system is fundamentally sound”. What is behind the Alliance motion? Is it questioning the system, that the medicare model is not sound? Is there a hidden agenda? Is this a clever way to create an illusion of concern for health care, all the while advancing the agenda of that party?

The health care critic said that he has solutions which he will present. We are really looking forward to those solutions, because all we have heard from those members to date are basically three models, and they are all variations of the two tier, Americanized style health care theme. One is that we go to the welfare model. Those of us who have the money would pay for our own and look after ourselves. For those who do not, we would make sure they have health care. There would be one system for the wealthy and one for the rest of us, and we can be sure who would get the best quality health care services.

The second option they have presented, which is equally suspicious in terms of any kind of integrity in its argument, is the notion of a parallel private health care system, with the argument that this would take pressure off our public system and, lo and behold, we would have a much more effective and efficient system which would be able to meet the needs of all Canadians in the future because those who could afford to pay would go their own way. They say this, notwithstanding the fact that every study on the issue of private for profit institutions in health care and any study done on private parallel health care models shows absolutely and unequivocally that it is not more cost effective, that it is not more efficient and that people get left behind and fall between the cracks.

The third suggestion we sometimes hear from the Alliance members is something about a voucher system, that we should scrap the transfers and give everybody money and they can go out and buy whatever they need. This is just like what they have advocated for education.

How would this build hospitals? How would it build community clinics? How would it provide public health care? Who would pay for it? Where would people go if they have the money and there is no infrastructure? This is equally fallacious in the arguments because all of it would end up being a two tier health care system.

I ask members of the Alliance, what do they really mean when they talk about the present system not being sustainable? Do they mean medicare? Do they mean universal public health care? Or, do they mean something else? Do they in fact question the very root of Canada's health care system? Are they running counter to the sentiments of Canadians and throwing those longstanding values to the wind? Are they in fact advocating something that Canadians absolutely abhor and would be repulsed by if it were put on the public agenda? Are they trying to advance an agenda in a clever way, pretending to create concern for health care, when in fact they are not?

Getting back to the Liberals for a minute, it is too bad that we are not here debating a constructive proposal, an initiative to respond to this crisis. All the Minister of Health does is stand in this House and say that there is no crisis. He uses the report put out by the provincial and territorial health ministers just last week to say there is no crisis.

He uses the report selectively, even though the report clearly leaves the impression that, with the rising costs in our health care system, we know that we could still manage the needs in our health care system if the federal government provided the leadership we have been calling for for so long.

Perhaps in pure fiscal terms one could say that there is no crisis. We have argued that if the government put the money where its mouth is we could sustain our health care system. To say there is no crisis in health care is to totally deny the feelings, the sentiments and the experiences of Canadians. The Liberals cannot do that. They cannot stand in the House and say there is no crisis.

How could they say that to someone who has spent time on a gurney in a hallway waiting for medical attention? How could they say that to someone who has had to be shipped to the United States for cancer treatment because we do not have the specialists in this country? How could they say that to the families who are spending more and more out of their own pockets to cover prescription drugs and home care? How could they say that to the Canadians who are now paying, on average, $36 per month for prescription drugs because the Liberal government has refused to advance the value of a universal health care system?

It is a shame that we do not have this government advocating a serious position in this parliamentary session. It is too bad the Minister of Health did not have the courage that Monique Begin had in 1984 when we had a similar crisis. What did she do? She brought legislation to this House. She addressed the issues. We had the debate and we moved forward.

I want to acknowledge the work of my colleague, the hon. member Winnipeg—Transcona, who was the health critic for the NDP at the time. He did an enormous amount of work to ensure that the concerns of Canadians and the threats to medicare were brought to the attention of the government. He worked actively to hold the federal government to account and to push for the kind of changes we finally saw in 1984 in the Canada Health Act. That should be a lesson to the Liberals.

In his speech on March 29, 1983, the member said:

This is one of those rare opportunities one is presented with in political life, and I hope there are more, when one has been able to follow a political issue through what we might call a chapter in history—in this case of medicare. I believe that chapter began in 1977. What we are seeing now is an effort on the part of the federal Government to shore up and correct some of the consequences of the mistake it made in 1977—

It is too bad that government could not have been here today in this parliamentary session with a similar piece of legislation—with an initiative to deal with the crisis at hand. What have we got instead? This spread of mythology and propaganda about how transfer payments have not really been cut and all the money has been put back. It is creating more and more antagonism at the federal-provincial level, instead of leaning toward a more co-operative approach.

What do the Liberals have to gain by continually denying the fact that there is a shortfall? The Liberal government took the biggest single bite out of medicare funding in the history of this country in 1995. What do they have to gain by saying that money has all been put back when it has not? That is where their selective reading of reports comes in.

Let us look at the report which the health ministers delivered last week entitled “Understanding Canada's Health Care Costs”. The report clearly talks about the shortfall. There is no question that there is a $4.2 billion shortfall. What do we have to gain by not admitting it and getting on with the job? It seems pretty straightforward if the government has the money, but it is obviously waiting for an opportune moment, probably an election. Why does it not do it now when the crisis is at hand and we can get on with the job?

Why did the government not stand up to bill 11? Why did it sit back and say, time and time again, that it was going to study it and take action when it had to? The bill has now been passed and still the government has done nothing about it. It is now going to wait to see how it will be implemented.

It is too late. It is over and finished. The Liberal government and the health minister will go down in history as being responsible for overseeing the death of medicare. I say to them that they should wake up, start the debate and do something today. Action is what we need, not more of the rhetoric that we have heard time and time again from the health minister.

I do not need to tell members our position. We have advocated time and time again, not just for money to be added to the health care system, but that a twofold obligation and strategy on the part of government is required. The government needs to at least keep its word in terms of restoring transfer payments and bringing some stability to the federal-provincial table to allow provinces to deal with the critical situation they are facing right now.

However, we need more. We need leadership from the government to actually reform, renew and strengthen our medicare model. We have presented idea after idea on how to achieve that. We have talked about how one has to look at health care on a continuum and ensure that coverage is there for people who are in the hospital or outside of it. We have talked about the need to address the root causes of ill health and trying to get the government to deal with the fact that poor health comes from poverty, and on that, we note the recent statistics and this government's record. Ill health also comes from people living in deplorable housing situations or on the streets. It comes from a lack of clean water, which we see on many of our reserves. It comes from many things and the government sits back and lets it happen.

We have called on the government to do some very specific things when it comes to renewing our medicare model. We believe that the medicare model is sustainable. We believe that with financial commitment and political leadership we can sustain our health care. If we look at all the studies, we know that when we invest in community care and preventative measures, and when we ensure that home care, pharmacare, community care and maybe even dental care are provided, we can sustain the system. Would this not mean people would be less of a drain on our health care system in the long term?

Our system is one of the most cost effective and efficient in the world. Let us keep it that way. I agree with the Alliance, we do have a crisis. I agree that we do have serious problems but it is not the public sector aspect of our health care system. It is because 30% of our health care system is now in private hands. It is because drug costs have gone through the roof. It is because the government and Alliance members, with their complicity, have not stood up to the multinational drug companies that have a hold over our health care system.

There are many things we can do and much that can be done. I hope that in presenting this motion the Alliance is genuine and sincere, and that it will state today that it is committed to the medicare model, that it will work to make it sustainable, that it believes in a universally accessible public health care system, and that it will join with us in championing this cause and ensuring that health care, the number one priority of Canadians, is addressed and addressed soon.

[Diane Ablonczy, Reform, Calgary Nose Hill, AB]

Mr. Speaker, I listened with great interest to my colleague's speech. I have always respected this colleague because she is obviously very passionate about health care and very focused on what needs to be done. However, I was disappointed in her speech. For some reason, she chose to spend the most of it in a diatribe, a rant against the Alliance Party, which is the only party that has brought forward the opportunity to talk about real, constructive proposals for health care.

I want to tell the hon. member that the Alliance members get sick and their families get sick. They want health care and need health care. They care about medical services as passionately and as deeply as any member of any other party. I urge the NDP and the hon. member to focus their remarks and their fire on the government. The government is the only one that can actually do something about this issue other than advise, which is what we have tried to do.

I would suggest that to use half of a 20-minute speech to tear down an opposition party that is simply working honestly and openly with all parties to try to fix a broken system, is a misuse of time, which is pretty unwise and disappointing.

In addition to the member putting forward conspiracy theories, I noticed that she did make two suggestions: first, that the government should put more money into health care; and second, that the government should show leadership in reforming and strengthening it. That is exactly what this motion is about. It is about reforming and strengthening the health care system to ensure that all Canadians have health care when they need it regardless of their ability to pay.

I would ask the member to focus on the solutions that we are trying to reach so that we can then put pressure on the government to actually do something. I also would ask the member to spend a couple of minutes on solutions, for which can all get behind and support and which would really help Canadians, and not just more political rhetoric.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Mr. Speaker, I am delighted to answer the question. The first thing I want to say is that this is not the first opportunity we have had to debate these issues. The NDP has presented two previous motions and we have had two full days of debate. We have presented options and solutions but we have not had the support of the Canadian Alliance. One option was as fundamental as trying to get a change to the Canada Health Act to stop private for profit hospitals. If that is not a concrete solution what is, given the crisis we are facing and the threat by American multinational corporations to get their tentacles into our health care system?

We have tried very hard over the last number of months to engage everyone in the House in this discussion. I have not just focused on the Alliance. I have focused just as much on the Liberal government. I say, a pox on both your houses. I worry when two parties start to sound exactly the same. In fact they are both prepared to passively allow for the privatization of our health care system and oversee a climate of negligence. That is the fundamental issue here. We have presented many solutions.

If I was given another hour I could go into line and verse over the health care proposals offered by the New Democratic Party. I could go into detail about how we believe home and community care should be an integral part of our national health care system. I could talk about our plan for introducing a national pharmacare plan in conjunction with measures to contain drug costs. I could go into our proposals for developing national health goals to guide co-ordinated action in collaboration.

I could go into our proposals for creating new ways to integrate federal policy in support of national health goals. I could talk about our proposal for establishing a ministry of state for public health within Health Canada. I could talk about our proposal for a forum to work with all senior civil servants providing an integrated, co-ordinated approach to health policy.

I could talk about our proposal for requiring formal health impact assessments of all related federal policy. I could talk about our need to democratize the development of health policy at the national level. I could talk about our recommendation for appointing a national public health commission.

I could talk about our recommendations for stable funding for public education, policy research and advocacy for health consumer groups. I could talk about the need for a broad public dialogue on the ethical challenges facing all of us in the face of these burgeoning technological changes.

I could talk about the specific suggestions we have for dealing with the absolute deplorable conditions among the remote and northern communities. I could talk about the situation facing aboriginal communities and what needs to be done. I could go for hours giving members very specific details—

[Diane Ablonczy, Reform, Calgary Nose Hill, AB]

Why didn't you?

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

The member asks why I did not. I think I did a pretty good job outlining our proposals in my 20-minute speech.

However, all members of the Alliance have to understand that what is at stake here, first and foremost, is our ability to stand up and preserve medicare.

What I have not heard, and what I am still waiting to hear from that party, is: Does it or does not support the medicare model? Does it support universally accessible, publicly administered health care? Do not give me the line that we do not have it now. We know we do not have totally universal health care system. We know we have two tier health care. We know we have people going to the States for coverage.

The question is: Where does reform stand on where we go in the future? Do we try to deal with those problems? Do we try to convince the federal government to not only put in more money but to show leadership around innovative ways to meet the needs of Canadians, or do we cave in, as the Alliance appears to be doing, to the forces of multinational corporations and the global corporate agenda, and actually say “the market is open, come in and get your share and let whoever goes by the wayside, let it be?”

What it really comes down to is whether or not we want that kind of system. This is the turning point in the history of the country.

[Yvon Charbonneau, Liberal, Parliamentary Secretary to Minister of Health]

Mr. Speaker, the New Democratic member for Winnipeg North Centre speaks with passion about health care.

I would point out a certain contradiction in what she is saying. Today, the House has before it a motion moved by the official opposition, the Canadian Alliance.

This motion is based on the assumption that the health care system is in a critical state, in crisis, and that, as a result, it needs to be overhauled.

The member for Winnipeg North Centre waxes eloquent against the Canadian Alliance stand on health care but is getting ready to vote with the Canadian Alliance, against the government, on this motion. I am trying to follow her logic.

Mr. Speaker, you, who follow our debates closely, heard her as well as I did. She spent most of her time shooting down in flames the positions of the Canadian Alliance and then, at the end, suggested that she was going to support the motion because the opposition parties must stand together. Is she serious? Is not her greatest threat the Canadian Alliance and its proposals?

She is well aware that the government has done everything necessary to maintain the basic characteristics of our health care system. It is getting ready to increase the level of funding. It is working with the provinces to improve the system. There will be more discussions this afternoon between ministers. She knows all that.

We are being told to listen to the provinces. That is another contradiction because what are the provinces saying?

Canada's publicly funded health care system is not in crisis. Canadians continue to be well served by their health care system, but it is under serious challenges due to rising demand, et cetera. We know that. This is what the provinces have said. Among the provinces, there are three governments led by the New Democratic Party.

We are paying attention and listening to what the provinces are saying. The system is not in crisis but we have to prepare new responses for the new challenges and new pressures we are feeling now.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Mr. Speaker, perhaps the member did not catch all my remarks because I was speaking so quickly, but I want to be very clear about a couple of things.

First, we take umbrage with this government's suggestion that the system is not in crisis. The member can argue the statistics. Yes, I do have the report he quoted from and I do not disagree with him in terms of that selective quote. However, as I have just said, the people who use the system, the people who want to know health care is there when they need it, are not at ease with what is happening. They are worried, anxious and fearful. When that kind of level of fear and anxiety occurs, we have a crisis. Whether we can back it up in terms of statistical numbers or not, it is a human fact and it is a problem we have to address.

Second, the Liberal parliamentary secretary tries to suggest that the whole system is sustainable. We say that the medicare model is sustainable, and we have shown documents that back that up. The real question is, which was also stated in the provincial document the minister quoted from, that the rising need for additional health services is not sustainable without significant new federal funding.

Time and time again we have said that there is a crisis in the health care system because of failed federal leadership and a climate of negligence. We can address the problems and ensure that medicare is sustainable, but it takes the federal government to put its money where its mouth is and to show federal leadership and political courage.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Mr. Speaker, it has been an interesting debate. At the outset, I do want to thank the member and the party who introduced this motion. I think it is a motion worthy of debate and it is a motion that most of us on this side of the House can and will support. Let us take a look at the wording in the motion. I know the government has trouble with, but the motion reads:

That this House recognize that the health care system in Canada is in crisis—

The government has a problem with the word crisis, but there is no question that the system is in crisis.

I compare it to a home or a building burning down. At some point the fire can be put out and the structure saved. It is the same with our health care system. It is in a crisis and the truth is that on the government's watch it has done nothing to save it. It has not come up with any innovative ideas. Basically the government has been running on empty for seven years on this file. The truth is that it is responsible for the state of anxiety that we are seeing in our health care system from coast to coast.

We debated in the House bill 11 in Alberta. We are hoping the government will take a position on it one way or the other. The criticism we are throwing back at the government in relation to bill 11 is that it is forcing the provinces to perform radical surgery on their health care system. The reason for this is that they have been in an animated state of suspension since 1993. The provinces have no idea where we are going on the health care file.

Most premiers probably believed that the Liberal red book promises in 1993 or in 1997 would count for something. The Liberals promised to look after our cherished health care system, and obviously they have not. It is just one more red book promise they have not honoured.

Getting back to bill 11 in Alberta, it is simply a case of provinces doing what they have to do to salvage their health care system, to save their health care system.

You may know, Mr. Speaker, a bit about the policies and platforms of the NDP. From time to time I think you have made the statement that your party is sort of the father of health care. We could talk about Diefenbaker and the work that our party and the Liberal Party did. I think we all want to take credit for it, but the fact is that the NDP had a lot to do with the creation of health care in Canada. It is a basic reality and we all acknowledge it.

We want to preserve a health care system based on the five principles we often mention in this place: universality, accessibility, comprehensiveness, portability and public administration. We want to preserve it, as does your party, Mr. Speaker. Horror of all horrors, yesterday in Saskatchewan, your home province, Premier Roy Romanow had to look this thing straight in the eye and say they had a problem and had to do something about it.

I will quote from the National Post . I know it is a newspaper that you and I do not have much love for from time to time, Mr. Speaker, but here is the story headlined “Health care under review in Saskatchewan”:

Commissioner appointed.

Premier looks to remodel system, keep the dream alive.

Saskatchewan, which created medicare nearly 40 years ago, is launching a far-reaching review of health care that will include an examination of what services should be publicly funded.

Most NDP members would have hid under their desks if they heard that a few years ago, and I would not have blamed them. The truth is that the federal government is forcing the provinces to do exactly what the Premier of Saskatchewan would have to do: take a hard look at their expenses, where they are going and whether they can sustain the system. My belief is that they cannot.

Following the 1993 election this government extracted $17 billion out of the system. If it is allowed to stay in office until the year of 2001, it will have taken $30 billion out of the system. No province, NDP, Liberal or Conservative, could live under that type of severe cutback to the funding of its health care system.

We must remember that the provinces are the primary health care givers. They depend on the federal government to help cost share health care. When it was introduced many years ago it was a 50:50 formula in which the federal government paid 50 cents on the dollar to help the provinces provide primary health care. The Liberal government has reduced that to an average of about 20 cents on the dollar. In some provinces it is as low as 15 cents on the dollar in terms of the federal share of health care spending. It is not much wonder the system is in trouble.

Let us consider what is happening in New Brunswick in terms of the leadership of this government and what it has done in the last number of years. I will quote from June 10 edition of the Telegraph Journal . The health care minister of the province of New Brunswick, Dr. Dennis Furlong, has been in the health care field as a professional, as a doctor, for at least 25 years.

[An hon. member]

He is a good Newfoundlander.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

I am told he is a good Newfoundlander. That tells us something about the quality of care we will get in New Brunswick from this gentleman. We are quite impressed with his credentials. The story in the June 10 edition of the Telegraph Journal was headlined “Health-care cost spiral can't go on” and started out by saying:

Health Minister Dennis Furlong expects the province's annual health-care bill to top $2 billion in five years.

The article indicated that was in the best case scenario because presently New Brunswick spends about $1.5 billion, which will rise to $2 billion in the best case scenario, and that the province would be forced to spend almost 50% on heath care for its citizens. Referring to the federal government, the article continued:

We're at a stage now where we have to tell them that we can't go on. If it continues to go on it's them that are putting pressure on the Canada Health Act, not the provinces.

I think all of us in the House, at least those of us on this side, are in agreement with that issue. The federal government is putting the provinces into a situation where they cannot sustain their system. According to the article, Dr. Furlong went on to point out what was going on in Ontario in defence of his case:

Dr. Furlong said Ontario is estimating that 60 per cent of its provincial budget will be taken up by health care spending by the year 2010 unless something changes.

When we have the premiers doing what is being done in Saskatchewan, as an example, it tells us something is wrong. It tells us that these people across the aisle in the Liberal government have mismanaged that file despite the promises they made back in 1993 and 1997 via the red book. That was a convenient sort of political thing to do, was it not?

Let us go on. In terms of criticism of the government Tom Kent, who is sort of the social architect of the Liberal Party and I believe a resident of Kingston, Ontario, and despite the fact that he is a Liberal, most of us in the House would agree has a social conscience. When people like Tom Kent speak most of us listen because he does have a statesmanlike stature about him on the issue of health care. He said that federal action was required. Brian Stewart on The National interviewed Tom Kent last evening on the news. He said that federal action was required, because he is smart enough to know what the present Prime Minister does not understand, that the Liberals are in the driver's seat and that they have to show leadership on this issue. They have not done so for seven consecutive years.

What amazes me is that they are suddenly realizing that we had better start talking to the 10 provinces, our partners back home. We have to get them into the same room and come up with a solution. It has taken them seven years to realize that there has to be some kind of meaningful dialogue between the provinces and the federal government.

The truth is that they poisoned the atmosphere back in the 1993 era when they started to make draconian cuts to health care after having promised that they would not do it in the 1993 election campaign.

[An hon. member]

And then they bragged about balancing the budget.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Exactly, and we know how they did it. It was on the backs of ordinary Canadians and on the backs of the health care system in our respective provinces. Then they have the audacity to stand in the House and say that they balanced the books. It is fine that they balanced the books, but at what expense? It was at the expense of putting our health care system in a crisis situation from which we may not be able to recover if these people stay in office.

Obvioulsy there is a solution to the problem: replace them when the next election comes around. That is what we are hoping we can do because we need federal leadership in this regrd. That is exactly what Tom Kent was talking about last evening and continually spoke about over the last five or six years after witnessing the horrible things his party did to the health care system. I am saying good for Tom Kent. He should keep speaking up because those are the types of people we want to hear from on this issue.

The interesting point about the cutbacks in the 1993 to 1997 era and the damage they did to the health care system is that the provinces had nothing to say about it. The government just simply went ahead and did it. The provinces suddenly woke up to find that the money was not there and asked how it could be done.

In fact, every member of the Liberal caucus nodded in silent agreement as the government did it. They stood on their hind legs in this place and supported those draconian cutbacks to our health care system. That is deplorable. As Liberals, I do not know how they could have sat there and allowed it to happen.

The hon. member for St. John's West certainly knows the Premier of Newfoundland who campaigned hard via another candidate to try to keep that member out of the House of Commons but did not succeed. The Premier of Newfoundland, for goodness' sake, stood in this place in 1995 and voted for cutbacks to the health care system. Now he is regretting it. One of the strongest critics of the federal government in terms of what it has done to health care is the Premier of Newfoundland. He goes by the name of Brian Tobin, just for the record.

The Liberals bragged last year when the budget came down about putting $11.5 billion in the health care budget. In writing about last year's budget in the February 3 edition of The Globe and Mail Jeffrey Simpson stated:

Anyone who believed the $11.5 billion pledged in the last budget would suffice did not understand the economics of health. That increase amounted to a 4% yearly increase in public sector health care spending. Four per cent is about the medical inflation rate, so the additional spending would only prevent the system from deteriorating further.

We have gone a year with $11.5 billion which would basically keep up with inflation, if it did that; in some jurisdictions it did not even do that. This year the government put in $2.5 billion to keep the system going for four years. It was $2.5 billion over four years or take it all up front. For example, if the province of New Brunswick took it up front, it would keep its system going three days. It is the same in Newfoundland.

That is not leadership. That is attempting to salvage political careers. That is exactly what the Prime Minister is famous for doing. The Liberals did the same thing in 1997 on the eve of the federal election. When the Liberals were in trouble right up to their eyebrows, they came up with a deathbed reprieve. They suddenly threw a bunch of money into health care to make up a fraction of what they had taken out of it, only a fraction.

That is exactly what is wrong with the system. It is ad hoc, make it up as they go along, fly by the seat of their pants. Our leader Joe Clark is suggesting that we have a sixth principle in addition to the ones I mentioned. That principle would be predictable sustainable funding.

No business can run that way. A business cannot be run by saying, “We do not have a plan. We are just going to run and hope that it works”. Usually when someone runs a business like that, at the end of a year or two it is bankrupt.

That is what the Liberals have done with health care. They have bankrupted it because of no direction, no ideas and no plan. They have done it now for seven solid years. In the meantime, they have poisoned the atmosphere with the provinces. The Prime Minister cannot get into the same room with the first ministers or the health ministers to solve the problem. Why? They do not trust him. Would anyone trust him? It is like someone who sneaks into a house in the middle of the night and steals the furniture. That is what he has done with health care.

I want to say a couple of things about the health minister. On a personal basis I like him. He is a good man. There is no question about that. He is very articulate, well coifed, well dressed, maybe not rock solid on this file but he is a good person nonetheless. I am not attacking him on a personal basis.

What he reminds me of is the little man on the wedding cake. He is properly dressed, well attired, like the perfect little gentleman on the wedding cake. That is exactly how the Prime Minister treats him. But the icing is melting. The Prime Minister does not give his minister one ounce of support. How he could stand up in this House day in and day out and prop up a Prime Minister that pulls the legs out from under him on a routine basis, I cannot fathom. I cannot understand that.

If I were the Minister of Health, I would resign. I would not allow the system to deteriorate or allow someone to take a wrecking ball to the system under my watch. If the Prime Minister wanted to do it, he could go ahead but it would not be on my shoulders. If I were the health minister, that is exactly what I would say to the Prime Minister. I would walk up to him with my resignation in my hand and tell him to show some leadership on this issue and do something about it.

Of all the issues in this country, this is the number one issue on the minds of Canadians. As the minister mentioned this morning, and I agree with him, we do not want to go down the road of Americanization of the Canadian health care system.

There is an article which states that the American people are one sickness away from bankruptcy. I live right next to the American border. I have worked in the United States. I have lived there and some of my family members have been bankrupted by the American system. That is one point on which we agree.

What he has to do is show some leadership to avoid us moving in that direction because on his watch we are going to do it. The health care system is in a crisis. We support the motion. We want the government to fix the health care system.