Mr. Speaker, today we are debating a very strange motion.
I do not know how to say weird in French, but what we have here is a motion in which the Bloc finds itself in strange alliance with both the government and the Alliance. It has given the Liberals far too much credit by suggesting that the Liberals have a national vision of health care which they want to impose on the rest of the country--and here is where it gets really strange--through the preliminary report of the Romanow commission.
I have not read it from cover to cover but it seems to me what I remember of the Romanow commission report was that it laid out a bunch of options for dealing with the problems in health care. How laying out options can be construed as imposing a particular vision on the provinces is strange to me.
The other aspect of the strange situation I think the Bloc members find themselves in is that the Alliance supports their motion. It would seem to me that the Alliance vision of health care is a far cry from the more social democratic view of how health care should be provided that we find in Quebec and which presumably the Bloc in some way or another supports.
If I were the Bloc mover of the motion, I would go back to the drawing board and ask myself how it is that I could have devised a motion which gave so much credit to the Liberals and which drew so much support from the Alliance. However, enough of that.
Today we have the opportunity to debate future health care in this country. There are a few things I would like to say; in fact, there are many things I would like to say but I will not have time for them all.
The fundamental thing that is being overlooked by the government is its own culpability in terms of not living up to the commitment the federal government made at the time of the establishment of medicare. It was federal money that was the midwife, that gave birth to medicare in Canada. It was the federal spending power which said to various provinces, even those that were ideologically reluctant, that it would offer the spending of 50 cent dollars on health care if they would agree to become part of the national medicare system.
It is those 50 cent dollars that are absent today. It is the absence of those 50 cent dollars that gives the provinces, even those which are lacking in any other moral high ground, a certain kind of fiscal high ground when they are talking to the federal government about health care. I am thinking in particular of Alberta. It has a point, as do all the other provinces, about federal dilution of its commitment to cost sharing health care.
I find it passing strange, and it points to the ideological dimension of this debate, that it is the province of Alberta which claims that it is under such pressure that it has to experiment and innovate even before the Romanow commission reports. Is it just a coincidence that all the experimenting and the innovation points toward the corporate sector and the private sector being more involved in health care? Why is it that Alberta feels so much pressure? Alberta does not even have a sales tax. Alberta has oil. Alberta has 100 different reasons that it does not have to feel the kind of pressure it claims to feel.
Poorer provinces like Manitoba, Saskatchewan and the maritime provinces are the ones that are under pressure. However because they are more committed ideologically than Alberta is to the principles of medicare, and appropriately so because so are the Canadian people, they are trying to make do with what they have.
It is the height of hypocrisy for Alberta to say “We are under pressure. We have to involve the private sector. We have to have more private clinics. We have to have more patient participation. We have to have this; we have to have that”. The fact is Alberta is the province most capable of sustaining the cost of health care in the province and it is unwilling to do so.
The Alberta government's real agenda is not fairness between the federal government and the provincial government, or having the federal government live up to its commitment that was established at the beginning of medicare, or anything like that.
Its real agenda is ideological. In the end it wants to turn over the health care system to the private sector so it can become another place where people make money, so that health care can become a commodity like oil. That is what is really going on here. That is totally contrary to the principles of medicare.
That is exactly what the people who fought for medicare in this country were against; the commodification of health care, the reduction of the provision of health care to a commodity in the marketplace like any other commodity. I believe that is the underlying agenda of Premier Klein and others like him.
However the problem is that they will not just do that in Alberta. If they succeed in doing it in Alberta, given the nature of the North American Free Trade Agreement and given the possible nature of the general agreement on trades and services that is being negotiated now at the WTO, it may well be that they could set precedents for private sector involvement in health care that will be binding on all other provinces.
What gives Alberta the right to do this to the rest of the country? We heard the former leader of the Alliance Party, the ghost of Alliance past and perhaps maybe the ghost of Alliance future, we do not know we will find out in March or April, talking about the horrible federal government imposing national standards on provinces. Yet he does not seem to be offended at all by the notion that by acting alone and by involving the corporate sector, particularly if that corporate sector comes to be American owned and therefore would have rights under chapter 11 of the NAFTA, Alberta might, by doing what I have just described, be imposing a burden on the rest of the country. That does not bother him at all.
I find it much more morally and politically offensive that Alberta should decide on its own to walk through this trade related minefield and at some point might step on something that will blow up not just in the face of Alberta, but in the face of the whole country.
I share the view, only I wish the federal government would express it more strongly, that at the very least the provinces, and in particular Alberta, should wait until the report of the Romanow commission before acting. Let us see what Mr. Romanow has to say before going any further. But one thing that has to be preserved, Romanow commission or not, is the basic principle at the heart of the Canada Health Act. That is, any kind of patient participation at the moment when someone is sick and in need of treatment is unacceptable.
Before the Canada Health Act, we had the Medical Care Act which laid out the five principles. Sometimes when we listen to the debate we think that the five principles of medicare were only established with the Canada Health Act. They go back further than that. What the Canada Health Act did was establish two new things. The practice of extra billing by physicians and the charging of user fees by provincial health care systems would be practices that would be sanctioned by the federal government by virtue of withdrawing from federal transfer payments to provinces the equivalent of what was being charged to patients in those provinces through the imposition of user fees or extra billing by physicians.
What is unacceptable about these two things is that it is a form of patient participation; that is when a person is sick the doctor has to be paid or a user fee has to be paid. One of the things that jumps off the page at me, and which the former leader of the Alliance seemed to be recommending, is these individual medical accounts where people have so much that they can spend and beyond that they might have to spend some more of their own money. That is a form of patient participation when someone is sick. That is a form of having to pay because one is sick. That cannot be advocated and at the same time say what the former leader of the Alliance said when he said he was against having any financial barriers to being treated. That is a contradiction. Both of those things cannot be done.
Whatever comes out of this debate, the notion that there should not be any form of patient participation on the basis of sickness or disease or need of treatment is the thing that has to be preserved if the principles of the Canada Health Act are to be preserved.