Mr. Speaker, I rise today to speak against the motion brought forward by the member from the Bloc Quebecois. In order to speak against the motion I want to give a thumbnail history of how cost sharing began.
In 1961, 10 provinces and 2 territories signed an agreement with the federal government for cost sharing for in-patient services in hospitals only. In 1962 they agreed to extend that cost sharing to physicians. Money was directed clearly at specific health care spending.
In 1968 medicare was enacted and between 1968 and 1972 all of the provinces and territories finally agreed to come in and participate in probably the largest social program that Canada has ever known.
In 1984 the Canada Health Act was enacted to enshrine five fundamental principles, and everyone agreed how the money was going to be transferred and how the funds were going to be shared. It was to ensure that the greatest social program that Canada has ever known was paid for with both federal dollars and that the provinces had a role to play.
There was an agreement then. All the provinces, that today are crying out for money to be given to them without any strings attached, were in agreement back then. There is a precedent and history that since 1961 there was a clear agreement that there would be cost sharing and that money would be transferred for hospital and physician services, and medicare extended it even further, into dental care. That is the crux of what medicare was about.
When Roy Romanow went around the country he went not merely as someone who had been there from the beginning but he went also as a premier of a province. This was a man who understood the issues from a provincial perspective. He understood the problems facing medicare. He understood and supported medicare. He heard from Canadians that medicare was a fundamental value to them. They said it was probably the social program that they most believed in. They believed in the five principles of medicare but they wanted a sixth one attached, namely, accountability. We must avoid the chicken and egg game that we keep playing between provinces and the federal government, where one does not do one thing and the other does not do another.
Mr. Speaker, I am here to tell you that as a physician who practised medicine for 23 years, and as an MP for the last nine, I have consistently heard the same story from patients and from constituents across the country. They do not want to hear this squabbling anymore. The same dollar that we are all fighting over is the dollar that came out of their pockets. They were prepared to put that dollar into their tax spending in order to support a social program called medicare. They believed in it in1961 and they believe in it now. If we read the Romanow report Canadians said that, only if necessary, they were prepared to take more tax dollars out of their pockets provided it was to support nothing else but medicare.
I find the motion to be very droll. If we look at medicare there are three groups involved: the public; the people who provide the care, physicians, nurses, physiotherapists et cetera; and the governments. We have heared from two of those three groups. From Mr. Romanow's report it is clear that the public wants to have accountability in terms of fiscal funding for medicare.
We heared from the Canadian Medical Association in its post-Romanow comments and in its pre-Romanow submission. It said that Canadians had a right to know how much of their federal tax dollar was being transferred to provincial and territorial governments to support medicare.
It is the least that Canadians can expect from their governments in terms of accountability. It serves to underscore the fact that the underlying purpose of fiscal federalism is to support medicare and other important social programs and not the reverse.
This is why the motion we are debating today is not only droll but it is also ironic. I have yet to hear Bloc Quebecois members, who are speaking perhaps on behalf of their province and all of the provinces that today do not wish to have strings attached to the fiscal funding, comment when they are given money under fiscal federalism. They love fiscal federalism. They want more and more money to be transferred in fiscal federalism but they do not believe in one of the primary things that Canadians are seeking in their governments and that is accountability for the taxpayers' dollar. I find this to be sort of talking out of both sides of our mouth.
In order to deliver medicare in New Brunswick, British Columbians, Albertans, Quebeckers, and Ontarians are putting tax dollars into that transfer. The federal government gets its money from Canadians across this country and transfers it to provinces so that every province that gets a transfer of payments for health care gets it out of the pockets of every Canadian regardless of what province they live in.
This is something that I find remarkable, that provincial governments do not understand that they are dependent on the money they are asking for from every province. It cannot be decided on solely by each individual province. There has to be some accountability. People want to know that the money is clearly going to support medicare.
We have seen that there is a need for this accountability over and over again. When $800 million was transferred for primary care innovation, every province took the money. Many of them did not spend it on that. When we transferred into the 2000 budget $1 billion for spending on equipment, we saw lawnmowers bought with that money. Governments like the Quebec government had money that was transferred to it for medicare sitting in some sort of trust fund and was not being used.
Canadians are fed up with this nonsense. It is their tax dollar that is sitting in a trust fund somewhere not being spent. It is their tax dollar that they gave to medicare that was buying a lawnmower somewhere. It is their tax dollar that is building a road somewhere with no one accounting for that money. Canadians have said that they value medicare. They would like, when they are ill, to be treated equally regardless of where in this great country they live or what their pocketbook can afford. This is inherent in the concept of medicare.
Many provinces are already skirting with the five principles of medicare. When I practised medicine, for example, and I had patients come to my office from Quebec, I knew that I would not get paid for the service which I was supposed to under the portability requirements in medicare. I knew that patients would have to take money out of their pocket, pay me and be reimbursed later. However, they would never be reimbursed the money they paid. They would only get what the Quebec government chose to give them.
This is not acceptable to Canadians because that money does not come out of one province. The transfer from the federal government comes from every Canadian regardless of where they live. Canadians want that money to be spent in a manner that tells people that they understand that the money comes from every Canadian regardless of where they live and should be spent on health care.
There are some fundamental issues here. Inherent in fiscal federalism is this idea and sense that there is an entitlement by provinces to get money. The provinces have played fast and loose with this money. The concept of tax points came out of the provinces historically. I would like to go over it even though many members of the House do understand it.
The concept of tax points is where the federal government agreed not to raise taxes so that the provinces could raise the equivalent amount in taxes to fund their programs or their share of programs. That was the agreement. Today, the same provinces ignore those tax points. They love to say that they have cut taxes for people. This is not so. This is playing fast and loose. This is a shell game. This is what makes Canadians so cynical, this kind of game that we play with money and pretend that it does not happen. Those tax points are inherently a part of the federal contribution. When we say we only give 14ยข, people are not counting the tax points.
The same provinces also accept equalization payments very happily. It is based on the fact that have provinces contributed money in order that have not provinces could be able to have a level playing field, so that they could produce medicare and valued social programs at the same level across the country because they did not have the wherewithal and thus required an equalization transfer. Those are things that the provinces never count. That is again hypocritical to say the least, and I am trying to use a kind word here.
When we play these games with money, we are playing games with taxpayers' money. This is not my money. The federal government does not take money out of a tree, it comes out of taxpayers' pockets. It is taxpayers in their own good will in British Columbia agreeing to transfer money to Quebec, and people in Quebec agreeing to transfer money to Ontario, and people in Ontario agreeing that their taxpayers dollars will be transferred to help New Brunswick. This is how it works. This is what fiscal federalism is about.
When Canadians agree to pay tax dollars they put a value on how they want that money spent and where they want to see that money go. Mr. Romanow did not produce Roy Romanow's report. Mr. Romanow spoke with the voice of Canadians. He echoed what he heard.
I am not Roy Romanow but I hear the same things wherever I go. People are saying they do not particularly care what the provinces and federal government want to do, they just want to ensure that medicare, which is important to them, is there when they are sick.
A wag once said that medicare was too important to leave to politicians. I would like to prove that wrong. I would like to prove that federal and provincial politicians can come together in a spirit of cooperation and an understanding of what Canadians need, and get together and deliver on medicare.