If I intended to split my time, Mr. Speaker, I would have indicated that to you at the beginning of my speech. However, I thank you for your concern.
The leader of the official opposition is reported to have said that he does not really care who delivers health care. Whether it is public or private, it is not a big deal for him. I commend the leader of the official opposition for at least being honest about his position. If he had said otherwise, I would not have believed him. I know where he is really at. I did not just walk into this chamber yesterday. Anybody who has listened, particularly to former Alliance members over the years, really knows where the Conservatives also are on this, and is not surprised by that position. I commend him for at least being straight up about his indifference. I would say he probably has a preference in some cases for private delivery, but at least he is willing to say that it does not make any difference to him.
Whereas the Liberals are being quite disingenuous and dishonest with the public about their true feelings on private for profit health care. Either they are indifferent or in their heart of hearts they think this is part of what they mean when they talk about the need for innovation or part of what they mean when they talk about the accord they want to reach with the health ministers on new federal money, plus innovation and reform in the health care system.
When I asked the Minister of Health the other day in the House if he saw a place for a privately owned chain of MRI clinics in the Liberal vision of health care in this country, he would not answer the question.
If we were going to have an honest debate about health care, then instead of answering a question I did not ask or repeating the mantra about the Canada Health Act, which is what he did, would it not be useful for Canadians to know before the election what the Liberal position on this is? We know what the Conservative position is. We know what the NDP position is. Why can we not know what the Liberal position is? Why can we not even know what their preference is? Liberals might say that this is what they prefer and then go into negotiations with the provinces, but they will not even go there. We hope they might go there today and shed a little light on their position.
While I am talking about user fees, extra billing and the origins of the Canada Health Act, I was very distressed to see that the National Post , in its editorial about the Canada Health Act, actually had the nerve to recommend user fees in an article by Nadeem Esmail, senior health policy analyst at the Fraser Institute. I suppose it does not take much nerve at the Fraser Institute to come up with a recommendation like that. If the Fraser Institute has its way, I cannot believe we will have another debate about user fees. I thought that debate had been put to rest 20 years ago.
We have had study after study. We have the Romanow Commission. We even have studies that do not necessarily agree with everything that the NDP says. None of them have advocated a return to user fees. Unless we have significant enough user fees, the cost of administering them cancels what we gain from the user fees. If we have significant enough user fees, then we begin to punish people who do not have the money straight up to go to the doctor or whatever the case may be, and we begin to penalize people. This has been proven over and over again.
Every once in a while we might get an intelligent notion from the Fraser Institute or from the National Post about these kinds of issues, but to suggest that somehow a return to user fees is the answer is really retrograde and harmful to what could be a useful debate about the future of health care.
While I have not had a chance to check, at the end of the debate on the Canada Health Act 20 years ago, on various occasions during that era I had occasion to say that no amount of principles enshrined in the Canada Health Act and enforced by the federal government would save medicare if it were progressively underfunded to the point where the system became untenable and people therefore felt they needed some kind of alternative to the publicly funded health care system.
We have not exactly reached that point yet, but there is no question that over the last 20 years successive federal governments have unilaterally changed the terms of reference by which medicare was created in the first place. The original deal that brought provinces into medicare, the fiscal midwifery that brought provinces into medicare, was the fact that for every 50¢ provinces spent on health care, they would receive 50¢ from the federal government. What is that 50¢ down to now? The most popular and accepted percentage that I have heard is 16% of spending on health care. Clearly, we have a case of governments progressively, in an unprogressive spirit, reducing the role of the federal government in health care.
This goes all the way back to a Liberal finance minister under Allan McEachern. Under the Mulroney Tories in 1984, the first budget had unilateral cuts in federal spending on health care. This occurred in budget after budget. The mother of all cuts was in the budget of 1995, when the Prime Minister was the then minister of finance. All those other nicks and cuts were bad, but they paled in significance to the cuts that came under this current Prime Minister. Billions of dollars were taken out of the federal transfer to provinces for health care.
It is that cut, the deepest cut of all, that created the circumstances in which we now have this debate. There would not be any need, perceived, real or otherwise, for MRI clinics and for other private for profit delivery of health care services if the public system was adequately funded. If we are to save medicare, the public system does have to be adequately funded or Canadians will rightfully want an option to a system in which they have no trust.
I think at this point Canadians still have trust in their health care system, although they know that it is not perfect. They know that with respect to certain kinds of services, diagnostic tests and others, there are unacceptably long waiting lists, et cetera, but they do not think it is beyond repair, and it is not, if we can gather the political will across this country to create a federal government that is willing to contribute its fair share.
What are we talking about here? Romanow was only talking about 25%. A minute ago, I was talking about 50%. That was the original deal. For the longest time, the NDP and others who were concerned about medicare advocated a return to fifty-fifty cost sharing. We still do in our heart of hearts, in our dream world. However, for now, we would be happy with a Liberal government that is willing to spend 25%, half of the original contribution by the federal government to medicare. That is not what we have over there.
It is clear to us that we need to have a much more honest debate about health care. The Minister of Health has come into the House. I hope he is not here to tell us that he stands by the Canada Health Act over and over again. As I said before, and I will say it for the benefit of the Minister of Health, that is not enough. The Canada Health Act was not designed to deal with that which now threatens the health care system; and that is, the proliferation of private for profit delivery of even insured services. However, we have the private for profit delivery of diagnostic services, which people are able to pay for and then they jump the queue.
Since 1993, there has been a complete lack of will on the part of the Liberals to deal with this. Why have they been unwilling to deal with it? They do not exactly have the moral high ground with the provinces. On the one hand they are drastically reducing their contribution to health care and on the other hand they are laying down the law to the provinces. The provinces are rightly irritated that the Liberals are reneging on the fiscal side, but they want to get tough on the regulatory side, and they have a case with regard to this. Some provinces have tried to deal with it differently than others.
We think it is time for the Liberals to fess up to where they are really at on private for profit delivery of health care. They should share our concern. Even if the for profit sector in our health care system is providing insured services now, at some point a second tier will be created. A private health care system would be created that initially would deliver insured services, but five or ten years from now say that it could make a lot more money if it were not under medicare. It could break free of medicare and create a second private tier all by itself. That is the danger.
Our system has always been an ideological hybrid, but public delivery and non-profit delivery of health care has been the dominant mode. If this Liberal government allows the private for profit delivery of health care to become the dominant mode, to expand even more so than it already has in their last 10 years of government, medicare will suffer a defeat on its watch, despite the fact that the Prime Minister's father had something to do with it in the 1950s.