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House of Commons Hansard #16 of the 37th Parliament, 2nd Session. (The original version is on Parliament's site.) The word of the day was money.

Topics

Health Care SystemGovernment Orders

5:55 p.m.

Liberal

John Harvard Liberal Charleswood—St. James—Assiniboia, MB

Mr. Speaker, my friend from Calgary has a point. Perhaps we should compare our system more often with that of Britain, France, Germany or one of the Scandinavian countries. I will allow my friend from Calgary that point, but the fact is we live beside this behemoth called the United States of America. It does not have the kind of health care system that we have. It has privatization.

Canadians, and those who support our health care system, must always be on guard. There are always voices who preach privatization. It is interesting to note that many of those voices are in the Canadian Alliance. They are the ones who would love to have a two tier system. They would like to have more privatization.

It is the responsibility of the members on this side to remind Canadians over and over again that we cannot have truck or trade with privatization because we run the risk of having a system closer to that of the United States and that will never do.

Health Care SystemGovernment Orders

5:55 p.m.

Bloc

Pauline Picard Bloc Drummond, QC

Mr. Speaker, might I begin by stating that this is not the most brilliant motion on which I have had the opportunity to speak. For us it is devoid of meaning and insignificant. I will justify our opinion by reading the motion:

That this House take note of the on-going public discussion of the future of the Canadian health care system.

The Liberal members across the way have not yet realized that their decision to slash transfer payments had serious consequences for the health system. I really wonder where they have been for the past ten years.

I believe we have had this motion moved today because the federal government is stuck and had nothing else to propose. It might have been worthwhile to consult the members of this House on fiscal imbalance or the financial leeway the Minister of Finance will soon be announcing to us. We could have discussed how part of that could have been transferred to the provinces for health services delivery.

As far as this motion is concerned, it seems that the Liberals in this House are the only ones who have not yet taken note of the fact that health care in Canada has been under discussion for some years now.

The mess the health care system is in is a harsh consequence and proof that fiscal imbalance indeed exists. The federal surplus announced for the past few months is clear proof that Ottawa is collecting too much for the services it delivers to the public.

With this surplus, the federal government keeps looking for opportunities to interfere in areas of provincial jurisdiction, and to create duplication and overlap.

How can the provinces manage to do any financial planning when here in Ottawa the federal government is resorting to its discretionary and arbitrary spending power. Over the years, the federal government has had many reminders that what it was doing was not the right approach. The provinces are short of money for health care, social services and education. The bulk of the responsibility for the health care system problems of the provinces lies, no doubt about it, with the federal government.

The conclusions of Quebec's Séguin commission, which confirmed the existence of fiscal imbalance, produced a broad consensus, not only among MNAs but also throughout the general public.

What more will it take for the Liberals to acknowledge that they are painting the provinces into a corner when it comes to their finances? Because of the fiscal imbalance, the provinces will have to deal with growing needs, particularly in the area of health funding. According to Conference Board projections, the pressure on Quebec's spending will come, for the most part, from the health care sector, which will eat up the lion's share of Quebec's revenues if nothing is done to rectify the fiscal imbalance.

This means that if we do not receive our fair share to fund the health care system—given that health care needs are growing due to an aging population, very high drug costs and high technology—not only Quebec, but the provinces will find it very difficult to fund their other responsibilities because health care will take up the largest share of their budgets.

The fiscal imbalance is in the process of becoming a fiscal strangulation. If this situation persists for long, Quebec and the provinces may be left unable to provide significant funding in other areas.

The federal government has no choice but to acknowledge the fiscal imbalance and take measures to correct it. If it continues to stubbornly deny this reality, given everything that has been said and written about the imbalance, we will have to conclude that it is acting in bad faith.

The Minister of Finance will present his economic update this week. Once again, he will announce that his wallet is fatter than he thought. The current Minister of Finance is no different from the last one: he too minimizes revenue and overestimates spending so as to make us think that tax revenue will be down and that we need to continue tightening our belts.

This type of accounting keeps a large amount of money away from the public eye. With this kind of bookkeeping, these amounts—almost $9 billion to the end of the current fiscal year, 2001-02—can be transferred directly to debt repayment. In this way, people do not have the opportunity to assess priorities or to transfer any money. Of this more than $8 billion that is being taken away from the public, $3, $4, or $5 billion could have been put back into the Canada health and social transfer to help the provinces with their health care system.

Yes, a surplus. The Minister of Finance tells us that he will use the same method as his predecessor, which is to continue to underestimate his revenues. That is what he is telling us when he says that he will be prudent.

We in the Bloc Quebecois predicted that the federal government would have a huge surplus. We said $10 billion; the government says $8.9 billion. We were not too far off. We were called stupid; we were told that we were out of touch with reality. As it turns out, we were right again.

Some members opposite claim that Quebec, among others, is jealous of the federal surplus and that is why it is fueling the discussion on the fiscal imbalance. Need I remind members that it is the way the federal government balanced its budget that has brought this imbalance to light? This imbalance began to exist in 1993, 1994 or 1995 when drastic cuts were made to transfers to the provinces. But the provinces are the ones that have to face the cost of the health care system.

The Liberal government's behaviour has been compared to that of a stingy brother-in-law who leaves the table just before the bill arrives. I could also compare it to a father who, to pay his gambling debts and finance his unreasonable expenses, decides to reduce his child support payments. This last example shows unfairness. However, in the case of two governments having the same taxpayers, it is an imbalance.

In health care, the provinces are the ones that have to absorb cost increases. They have had to bear the burden of increasing health care costs.

The figures released in June by Statistics Canada bore it out. While health costs for 2001-02 literally exploded in the face of the provinces, this Liberal federal government managed to reduce general spending, another clear indication of fiscal imbalance.

A journalist wrote in a Quebec paper this morning, “In Ottawa, they have found the solution to the problems that plague our health care system: Ottawa has to step in.”

The federal government has set the machine in motion to try to convince the public that this is necessary. Witness the Senate committee report tabled last Friday, and that of the Romanow commission.

Hinting at massive federal interference will do nothing to reassure us. Why is the federal government planning to cause chaos in health care?

What are we to make of an assertion like turning medicare into a more consistent and integrated national system instead of a combination of 13 increasingly unequal and dissimilar systems?

Do the Liberals intend to make the words universal and uniform interchangeable?

As far as the Kirby report tabled last Friday is concerned, how can digging into the pockets of the taxpayers to the tune of $5 billion, when the federal government is rolling in surpluses, be justified?

When it cut provincial transfers in 1993-94, the federal government created, as indicated earlier, the fiscal imbalance. While substantially reducing its share of health care funding, the federal government left the provinces to deal on their own with skyrocketing health costs.

Once again, we in the Bloc Quebecois are recommending that the government solve the fiscal imbalance problem. The surplus of recent years and those forecast for the next few years show that the government has the flexibility necessary to tackle the issue immediately.

The motion we are currently debating reads as follows, and I quote:

That this House take note of the on-going public discussion of the future of the Canadian health care system.

Yet, we have been concerned about this for a very long time. We sounded the alarm quite a while ago, but the people opposite were unmoved. Now they are waking up; our universal health care system has deteriorated to such an extent that alternatives like private health care paid out of the pockets of recipients have surfaced and are being discussed.

One of the positive points of the Kirby report is the recognition of the fact that the system is not viable in the long term under the current funding level. The report confirms what we have been contending since we first came here in 1993, namely that the federal government can no longer evade its responsibilities, but must assume them. How? By increasing its financial contribution, of course, but also by guaranteeing to the provinces that this funding will be stable and not affected by economic fluctuations.

As for the rest of the Kirby report, it is unfortunate that it neglected two important facts: first, the federal government does not know anything about health care management and, second, the provinces do not need new additional constraints. Their task is already complicated enough as it is.

Finally, while the provinces are condemning the fiscal imbalance that exists between them and the federal government, the federal Department of Finance is announcing an $8.9 billion surplus for the 2001-02 fiscal year.

Provincial fiscal balance is precarious all across Canada: Quebec has zero surplus, zero deficit and zero reserve; in Ontario, they have zero deficit, but a $1 billion reserve. These two provinces are on a tight rope and it would not take much to put their public finances in the red again.

It is desolation in British Columbia and not much better in Newfoundland and in Prince Edward Island, which are in a deficit situation. Saskatchewan has balanced its budget, while New Brunswick, Manitoba and Nova Scotia have managed to achieve microscopic surpluses.

By contrast with this sad picture, Ottawa is announcing surpluses. Yet, the aspiring Prime Minister and former Minister of Finance did not anticipate any surplus, only a balanced year at best.

Is this sound management of public funds? Not at all. The scandals and blunders that we have discovered and strongly condemned show rather clearly that the federal Liberal government is very prone to laxness and improvisation when it comes to managing taxpayers' money.

During the summer, the federal Minister of Intergovernmental Affairs circulated a document among the media to try to justify denying the existence of a fiscal imbalance.

He suggested, among other things, that the provinces have access to the same major tax bases: individual income tax, corporate tax, sales tax, specific taxes, and that they are free to make their own decisions.

The federal government is forgetting that there is a limit to taking money from taxpayers' pockets and that these tax grabs can have serious consequences, including moonlighting, smuggling, loss of competitiveness, taxpayer revolt and widespread disillusionment.

Liberals argue that provincial revenues exceed federal revenues. That is not particularly helpful to the debate, because it does not reflect what is needed. The federal government needs more money to finance old age pensions, native programs, technological research and development and security measures. But that accounts for only a fraction of what the provinces need.

It is very plain to see that the provinces expect to become less able to deal with their growing expenses, in part because of the dramatic increase in health costs. They demand that the federal government increase its contribution to health care funding, and rightly so.

Let us review some of the conclusions found in the Conference Board study on which the report of the Séguin Commission on fiscal imbalance is based.

Provinces are faced with a dramatic increase in health costs. These currently stand at $72 billion, but should reach close to $167 billion by 2020. Health costs are the fastest growing expenditure item for both the federal and the provincial governments. In 18 years, they will represent over 45% of all provincial revenues.

Of all the provincial sources of revenue, the one that has increased most slowly is the federal transfer payments, which have gone from $35 billion to $59 billion. Over the next 18 years, provincial health expenditures will rise nearly two times faster than all federal transfer payments, including equalization payments.

I will repeat that, so that everyone gets it: Over the next 18 years, provincial health expenditures will rise nearly two times faster than all federal transfer payments, including equalization payments.

The increase in expenditures for education will slow down because of our greying population. Education absorbs 22% of provincial revenues, and by 2020 this will be down to 19%. This is indeed a reality, but it will not be sufficient to compensate for the explosion in health costs.

What will the future of the provinces look like? Under these circumstances, they will have no choice but to sink back into deficits and debt. When the Bloc Quebecois had an opportunity to address fiscal imbalance in an opposition day last March, not one member of the party over there rose to speak, not even those primarily concerned, namely the ministers of intergovernmental affairs and of finance.

This is in strong contrast to their attitude outside this House, where they agree to provide the press with brief responses. If they cannot come up with an answer, one or the other of them will settle for the answer that fiscal imbalance is a conspiracy of the political pundits.

The Bloc Quebecois is, therefore, the only party capable of defending the interests of Quebeckers.

Health Care SystemGovernment Orders

6:15 p.m.

Bloc

Diane Bourgeois Bloc Terrebonne—Blainville, QC

Mr. Speaker, today we have been treated to a true plea in favour of Canada's health care system.

I now have the opportunity for a few minutes to condemn what is going on in the House. We have wasted time on a meaningless and empty motion, as my colleague said. I do not know how much it costs the House to talk into a void for a day on a motion that asks that we take note that discussions are currently taking place. We are all able to read the papers and everyone knows that discussions are underway.

I do not know how much this type of day has cost. What I do know is that community organizations, organizations that work in the area of mental health for women and organizations that help families, are having trouble making ends meet and they would not want us to spend money in an alleged attempt to control the problems in health care. They would not want us to spend money on empty talk about motions that do not mean anything.

Today, I read a document from Carrefour familial des moulins. This organization is involved, among other things, in providing respite care to women who have had difficult deliveries. It also provides young women aged 13, 14, 15, 16 years and older with eggs, milk, orange juice and the like. These are single mothers who did not marry and are in school. Carrefour familial helps women with several children by providing classes on food preparation, teaching them to help themselves out of poverty.

Carrefour familial describes its precarious financial situation and asks “When will something be done to help us?”

Today, all the discussions I have heard dealt only with immediate care. I heard nothing about prevention. Nothing either about the overall health of women. Looking after the health of women, children and families requires being able to take an overall look at what is causing the health problems.

The problem with this government is that it does not have any global vision of how to address health problems. The World March of Women asked “Where are the federal Liberal MPs, the government MPs, from Quebec?”

I must not be the only member to have starving community groups in her riding. I must not be the only one to receive requests from women's groups, shelters, family centres, early childhood centres. Where are these federal Liberal MPs from Quebec? They are keeping quiet right now. They are not asking for money for the people in their ridings.

Where are the federal Liberal MPs from outside Quebec who have French-speaking communities in their ridings? These communities came to my office telling me they did not have access to health care in French, nor to psychosocial services.

Thank you, Mr. Speaker, for allowing me to at least describe one situation, and to vent, because this is infuriating today.

Health Care SystemGovernment Orders

6:20 p.m.

Bloc

Pauline Picard Bloc Drummond, QC

Mr. Speaker, I thank my colleague for her comments. She has talked about points that have not been raised today. We are not talking about prevention, because we are debating a motion the meaning of which is hard to figure out.

This is ridiculous. It would have been much more interesting to have had a motion inviting a debate on precisely the points my colleague just raised.

Why did the government move this motion? I think it is not very clever. It did not have to look very far to come up with such a meaningless motion, which says that there is an on-going public discussion of the health care system.

The health care system has been talked about for years. We have been talking about it since cuts were made in the Canadian social transfer. Ever since, provincial governments have set up commissions to assess the needs and priorities of their citizens. In Quebec, the Clair commission did a fine job.

Why did the government appoint commissions such as the Romanow commission or have the Kirby committee produce a report? Today, all of a sudden, we are reminded that it might be a good idea to discuss the situation of our health care system in the House. Clearly, the government cannot fool the public all the time. What is going on here does not make sense. We saw it during oral question period. This is unprecedented.

Everyone was flabbergasted. If this goes on, we should stop our proceedings and adjourn, because it is ridiculous. It is beyond comprehension. In order to move motions such as this one, the government must really think that we cannot sit in this House. They tried to pull a fast one on us to be able to keep going next week, because seemingly there is not much on the legislative agenda.

This is really not serious. If the government had been serious, it would have used some of the money available, some of the surpluses that the Minister of Finance will announce. This is no secret. We know what the minister will announce on Wednesday in his economic statement. Everyone knows.

Indeed, everyone knows that there is an $8.9 billion surplus. If the government had been serious, it would have said, “We are having a debate because part of this surplus must be given back to the provinces to help deliver health services to the public”. It was agreed long ago that health care would be accessible to everyone, under the five basic principles governing health care services.

Now, there is a need for money. This is normal. Everyone agrees on the reasons why the provinces need money. As I said earlier, it is because of the aging population, because of the cost of drugs, because of the new technologies and because of research.

It is easy to understand. Why does the federal government stubbornly refuse to give the money back to the provinces, when their needs are so urgent?

Health Care SystemGovernment Orders

6:25 p.m.

Liberal

Murray Calder Liberal Dufferin—Peel—Wellington—Grey, ON

Mr. Speaker, I have been listening to this debate with a lot of interest. The member across the way raises an important point which is key to what we will have to discuss here because eventually the debate will get down to the dollars.

As the chair of national rural caucus, our caucus has been debating the health issue in rural Canada at great lengths. We know first off that by 2024, 25% of the population will be 65 and older. It will start using the health care system much more than it has in the past. We know that a large number of people who are now in urban centres will retire back to where they originally came from, which was rural Canada. That will put a lot of stress on the health care system in rural Canada.

We must look at the funding aspect, which is accountability. We currently transfer money to the provinces through the Canada health and social transfers. Tax points and equalization payments are transferred to the provinces for direct health spending. When we take all that into consideration that is nearly 40%. Yet the provinces say that we only transfer 14%. If we are to have accountability, there has to be a transparent accounting system so we can see how much the federal government is putting into health care and how much the provinces are spending on health care. Currently that does not exist. Statements like this would not stand. We must come up with a better accounting system.

Baby boomers make up a huge part of our population, of which I am a part. Approximately 9.8 million of us were born between 1946 and 1966. That is a third of Canada's population. We are aging right now, turning 50, at the rate of 50,000 a year. We can see how this will translate.

I would hope that when the Romanow and the Senate report come out they will directly look at how we work with the provinces and the accounting system for the money that is being transferred from the federal government to the provinces. Last year we saw some high tech money that was supposed to be put into MRIs and CAT scans spent by some of the hospitals on low tech equipment like lawnmowers. I am a Kinsman, a life member of a service club. If hospitals were looking to buy low tech equipment for which the federal government has allotted high tech dollars, they should go to their local service clubs in the community and get the money that way.

I want to stress the fact that we must have a good accounting system. The federal government and the provincial governments must get together and negotiate how the accounting system will work or we will constantly be in the same trouble we are in right now. When we get into the shortage of doctors in rural Canada, we can look at things like telemedicine and nurse practitioners.

Health Care SystemGovernment Orders

6:25 p.m.

The Deputy Speaker

It being 6:30 p.m., the House stands adjourned until tomorrow at 10 a.m. pursuant to Standing Order 24.

(The House adjourned at 6:30 p.m.)