Mr. Speaker, I rise today to speak in favour of the Bloc Quebecois supply day motion on health care.
I am pleased to rise today in the House to support the motion on health that was moved by the Bloc Quebecois.
The motion puts the problem precisely right. The Liberal government has withdrawn its support from Canada's health care system. It has hacked and slashed support levels for health care through the transfer payments but, at the same time, has continued to invade and erode provincial jurisdiction over health care services. Most recently it has told the provinces, which are facing a health care crisis due to the federal funding cuts, that they must wait until the federal Romanow commission files its report before beginning vital health care reforms. In other words, the Liberals no longer pay the piper but they still want to call the tune.
As a former finance minister, each time I tabled a budget I warned of the increasing percentage of the budget that was being consumed by health care costs. This is true right across the country. It should not be a surprise to us that this happens because the system itself defies the most basic laws of supply and demand. A quality product and a quality service is being provided at no apparent cost to the consumer. Unchecked the costs can only continue to rise.
I want to address the areas of funding and jurisdiction as both increased and stable federal financing for health care and allowing innovation and flexibility within the provincial systems. These are two of the necessary remedies for the system's current maladies that they face.
To make the problem worse, between 1995 and 2000 the government ripped some $25 billion out of the health care system compared to previous transfer levels. Even with the agreement reached right on the eve of the last election, which was interesting in terms of the timing, health care funding in nominal, non-inflation adjusted dollars is still not what it was seven years ago.
In the meantime, health costs keep rising. While federal transfers were slashed, the provinces tried to manage a health care system for an older population and a system requiring new technologies and increasingly expensive medication.
Liberals now tell us that the health care cuts of the mid-1990s were a necessary evil to reduce the threat of a deficit. What they did not tell us was how they went about reducing that deficit. More than half of the deficit pay down was done through raising taxes. That is a no-brainer. Of the spending cuts that were implemented, the federal government cut health care spending six times as much as it cut its own federal programs. Its pet political programs were left largely untouched while health care was ravaged. Even now the federal government has not clearly restored the status quo. Federal funding for health care as a percentage of health care spending is at its lowest level ever, around 14%.
In the last election the Canadian Alliance acknowledged the need for secure health care funding for the provinces. We committed that we would have increased health care funding back to these 1994-95 levels. We committed ourselves to adding a sixth principle to the Canada Health Act, stability of funding by statute. That would give the provinces the stability they need to plan for the future.
In a letter to the Prime Minister and the premiers, I also suggested that federal funding in the longer term could move away from the current system of cash transfers toward a greater use of tax points, especially to those provinces that wanted to and were willing to pursue that. That would be a situation where the federal government would agree to lower its taxes to give the provinces room to increase theirs where they wanted to but with no net tax increase to their citizens.
These tax points, which could be equalized so that they would benefit poorer provinces as much as richer ones, would increase in value as the economy grows. Moving to tax points would have a built in growth factor in funding over time as opposed to provinces continuing to come back every year or two to beg the federal government for more funding.
The main Liberal objection to that idea is that the federal government would lose its stick, its threat of penalizing provinces by cutting their transfers. That attitude, which was expressed by the Prime Minister and the then minister of health, was an expression of contempt for the provinces.
The Liberals seem to believe that only they can protect medicare. They believe that the provinces, whose representatives are democratically elected by the same people who elect representatives of the federal government, somehow do not care about the health care of its citizens. That is absurd.
Liberals believe the provinces, which have the day to day experience of running hospitals, clinics and health boards as opposed to just carping from the sidelines as the federal Liberals do, somehow do not know enough about health care to manage their own systems. This is what the federal government suggests. It says that only the threat of father knows best Ottawa of cutting off the provinces' allowance can be trusted to keep provinces and their citizens in line. That attitude is absurd but it is widely shared by federal Liberals.
Unfortunately, I think it goes a long way to explaining why federal Liberals have never sat down and negotiated a dispute settlement mechanism for health care as they promised in the social union accord which was reached in 1999. They still have not fulfilled that promise.
I was part of the negotiations which led to the social union agreement as Alberta's social services minister and later finance minister. I know how much the provinces were relying on an impartial dispute settlement mechanism that would set the parameters within which the provinces could innovate in health care and in other social services. Unfortunately, the federal Liberals liked being the judge, the jury and the executioner over the provinces. They like that role too much to allow a joint federal-provincial body or some other kind of acceptable impartial panel to judge the provinces' adherence to the Canada Health Act.
The federal government must let go of this stubborn behaviour and finally allow the provinces more flexibility when it comes to renewal of the health system.
If provinces want to experiment with greater use of private clinics, including overnight stays or hospitals built and managed by public-private partnerships, or medical savings accounts which promote individual accountability for health care costs, then the federal government should allow that innovation to proceed. Instead we see a government which ran attack ads against a provincial initiative in the last election campaign. An attempt to even introduce modest health care reforms was attacked by the federal Liberals.
The provinces must have the flexibility to innovate within the framework of a publicly funded universal health insurance system. As long as no one is denied necessary services because of ability to pay there should be no ideological barriers to the provision of health care services. Patients do not care whether their wounds are being dressed with a private or public sector bandage, as long as they get the care that is there when they need it and without financial barriers. These waiting lists continue to grow and the demand for services increases exponentially. All the minister can counsel is more waiting.
Two years ago the previous minister of health stated:
Now I started by saying that the status quo is not an option. We have to change, we have to improve Medicare....On many of these practical issues we've had enough studies, we've had enough reports, we've had enough commissions. We're now at the stage where by working together we can move from recommendation to action.
Bold words indeed. What did the government do after the election? It appointed another commission and asked the provinces to stick to the status quo for a few more years.
The provinces cannot wait, should not wait and will not wait. They will go their own way following the recommendations of the Fyke commission in Saskatchewan, the Clair commission in Quebec and the Mazankowski commission in Alberta. These commissions recommended positive steps for reform and now it is time to implement them.
I met with doctors and nurses in a hospital in my constituency in Penticton, I met with health care advisers in Merritt, and I talked to residents of Summerland who are at risk of losing their hospital services. People are losing supplementary services and it is clear we cannot wait. Rather than standing in the way, the federal government should encourage provinces to innovate.
I urge the minister and Mr. Romanow to dedicate their reforming zeal to achieve these two goals: more stable funding, including the approach of tax points for provinces; and a dispute settlement mechanism, an impartial body respected by the provinces, which can lay down clear parameters to both levels of government. Individual provinces should be allowed to reform their own health care services.
The supply day motion is useful to remind the government to fulfill its end of the health care bargain before it begins telling underfunded, overburdened provinces how they should do their job. It instructs the government on its responsibility both to ensure stable funding and to allow the provinces the flexibility they need to reform the system. This is the way we can move ahead and we challenge the government to move in this direction.