Mr. Chairman, we are here today to focus on the work of the commission on the future of health care in Canada, arguably the most important national discussion about the character of our nation since the last constitutional debate. No issue is more universal than life and death. The work of the commission will impact on the life of every Canadian. It is very appropriate, therefore, that we address the commission's work in this place.
When the commission was announced a little more than a year ago, the reaction of many Canadians was why. Why just four years after spending $10 million on the National Forum on Health would the government embark on yet another study? Why would it not act on what it already knew?
Some speculated that the government did not get the pro-corporate answers it wanted from the national forum and would keep spawning studies until it did. Others pegged it as the all too typical Liberal misuse of a royal commission to take the heat off a government on a controversial issue: its appalling record on health care.
Most Canadians, desperate for some action to save their health care system, quickly set aside their cynicism and embraced the Romanow commission with their hopes for getting medicare back on track. The degree to which Canadians are pinning their hopes on the commission has become apparent as the work has progressed. Commissioner Romanow has even expressed concern at being able to live up to the high expectations being placed on him to solve our current problems.
The intense pressure is not just on Mr. Romanow and the commission. It is shared by all of us as members of parliament. Canadians are watching closely to see what measures will be taken by the government to act on the commission's recommendations once the final report has been tabled.
This is a test not only of Commissioner Romanow but of our entire parliamentary system as the vehicle to respond to the vital needs and concerns of Canadians. The debate around the future of health care has become a microcosm for the debate over the relevance and capacity of our parliamentary institutions.
Why is this commission so important to so many Canadians? Why have thousands of people invested the time and effort to respond to the commission's questionnaire, to write or call the commission with comments, to submit briefs, to come out to public hearings and follow the issue debates in the media? We know that Canadians value their public health care system. That is not even disputed by those who would like to drastically change it.
We know that some people have been affected more than others by successes and shortcomings of the system and want to advocate for improvements in specific areas but it is more than that. Canadians understand that what is taking place around the Romanow commission is an epic struggle for power, for control.
At play are two distinct views on the nature of health care and the nature of government. One side sees health care as so fundamental to our well-being that it deserves unique status outside the play of market forces where decisions are health based alone. The other side views health care as a commodity similar to other service industries.
It is a struggle as well between two opposing views on the role of government in health care. One sees government as an accountable active agent for the public interest. The other sees government as a facilitator and partner in the development of private corporate interests.
The position of the New Democratic Party in this titanic struggle is clear. Our vision is grounded in an approach based on need not on ability to pay. It is reflected in the five principles of the Canada Health Act. It involves the collaboration of all levels of government anchored on stable and adequate funding. It looks beyond treatment to the economic and social conditions that contribute to ill health. It demands government independence in assessing health protection needs. It is a vision unequivocal in its support for a public non-profit health system.
New Democrats see a positive future for public health care. We believe it can be realized through increased public funding, yes, but also more efficient, co-ordinated and comprehensive approaches that include drug costs and home care, a more appropriate use of health professionals, greater public access to the benefits of research and health information and a proactive approach to preventing illness by investing in the social determinates of health.
This requires a strong leadership role for the federal government in rallying the collaboration of all levels of government. This is a vision that my colleagues in the NDP have fought so long and hard for in the past. It is a very different vision from positions held by other political parties. We have had some of that debate already tonight
I am sure the Minister of Health is paying attention. The Liberal Party vision is in our view a hologram of health. It depends how or when it is looked at. Election campaigns produce promises of home care programs, national pharmacare programs, drug patent reform and going to the barricades in the defence of public health care. However when it forms the government, that vision is replaced by a starkly different reality of underfunding and inaction.
I have already touched on the confusion and concerns we have with respect to the Alliance position. I do not need to elaborate any more. I am sure the member will have questions for me at the end of my speech.
As Commissioner Romanow has said, this is a time for choices about competing values. Thankfully Mr. Romanow, unlike his corporate shadow from that other place, Senator Kirby, has adopted an evidence based approach to his work. That is good news for Canadians.
For example, let us look at the claim that the health care system is in crisis. New Democrats, along with many Canadians, challenge this cornerstone of the case for more for profit care repeated by corporate promoters. When we look at the evidence, the so-called crisis vanishes like a mirage. The Romanow commission heard from Dr. Wally Temple of the University of Calgary who has said that although the Alberta government has been shouting crisis, total per person health costs in Alberta over the past 20 years have barely kept pace with inflation. Public health spending actually dropped by 33%.
The Parkland Institute told Romanow that the crisis claim, repeated in the Mazankowski report, was “based upon some of the shoddiest use of statistics and some of the most flagrant misrepresentation of data ever foisted upon a commission”. Public health spending as a percentage of gross domestic product was virtually the same in 2000 as it was in 1989.
The claims that for profit care is cheaper and better than public care do not fare any better under public scrutiny. Evidence brought before the commission overwhelmingly concluded that the claim that for profit care was a way of saving health dollars was bogus.
Looking to the American system for evidence, the prestigious New England Journal of Medicine concluded that “No peer-review study has found that for profit hospitals are less expensive. For profit hospitals cost more to operate, charge higher prices, spend far more in administration and often provide poorer services than non-profit and public hospitals”. No sound evidence has been presented to prove that for profit care, whether in hospitals or other areas of health care, can deliver care cheaper than non-profit.
Neither is there evidence to back up the myth that private care is better care. It is just the opposite. A major study out of McMaster University last month showed that patients were more likely to die in U.S. private for profit hospitals than in not for profit hospitals. Similarly, studies of U.S. for profit nursing homes and kidney dialysis facilities show a poorer quality of care in relation to comparable non-profit facilities.
Those are my comments on some of the bogus arguments that are presented to the public and have to be dealt with by Romanow.
What the commission has received at the hearings has been the heartfelt testimony of hundreds of Canadians about their experience and the values they want to see reflected in its recommendations. Whether young people like grade eight students, Kyla Weinman and Laura Wilson, or the several seniors and pensioners associations, Canadians of all ages continue to present the commission with an extraordinary wealth of experience and expertise to consider.
Many innovative suggestions have been made for improving the public health system, ideas like a national health council to improve accountability as suggested by the Canadian Labour Congress and others. The Canadian Medical Association has suggested a health charter and a health care covenant has been suggested by the Canadian Council of Churches.
As well as innovation, there has been widespread agreement in traditional areas of concern to New Democrats: a national drug program, a national home care program, a national health human resources strategy, multi-professional teams and a concerted effort to address the economic and social conditions that undermine health.
New Democrats have also continued to call for a priority attention to first nations health, an area of exclusive federal jurisdiction.
Let me conclude by saying in the days ahead we urge that those who have not yet taken advantage of this unique opportunity to contact the commission to express their views. We know that they and the countless others who have been following the commission's work will be anxiously awaiting the final report in November and the government strategy to act on its recommendations. It will be an unfortunate day for public health care and for Canadian politics if this tremendous project of hope and commitment has been for naught.