Mr. Speaker, I have been a member of Parliament for about 10 years and I, nor other members of Parliament, have never seen one budget handle every matter that Canadians felt was a priority.
I see the chair of the finance committee is here. He has been involved on that committee for a number of years, and I was for about four or five year. The committee went across Canada talking to Canadians about their priorities. It prepared reports and made recommendations. The total wish list of all the groups that made presentations to the finance committee usually turned out to be tens of billions of dollars more than what was available to spend without putting us back into deficit.
This is the seventh consecutive balanced budget, and Canadians would not find it acceptable to go back into a deficit scenario. That means choices have to be made. Every budget cannot continue to address every item. If everything is done modestly, then nothing is done well. Certain things are priorities and decisions have to be taken.
I am quite pleased with this budget because it brings us back to some of the principles that have held Canada in good stead for the last 10 years to get our fiscal house in order.
This budget has four main themes: investing in our public health, learning, research and development and a new deal for our communities. There are a number of other areas, but I want to touch on a couple of these.
With regard to public health, members know about the additional $2 billion that will be given to the provinces. That was agreed upon with the provinces. It is another installment. We cannot look at the budget in isolation. We have to look at what has happened in health care over the series of budgets in which we have renewed the investment in our health care system. The increased investment in our health system has been enormous. It is about a 7% increase in each of the last two years.
Members may recall back in 1993 the National Forum on Health. Experts spent two years criss-crossing the country, talking to every stakeholder group, and trying to figure our where we were and where we should go. I remember the forum's report. I was on the health committee and I followed it very carefully. I also participated in it.
When the report came out, it indicated there was enough money in the system, but the problem was it was not being spent well. That was an interesting conclusion to reach because I heard the same thing from health officials at the very first health committee meeting I ever attended. They said that by spending 75% on fixing problems and only 25% toward preventing them, that model was unsustainable. They said that we needed to shift to healthy lifestyle choices and encourage people to live healthier lifestyles to alleviate the pressure on the health care system.
We have moved away from the conclusion of the National Forum on Health. It has literally been abandoned because demands continue for more health care dollars.
Ever since I have been a member of Parliament, since I have been aware of my role in our country, health care has always been the number one priority. I think it always will be. It is probably one of the aspects of Canada that defines us. I believe our system is the envy of the world. It is something we rely on and we want to protect. We cherish our health care system. We want to ensure that it is there for us when we need it.
I do not know what the figures are today, but back in the early nineties when I asked about them, I was told that about 75% of the health care costs in one's lifetime would be incurred in the last two years of their life. In a lot of cases that is when we are faced with life-threatening health conditions. It means the resource intensities go up. That means an individual needs more specialists, more specialized equipment, a more intense drug regime, et cetera. It means that if anyone were asked to pay for services when they received them, nobody could afford to get sick. That is why we have a health care system that is publicly funded, part of the five principles of the Canada Health Act. It means that we pay throughout our lives so the health care system will be there for us when we need it.
I think Canadians cherish that fact. I think they want us to continue to defend that and to ensure that those who need health care get it when they need it, not because they can afford it. They get it when they are sick. I believe health care will always be a part of the budgets of Canada. We should always continue to do what we can to improve the quality of the health care system and, indeed, the accessibility. However, there are problems within our health care system.
Today we spend as much on drugs as we do on doctors and nurses. The pharmacare costs are enormous. I am not sure whether it is appropriate, but I think we should find out why.
I attended a forum recently and I wrote down some things from the meeting. Pharmacare costs are a significant part of our health care costs. Today we spend as much on pharmaceuticals as we do on doctors. Some provinces have caps on the amount a senior must contribute to the cost of their drug needs. For those listed drugs, people in my province of Ontario pay the lowest costs in Canada. However, if the drugs people need are not on the list, that is they are not insured or are only partially covered, the costs are lower in other provinces.
All of a sudden I recognized that health care costs vary depending on which province one lives in. It really is different. Seniors in New Brunswick and Newfoundland and Labrador have absolutely no drug coverage at all. To qualify for drug coverage in New Brunswick and Newfoundland and Labrador, they have to be recipients of the guaranteed income supplement. It is a means test on drug coverage, yet we are spending as much on drugs as we do on doctors and nurses. There is something wrong.
I am not sure whether the portability and the comprehensiveness that we boast about in the Canada Health Act is being reflected. For instance, I know in the city of Toronto a senior who makes below a certain level of income can get dental care and vision care provided through the social services costs for seniors. In my own region of Peel, right next door, there is no such benefit. Why can people who live in Toronto get dental costs covered as a low income senior, but if they live in Peel they cannot? This is the same health care dollar.
Now I suspect if we looked at other provinces and regions within the province, we would find the same discrepancies. Does it really matter where we live in Canada? I do not think that is what the Canada Health Act had in mind.
We have some work to do. We know that the provinces deliver the services and the federal government's responsibilities are to protect the Canada Health Act and indeed to police it. As far as the taxpayers go, there is only one source of money. It is taxpayer money and they do not really care which jurisdiction is delivering the service. They care that every level of government is doing what they can to ensure that our health care system is responsive, equitable, portable, comprehensive, publicly funded, all the good things that we have in the Canada Health Act.
I wanted to raise that because we need to do more work in terms of the quality of our health care system. We need to know if we are moving in the right direction. A dollar spent on prevention is more productive in terms of better health outcomes of Canadians than a dollar spent on remediation or curing problems.
The model of health care has to change. I also raised this in my forum. I wrote about an item. It says that for most people primary health care includes illness prevention, wellness programs, self responsibility for our health and the very expensive acute health care services provided in our hospitals and in long term care facilities. It also says that we need a fully integrated system that provides us with what we need, when we need it and where we need it at the most appropriate cost.
The Ontario health minister recently described hospitals as the anchor of our health care system. Hospitals may be an important part of our system, but if the provincial governments honestly believe that hospitals are the anchors, then are we ever going to get any changes to the way our health care system operates?
Hospitals are places where people go when they are sick. However, if we are going to get a better value for our health care dollar, we must have a better balance between illness focus and wellness focus. As an example, 97% of seniors live in their own homes. We have $28 billion in our health care system in Ontario, but only 1% goes to community services. That 1% of the budget is actually dedicated to the 97% of seniors who live in their own homes. Some 95% of the money goes to hospitals, physicians and pharmacare.
We need to rethink the primary health care model. We need to spend more resources on wellness and illness prevention. The concern about obese children is an example. We see things happening in our society. We know what will happen with these children. They will be a tremendous burden on our health care system.
One of the previous speakers also talked about affordable housing. I believe the member said that one community in B.C. had a waiting list for affordable housing was one year, and that a person was quite ill and would be homeless.
Let me share with the House the situation of affordable housing in my region of Peel in the city of Mississauga. Affordable housing is in short supply, particularly for seniors. Half of our affordable housing is for seniors and half are family homes. The waiting lists for those seniors capable of living in their own unit are very long. According to the region of Peel, and February 25 was when I held the forum, the waiting list for affordable housing is seven to eight years. That is compared to two years in 1995-96. There has been almost no non-profit housing built in Peel since 1996. This is a problem. The dignity of having a roof over one's head, to be able to afford to have a dignified place to live is extremely important. It is a value of our country and we want that.
We need to look at our values when it comes to those in our society who are in most need. I am married with three children, my children are either in university or have completed their university education. We have a home now. We have pretty well everything we want. I do not want more for myself. However, when I go around my community, I talk to people who are in desperate need. People come to my office and before too long, they start to cry when they start relaying to me their circumstances. When people are driven to tears and despair and when that depression starts to set in, we know that we have work to do.
I would like to talk a bit more about the whole issue of seniors and why I am concerned about seniors. The seniors' issues were not effectively or specifically referred to in the budget but that does not mean that we are not concerned about seniors.
I want to share with the House a couple of thoughts I have with regard to how we might address seniors' issues. I believe seniors are the most vulnerable in our society. They are also the ones in our society who have very few tools to correct their situations.
I went through those issues during the break and I think it was last December 10 that I came up with a program. I had a couple of town hall meetings and received some very positive feedback from people. I actually tabled 17 motions in the House. I will highlight a couple of them.
First, I propose that Canada develop and implement a guaranteed annual income for seniors. I really do not care how a senior got there but there must be a level of income below which a senior cannot live in dignity. That means we would have to establish poverty lines. We do not have established poverty lines in Canada now. We have a number of measures which people use if it suits their purpose but we have not determined the level of poverty in Canada by provinces or region that we are prepared to tolerate. If we were to do that, that would be the benchmark against which we would be able to deal with matters, such as welfare, social assistance and other supplements to those in need. In fact, what we would be doing is establishing the level of poverty that we are prepared to tolerate.
I also propose that we do what we can to eliminate mandatory retirement at age 65. It is still part of collective agreements in a number of provinces. Can anyone imagine someone at age 65, who is vibrant, in good health, doing a great job and with a great set of skills, being told that now that he or she is 65 years of age that he or she has to go? It is wrong.
As a matter of fact, the age 65, in terms of retirement, came up I believe at the time of Bismarck and Hitler when they referred to people who turned age 65 as the unnecessary eaters. It is a little different now. I think that mandatory retirement is way past its time and we have to do what we can to eliminate it throughout Canada.
Caregivers, those who provide care to seniors, are a growing group. In the Income Tax Act we have, and I am pleased that I had something to do with it, a caregiver tax credit. It is for those who provide care in the home to an infirmed or disabled family member. I think that credit has to be increased. It is only worth about $500.
When people have to withdraw from the paid labour force to take care of their loved ones, an infirmed senior or someone who needs help because they cannot get enough home care assistance, they lose not only a net paycheque but they also lose years of employment in which they could be building up their own pension credits to provide for their own retirement. Caregivers are making a tremendous sacrifice and I think we should do more for them. We should provide employment insurance benefits for those who withdraw from the paid labour force to provide care. Why should they not qualify? It is unpaid work but it is important work.
I think the medical expense supplement should be increased. From time to time, and I have some examples which I will not go into now, seniors face significant spikes in their health care or pharmacare costs. Some things are not covered and we do not provide the relief they need for the extra expenses. I believe we should look for ways to ease the burden on seniors who have extraordinary legitimate health costs, especially seniors who have no control over their level of income.
I also think we need continuity in our Canada pension plan benefit for caregivers who leave the paid labour force. Why should they lose years of employment income credit to build up their own Canada pension plan? It does not make any sense.
How about improving home care? There is a gap in home care right now. People can get two to four hours of home care but what happens to the people who do not need constant supervision but who may get themselves into trouble just being alone for half an hour? If a person needs more than four hours of home care a day, someone will have to leave a job and take care of the person or the person may have to go to a nursing home which can cost anywhere from $2,000 to $2,500 a month. It is sometimes not affordable or even accessible.
The nursing home industry should be fully regulated, including the small private ones. We have had far too many cases of senior abuse and we need to address that. There should be industry standards for our nursing homes.
We also need to deal with those who are convicted of either elder abuse or defrauding of seniors. Seniors are vulnerable. People who are so low that they would take advantage of a senior deserves stiffer sentences. I would support that because it is an exacerbating factor.
We need to establish the office of the physician general of Canada. Health Canada has a lot of files open and a lot of battles going on with different interest groups. Would it not be lovely to have a physician general of Canada who would, among other things, address the health issues and needs of seniors to ensure they get the guidance they need?
How about establishing a cabinet position entitled secretary of state for seniors so that when we look at seniors' issues there would be someone at the table fighting for them?
How about a public education campaign on ageism? Ageism is racism on the basis of age. It is really endemic in our institutions. One example I have concerns a doctor in New Brunswick who has refused to take new patients over 60 years of age. This is ageism. They paid for it so why is it not available to them?
Another thing I recommended is that we adopt a seniors bill of rights. I am not suggesting that this should override the charter, or anything like that, but I believe we should establish a value system for seniors, one we would be prepared to use as a lens to look at all the things we do to see how it affects seniors and to ensure the rights of seniors are being protected.
This is one area that was not in this budget. I want Canadians to know that I and many other people in this place care about seniors and we will work to make sure that some of these seniors' priorities will appear in the next budget.