Mr. Chairman, that is an interesting question because originally when we looked at the Canada Health Act, which was going to pay for physicians and hospital services, it was not only primary care, it was also for secondary and tertiary care, whatever care was needed in a hospital setting.
As many people said in the House, that has changed. We need to now look at the Canada Health Act differently. If the Canada Health Act is the instrument that will serve whatever it is we wish to do with our medicare system, our health sustainability and broader areas, we will have to talk about what we mean by delivery of care. Where is the care delivered? We are not only going to talk about hospitals. These are questions we need to ask.
Should the Canada Health Act therefore look at home care, long term care, palliative care and community care? If so, how would the provinces come on side and collaborate with the federal government so that we could enter that domain? If we do enter that domain and decide that we would like to fund those areas, which right now are not in our jurisdiction, then that would be an excellent idea. However the question then would be, what things would we have to do in terms of the accountability? The member asked about that. What would be required of the provinces? What would be required of that new funding? Then we would have to talk about how we would judge outcomes, how we would look at national standards for home care, long term care, palliative care and community care?
When I talk to Canadians, they do not particularly care who pays and what level of government is responsible for what. They just want to know that when they are sick or their families are ill that they can go wherever they are and get the quality care they need.
The time has come for us to make the federation work, to really talk about Canadians as people who need their levels of government to come together. It is time we talk about how we open up the Canada Health Act and look at ways in which we can redefine where we deliver that care? Who are the people who will deliver that care because it will not only be physicians? Who are these people? How will we move in and collaborate in some of these areas? How do we define what is medically necessary? We need to use an evidence base to do that and not arbitrary measures like age, where people live or any such thing. What are the evidence base guidelines that we know would dictate necessary care?
We need to talk about those kinds of things when we talk about the Canada Health Act. Obviously we have to look at the Canada Health Act in a completely new way and see it as a tool to define where we want to go. However we have to decide where we want to go and how we want to do that, then let the Canada Health Act serve as the legislative tool for helping us to deliver the system we want.