Mr. Speaker, I want to reintroduce the motion so people throughout the country will know specifically what we are dealing with here. The motion reads:
That this House condemn the private for-profit delivery of health care that this government has allowed to grow since 1993.
I want to emphasize that by saying that we are talking about the private for profit delivery of health care and that there is no question that privatization and for profit services have been increasing in Canada since 1993 by great amounts. If there is documentation out there contradictory to that, I am certainly willing to take it in, but, quite frankly, I would be surprised if anyone found it because we have numerous documents that say otherwise.
Canadians still raise health care as their number one priority: access to new technology for testing, receiving care in a timely manner, cost of prescription drugs, cost of home care services, availability of services throughout the country and the numbers of health care providers, as well as the increasing costs for services that are not presently covered.
Canada is regarded as having the best, most affordable health system in the world. When critics of our system, mostly private for profit interests, highlight the faults in our system they tend to compare us with the U.S. and they tend to focus on two areas: one, Canadians have to wait too long for tests or treatments; and two, if those who can afford to pay want to go elsewhere or pay a private service they should be able to do so and this would free up spaces in the public system.
A few months back, Belinda Stronach, one of the Conservative leadership candidates, stated that she favoured a two tier system. That was no surprise. Two tier health care favours the rich, but even the wealthy have difficulty with the expenses of a serious illness. Thus, we have the push for private insurers.
Private insurers must market and make profit and, to sell their goods, make the need for private providers who can deliver to their clients quicker since they are paying. It goes without saying that those private providers want to make a profit so these costs are higher. To keep the costs down for their clients without giving up their profit, the private insurer and a service provider will argue that the public system should pay the portion it would have paid in the public system and the client should just pay the extra.
There have been a number of high profile reviews of Canada's health system. All those reviews came to the same conclusion: public funding of health care is more equitable and more efficient. The for profit supporters would have us believe their system is more efficient and more economical to the public purse. The facts do not support their statements.
First, Romanow's report on health care, which was extensive and included hundreds of presentations and meetings throughout the country, concluded that our health outcomes, with a few exceptions, are among the best in the world, and that a strong majority of Canadians who use our system are highly satisfied with the quality and standard of care they receive.
Medicare has consistently delivered affordable, timely, accessible and high quality care to the overwhelming majority of Canadians on the basis of need, not income. It has contributed to our international competitiveness, to the extraordinary standard of living we enjoy and to the quality and productivity of our workforce.
Opponents of our system fail to mention that in Canada administration costs amount to 16.7% of health care spending. In the U.S. the cost is 32%. Canada spends 10% of its GDP on health care, the same as in 1992. The U.S. spends 14.9%. In Canada everyone is covered. In the U.S. 44 million people have no health coverage. The same arguments that were used to oppose medicare in its beginnings are the ones being used today.
Canadian health economist, Bob Evans, described private pay advocacy for health care as a zombie: “intellectually dead but destined to keep rising”. Gordon Guyatt, in a Winnipeg Free Press article a few months back, noted that for the wealthy the security of universal publicly funded health care could not begin to make up for the necessity of waiting their turn.
One of my favourite quotes, and I apologize that I do not know who said it, is “The critics say in Canada we ration our health care”. That is true. We ration according to need, whereas in the U.S. it is rationed according to the bank balance.
I will gladly give whatever information people need on where I got my figures. I want that to set the tone for the discussion on whether or not for profit health care is what Canadians want. I suggest it is not.
Canadians want to have access to their health care services and to the new technology, and they should have that right. They would have had it made available in most instances without the long lineups had there been proper funding of our health care system.
When we have the health minister work around and fiddle with the fact of what is medically necessary, I am sorry I do not have the opportunity to question him or his colleague, the public health minister, because I am sure she would be indicating that if he has to work around what is medically necessary and possibly suggest that diagnostic tests are not medically necessary, I would question whether he should be the health minister.
No doctor worth his or her grain of salt would suggest that blood tests, when checking for different types of cancers, or an MRI, a mammogram or a PSA test for prostate cancer are not medically necessary when looking to make a diagnosis. To suggest that our health care system should not be funding those tests, I think, is unconscionable. Quite frankly, I think Romanow was very clear when he said that we need to enhance what is covered under our public system.
I will now go into the arguments on for profit health care. I have a pile of paper around me because there and so many reports that put to rest that ridiculous argument, which has been called a zombie, that private health care delivers quicker, is better and is more efficient. The facts just are not there.
Furthermore, it is not the best economically sound position for our government to be taking. The public system delivers a more cost efficient system.
In the United States the Americans have those figures. They have for profit and public hospitals. The figures show that the non-profits provide equal services, they are less costly per hospital patient to the tune of something like $1,000 U.S. It would be much less in Canada.
I will read into the record the following comment, “Independent health service providers, the private for profits, need to pay advertisers, investors, insurance companies, marketing and a whole host of other hidden costs which would in the end get passed on to the public deliverer”.
The government wants to use the argument that as long as health care is publicly delivered it is all right to waste taxpayer dollars paying a for profit company, when it can be provided, and the figures are there, for at least 15% less if it is in a publicly delivered system.
It is shameful that members of the Conservative Party, who at one time were reform and then alliance, who try to present themselves as the grassroots people and the protectors of the public purse, are in here saying that taxpayer dollars should be used to set up for profit clinics to provide health services. I make no bones about the fact that ideologically I do not believe anyone should be profiting from someone's ill health.
I firmly stand behind the principle of a balanced budget. Without question, we cannot do everything all at once. However, without question, the most cost effective way to provide existing services or new services is through the most cost effective measure, which is not for profit. The moment we bring in the for profit aspect, somewhere along the way there will be increased costs to the public deliverer or to the patient. I think that argument needs to be put to rest.
I would wager that most members have not read the Romanow report. I know most Canadians have not because, although the government supported the Romanow commission, the cost for a full copy of the report in hard cover is $50, unless people have access to the Internet. I know it may come as surprise to many members but not everyone in Canada has access to Internet services.
The report states that this is what private, for profit companies do:
--these facilities “cream off” those services that can be easily and more inexpensively provided on a volume basis, such as cataract surgery or hernia repair. This leaves the public system to provide the more complicated and expensive services from which it is more difficult to control cost per case.
I will say that this is like going to Shoppers Drug Mart for a loss leader sale. We buy something at a special rate, but we spend extra money. We should not be putting that kind of system in reverse into the health care system, where we have private companies that are going to deliver the services they will make a whole lot of profit on, but the public system has to pick up the real costs.
Here is what a colleague of mine once told me. The province of Manitoba had a program with Manitoba Hydro. To encourage sound energy resource use, it provided people with assistance such as loans if they wanted to put on new doors or new windows to conserve energy. These were loans, and people paid the money back. It came off their hydro bills. Someone asked me why it would do that when its whole intention should be to make a profit. I said, for crying out loud, if we had that kind of attitude on health care we would not do the preventive work to treat people with heart problems or diabetes. We would be waiting until people get really sick so we could make a buck. That is what a lot of private providers do. They want to make the big bucks. Quite frankly, that is what has happened in our health care system.
We have not provided the community clinics and the preventive measures. Health Canada or the Minister of Health did not come up with a piece of legislation to ban trans fatty foods. Those are the things that prevent excessive use of health care dollars. That did not happen.
There is something I want people to know. Frankly, I was quite surprised, because many times over the years I have heard about medicare and Tommy Douglas and the great things that were done, but I have to admit that I had not read the whole plan from way back then. Members should know that community clinics and preventive medicine were supposed to be there at the same time that medicare was brought in, but the Conservatives, Liberals and governments time and time again never did any of that stuff. As a result, we have greater costs within our health care system.
I do not believe in throwing the baby out with the bathwater, so I say we get in there right now, implement the changes that need to be done and put in place the community clinics. We absolutely need to do those things.
My colleague, the Minister of State for Public Health, mentioned Dr. Michael Rachlis. Dr. Rachlis mentions a number of different alternatives that we can do. They have been talked about time and time again, but the provinces have not been able to implement a lot of those projects or changes to the way things are done because they do not have the dollars. They have been fighting to survive and provide whatever services they could. Why? Because this Liberal government in the last decade has cut more from health care than any of the others all together. As a result, we are playing catch-up.
The time has come. There needs to be the commitment. There needs to be the sound commitment to our health system. My colleagues have asked how much has to go in and I will say that right now what is being recommended is to just get it up to the 25%. I think a good number of provinces have indicated that we should start with 25%. It was meant to be a fifty-fifty deal. We have heard that. The federal government provides 50% and the provinces provide 50%. I have yet to hear anyone argue that this is still not fair, but what we are hearing now is, “Let us just get it up to the 25%”.
What would that mean in actual dollars? We have to break down the health and social transfer payments, which covered a number of things. I think Canadians want to see transparency, not just within health care funding but within all the other government funding. We are seeing that there is not a lot of transparency. As a result, we are seeing a lot of misuse of taxpayers' dollars. Let us have some transparency. Let us look generally at the figures. It is not always easy to get the total figures, but the figure I have heard is roughly $24 billion. Right now that goes specifically to the health care funding that would apply under the Canada Health Act.
That is $24 billion. If we are looking at increasing funding to 25%, some have said it would be roughly $8 billion. I use those figures because those are the different figures that have come out. There is no specific breakdown because of the health and social transfers. We would be looking at $8 billion to bring it up to 25%.
My colleague from Winnipeg—Transcona mentioned Monique Bégin. At times I have been in attendance when she has spoken about public health care and its needs. She used a figure of 25% at one point too, but also said that it needs to be moved further. We should be back to the relationship where there was the agreement.
Again, I would not for one second suggest that we just throw a bunch of money at it and not have a guarantee that services will be provided. Or, quite frankly, what if we do not have the money? But if we have the dollars we should be putting them into the system and we should be ensuring that Canadians nationwide get the same services. It is not always easy to do. Sometimes we have to pay a little more in an area of the country.
I specifically want to mention first nation communities here. I want to tell the House about something that happens in first nation communities. Over the last number of years, through the First Nations and Inuit Health Branch, communities have been trying to get additional funding to have full time nurses in their areas. They could not get the additional funding through Health Canada. However, Health Canada was quite willing to pay out to a private agency to provide a nurse to the tune of $900 a day.
That was $900 a day to a private agency for the nurse, but Health Canada would not give first nations the dollars to provide full time services in the community. There has been a huge increase in agency nurses throughout the whole system. Hospitals may say they do not have to pay the benefits and stuff, and yet $900 a day was paid to a private agency to provide a nurse. That is way beyond the cost of benefits.
This being nursing week, I think it would be indicative to mention the stress on health care professionals overall but certainly on nurses as the government has cut time and time again. They were there because nurses tend to be the kind of people who cannot just say, “To heck with it. I'm not going to work here anymore”. They keep struggling along because people do not go into that profession unless they genuinely care about what they are doing. Anybody who has worked in a hospital will tell us that. People do not become doctors or nurses unless they care about their patients, and they have a hard time not continuing services and not giving their 200%. They have suffered a great deal under the cuts.
I mentioned the increase in agency nurses and Health Canada's position of not funding the first nation. The government says it does not want to encourage private health care but it seems to me that paying $900 a day is encouraging private health care costs.
There was another situation, and I can bring in the news articles about it to prove that this is accurate. Again it involved the first nations health branch. There was a mammogram clinic located in one of the remote communities. In order to make it cost effective, the clinic wanted to fly in patients from a short distance, from one community in the riding to another, to have the mammograms done. Let me tell members, though, that Health Canada would not cover the cost. The reason I was given by the health branch--and this is not just out of the blue--was that it did not cover the preventive side of health care. These patients could not just have a routine mammogram; that was their reason for not doing it. That is the type of health care service first nations are getting from this government, that is the position the government is taking, and that is not acceptable.
I know I only have a minute more. There is obviously a fair bit to comment on with regard to the private, for profit health care system. That is the key factor here and I make no bones about that fact. I am adamantly opposed, as most Canadians are, to someone profiting from someone's ill health. It is unacceptable. I do not think those private providers have any moral ground to stand on. There have been numerous situations involving drug companies in the States where court cases have been brought against them because of their illegal positions in a good many cases. I do not think they have any moral ground to stand on when they say they are going to give the same service. The proof is out there that private, for profit companies do not provide the best service.