Mr. Chairman, I am particularly interested in the reorganization. I think that from the Fyke commission on down, there is a view that if we actually could get an integrated, coherent system there probably would be a 30% saving in the system. I do not think there is a patient in Canada who has not had to have a test repeated because no one can find the results when the patient shows up for appointments. I believe that if we could make a primary investment in an information technology that would get us a real system, we could begin to think about what else might be necessary.
My primary goal is to develop a real system that is a reorganized, coherent, integrated, accountable and transparent system. I think that in order to get there we will need an infusion of money, particularly around the accountability and information technology framework. We have excellent evidence that user fees do not work. They are like some zombie that keeps coming back like a bad video game. People just continue to want to talk about them. As a physician I found it appalling that time and time again I would have to ask people what they could or could not afford. If I had wanted to talk about money all day I would have been an accountant.
It is extremely important to note the administration fee of trying to collect user fees, but also, user fees, in terms of asking for that extra, private part, are indeed a deterrent to the most vulnerable Canadians, like the fragile diabetic and the pregnant teenager. They are the people who do not seek help because of user fees and they are the people who will cost us buckets of money when they end up in an intensive care unit or the baby ends up in a neonatal intensive care unit.
I do not think there should be more private care in that sort of user fee way, but I do think that there are things in that model of core services, copayments or whatever, for which we have evidence that they do not work any more, that we should not be paying for out of the public purse.
I think that is a conversation to have with citizens: How we can get some of things that are core services now back out again? These are things such as the eighth ultrasound in a pregnancy to find out what the sex of the child is or cholesterol testing every three months because someone is obsessed by it when the person has had three normal cholesterol tests and the evidence shows the cholesterol only needs to be tested every couple of years. There are some things that can come out and if people really want them they can pay for them, but I also think this is a conversation that citizens are perfectly capable of having and we should not be making any of those decisions without them at the table.