Mr. Speaker, it is my privilege to speak to the amendment. I thank the many members who have spoken to the motion today.
Many members have made somewhat the same points. The system does need a lot help. I am disappointed that the health minister would choose to say that he would not support the motion. Therefore I guess he is saying that he does not believe the system is in crisis, that he believes the status quo is an option and that he thinks the system is sustainable. Obviously by opposing the motion he is saying those things. I am rather surprised that all members of the House could not agree that this is a non-partisan issue. It is an issue that we should be looking at because 78% of Canadians are saying that is their number one issue.
In summarizing what we have heard today, basically there are problems between the federal and provincial ministers talking to each other. We have heard about some of the turf wars that go on, whether it is between governments, between various professions or something much smaller at a very local level. We have heard about the lack of long term funding, the sustainability of that funding, and a major disagreement as to who is funding what and how much.
We have also heard from members that we are spending an adequate amount comparable to many of the OECD countries. We have had comparisons to some of them. We must recognize that the World Health Organization has said that we are falling in terms of our position in the world on health care. The OECD puts us in the bottom third for a great many areas within health care delivery.
We have heard a great deal of rhetoric and promises. We have not heard very many solutions or calls to action. We have not heard what we will do about the brain drain, technology, demographics and increasing drug costs. We really have not addressed a key factor, the extremely growing cost of health care.
Health Canada today says that the costs will increase at 3% a year for the foreseeable future. With our present spending of $86 billion on health care, by the year 2020 that figure will be $160 billion. That is our total budget of today. We are saying in some 20 years that will be the figure for health care alone. How will we deal with that? How will we come up with some solutions?
Let me try to put some of them on the table today. Obviously we do not have all the answers, but we are saying that someone had better start looking at them. We are saying it should be non-partisan. We are saying it should be for Canadians. Canadians do not care whether it is federal or provincial. They do not care whether it is one party or another party. They care about a system which 78% of them agree is broken.
Let us look at the solutions. I will try to summarize them. I remind members of the House that the former Reform Party had a task force report on health care entitled “New Directions: Setting the Course for Canada Health Care in the 21st Century”. I recommend that people read it. It has been condensed down to about 90 pages. It set some targets and goals. I certainly wish members of the House would quote it as opposed to quoting some of the other fictitious statements we have heard here.
To emphasize what I am talking about, our party would put forward to the House a patient centred, results based health care system. In a patient centred system the patient is number one. What helps the patient? What problems is the patient having? It is not the systems, not the government, not the various organizations, but the patient. The patient is number one. Then we need to look at the results. What are we achieving? We do not need to keep protecting the Canada Health Act and hiding behind it. We need to ask whether it is getting the results for the patient.
Let me start with two recommendations. The first one is to promote federal-provincial co-operation. How will we do that? We could go back in history and obviously say that in the sixties we came up with a formula where the federal government would provide 50% and the provincial government would provide 50%. Then we worked up to another system where we used cash and tax points. I do not think I need to go through all those figures. Then of course by 1995 we got to the CHST.
If we look at the 1993 figures, the federal government was transferring $18.8 billion. In 1998 it went to a low of $12.5 billion. Now it has been raised back to $15.5 billion. If we take all that into consideration, no matter how we do the math, had we stayed with the 1993 figures we are $24 billion short of what we would have been had we kept it at the 1993 figures.
No matter how the government twirls that around and hides that, those are facts that the provinces have recognized and identified. It does not matter whether it is Mr. Romanow's government, Mr. Harris' government or Mr. Tobin's government, they are all telling the federal government the same thing. We have to stop antagonizing the provinces. I certainly commend Mr. Romanow who said, I suppose in frustration, that he wanted to start a national study on this and at least hopefully get the ball rolling.
The reality is that people do not care about whether the jurisdiction is provincial or federal. They want it fixed. The need is obvious. The problems are obvious.
What about the solution to this federal-provincial co-operation? Let me put five things forward for consideration.
First, we believe as Mr. Romanow does, that we need a health care advisory board, a group made up of federal and provincial citizens and of course health care workers. We need to have that advisory group to look at the situation immediately. The federal government should be taking the leadership role, not the provinces.
Second, we need to restore long term stable funding to help federal-provincial co-operation. We cannot go to the table with the provinces and say, “We are not giving any more money”. We do not have to say how much we are giving them but we need to put all the cards on the table and talk about the money issue.
Third, we need to have an independent auditing of the health care system. It needs to be audited. It cannot simply have money thrown at it and no one knows what anything costs. I have visited many hospitals in the last three months and I keep asking, “What does that cost? What would that cost? What would it cost if we did this?” No one seems to know.
The health minister talked about the U.S. system and its administration and that all the costs are known. I am not saying that is what we want. I am saying we need to know. We need some accounting. We need to know what things cost.
Fourth, we need to learn about the innovations in other places. I was very fortunate to visit the Swiss health care system a few weeks ago. I was rather shocked at what I found. I was shocked that when a gentleman with heart pains came to the emergency ward he was immediately met by two cardiovascular surgeons, two doctors and two trained nurses. There were eight MRIs and he was in an intensive care unit within six minutes. All of his medical history was on a card. They knew exactly what medications he was on and what treatments he had had. Now that is technology. That man's life may well have been saved because of those improvements in that health care system.
We need to learn from those innovations. We need to look at what Sweden, the Netherlands, Germany, Switzerland and other countries are doing. Please, Mr. Speaker, advise the members on the other side to stop talking about the U.S. health care system as the only example. There are many other much better health care systems we should be looking at that are spending the same amount of money that we are. Switzerland spends 10.2% of GDP. We spend 9.8%. That is awfully close for those two different health care systems. We need to look at that.
Fifth, I would recommend that we appoint a health care auditor. He should be empowered by the Canada Health Act to standardize, co-operate and modernize the Canada Health Act. He should have that kind of authority. It is important to Canadians so that should be in place.
Those are concrete recommendations. There is a great deal of detail that can go with those which we will be providing.
We need to modernize the Canada Health Act. That is a complex issue which I can only touch on in the minutes I have left. We oppose a two tier American style health care system, one for the rich and one for the poor. Nobody wants it and nobody is talking about it or suggesting it. It certainly is not this party's position. There, it is said. I could repeat it three or four more times, but I am sure the crowd across the way still will not understand it.
I will state our position on the Canada Health Act. We believe in the tenets of the Canada Health Act, but we are saying it is not working. It needs to be modernized. I have heard many people say that in the House. I have heard many provincial health ministers say that.
The system is not accessible the way it is today. Some 200,000 people are on waiting lists. A lady in my riding wrote me a letter saying she had just come from her doctor and she needed to see a specialist and her appointment with the specialist was scheduled for April 11, 2001. That is not accessibility. That is a system that is broken, that is not working, that is in crisis.
We could talk about the shortage of MRIs and other technology. The average age of specialists is 59. It takes 14 years to train them. We train 1,600 doctors and some years 800 leave. We cut the number of spaces available for training doctors. We need 2,200 doctors just to replace what the system is going to require. It is not an accessible system. We need to fix these things. We need to fix the brain drain. We need to get the technology. We need to be prepared for what we are going to be facing in the years to come.
It is not a portable system and many have talked about that, whether a person is in rural Canada or whether they need specialized treatment or whether they are in Quebec. I have asked doctors in hospitals here about patients from Quebec. They told me that they encourage them to pay first and then to go back and fight with their government to get the money. That is not a portable system. That is not acceptable.
Is the system universal? In Alberta there are 333 positions open for rural doctors right now. It is certainly not very universal. The presence of specialists is not very universal, as I have touched on.
Is the system comprehensive? There are a number of delisted items from health care. We have a real problem with a comprehensive health care system. We are suggesting again that we must fix it.
Home care is another major issue. My mother is in Saskatchewan and is presently having serious problems. That province was a founder of health care and if that is how people are treated, it is inhumane and very troubling. We need to look at the home care and palliative care issues and see what we can do. The Senate just reported what it thinks about Canada's palliative care system and the report card was pretty dismal.
Let me talk about public administration. It is fine to say that the system is fine the way it is, but we need to look at how we administer health care. We have to open that up. We have to look at the options. I mentioned the Swiss system and I do not have time to go into that. This summer I intend to visit other systems and look at how they work.
We agree with the principles contained in the Canada Health Act, but they are not working. There is not a Canadian who is not touched by that. What are the solutions? Let me summarize them quickly.
One solution is a long term stable funding commitment with a minimum term of five years. We must work out that deal collectively with the provinces.
We must develop technology so that we enter the 21st century and not stay in the 1960s where we seem to be mired. I have talked about that. There is a surgeon who did a heart operation in New York and the patient was in Idaho. A robot did the surgery. The surgeon is able to do three of those a day just by running that equipment.
On education I have mentioned what we need to do in terms of the financial commitment to fix that problem. It is not the only answer but we must come to the table with some dollars.
We need to show leadership to modernize the Canada Health Act, to demonstrate co-operation between the federal and provincial governments. The health minister talks about it but then he goes out and does something dumb which makes the provinces that much madder. That will not fix the Canada Health Act and it will not fix what Canadians want fixed.
We need a health care auditor. As I said, we need independent auditing to make sure the provinces are abiding by the Canada Health Act and to make sure patients are not abusing the health care system. We need to know what things cost if we are to have a health care system like this.
We do not need to reinvent the wheel; we can learn from others. Many innovative things are happening in Sweden where the system now is 50% public, 50% private. I do not know if that is the way we should go, but we need to look at it. There are various insurance options. We need to look at those. We need to have open minds and not live with a 1960s socialized state run health care system such as those in North Korea and Cuba. We have to move out of that mindset.
We need to modernize the whole system. We need patient centred health care. We need to be prepared to look at medical savings accounts and patient guarantees. We have to fix the waiting list problem. We need to be prepared to look at new technology and decide if that is a solution to the problems we face. Above all, we need to work with the provinces and not work against them. We have to stop the drive-by smears. We have to stop the $2 million advertising campaign against the provinces. We have to stop antagonizing them.
In conclusion, the Canadian Alliance stands for fiscal responsibility. Members know that. We have developed our principles there but I want to say in the House that we have a social conscience. There are no hidden ghosts, as my colleague from the health committee might intimate. There are no ghosts. There is no hidden agenda. We believe in a patient centred, results based health care system instead of the Liberal two tier, turf dominated, non-sustainable, deteriorating health care system. Remember that we spend the fourth most of the industrialized countries and we are in the bottom third in terms of rating our health care system.
As we develop this policy collectively with the help of other Canadians, with the help of the provinces, we must remember that this patient centred health care system will result in something that is sustainable for Canadians. It shocks me that the government or any member in the House would not support that kind of co-operative policy to do what is best for health care for Canadians.