Mr. Speaker, I want to congratulate my colleague from Regina--Qu'Appelle. We are debating, as we wind down, that the House condemn the private for profit delivery of health care which the government has encouraged since 1993, and of course I am delighted as always to have the opportunity to speak.
I have the opportunity to speak, and for that I want to thank the Conservative Party, because it has managed throughout the course the day, a full day of debate on this important topic, to put forward one speaker all day long, a handful of hecklers and people who would have questions and comments, but one speaker. It has 75 members and purports to be the government in waiting, the official opposition that is ready to take over. By any public opinion poll, health care is the issue in Canada. We have a debate on private for profit health care and it has managed to put up one speaker all day long.
The New Democratic Party has carried this debate from start to finish, as admittedly it should because it introduced the motion. It is absolutely mind boggling and bewildering that the so-called official opposition has been able to put up only its health critic to take part in a significant and important way in a very important debate. Presumably the Conservatives are suggesting that their leader said everything that needed to be said yesterday on the topic when he introduced that party's platform on health care. Of course there would be no need to add or embellish perfection, if that were the case, except that the leader of that party has over the years said many things on the topic of health care and the private delivery thereof. I would like to note one or two of those.
In the House in October of 2002, the current leader of the Conservative Party said:
Monopolies in the public sector are just as objectionable as monopolies in the private sector. It should not matter who delivers health care, whether it is private, profit, not for profit, or public, as long as Canadians have access to those services...regardless of their financial needs.
Also in 2002, the leader's website--and I cannot remember which party he was running for at that time; he has been in so many leadership campaigns--stated:
Favours diminishing the Canada Health Act to allow provinces to “experiment with market reforms and private health care delivery options. [The leadership candidate] is prepared to take tough positions including experimenting with private delivery in the public health system”.
The point I am driving home is the Conservative position is that it does not matter who delivers health care or how it is delivered, as long as it is accessible. That is the point they make repeatedly.
The for profit health care folks deny the same level of care. People have pointed out that where they have made comparisons, the death rate in the for profit health model is significantly higher. The point has been made by the Canadian Health Coalition that 2,000 more Canadians per year would die under a for profit system than under a not for profit system.
Mr. Mazankowski, a well-known former Conservative cabinet minister and deputy prime minister, asked at the Romanow commission hearings a couple of years ago why everyone is afraid of private provision of health care; if the customers are not satisfied they will go out of business. There was a similar comment from Senator Michael Kirby who did that institution's report on health care. He said, “We do not care if health care is privately delivered. Frankly we do not care who owns the institutions”.
I want to refer to somebody who does care about how health care is delivered and who pointed out the difference very clearly and very eloquently. I am referring to Dr. Arnold Relman, professor emeritus of medicine and social medicine at Harvard Medical School. He was on Parliament Hill a couple of years ago to tell a Senate committee about the U.S. experience on health care. Dr. Relman said:
My conclusion from all of this study is that most of the current problems of the U.S. system--and they are numerous--result from the growing encroachment of private for-profit ownership and competitive markets on a sector of our economy that properly belongs in the public domain. No health care system in the industrialized world is as heavily commercialized as ours, [referring to the United States] and none is as expensive, inefficient, and inequitable--or as unpopular. Indeed, just about the only parts of U.S. society happy with our current market-driven health care system are the owners and investors in the for-profit industries now living off the system.
Dr. Relman went on to say:
Private health care businesses have certainly not achieved the benefits touted by their advocates. In fact, there is now much evidence that private businesses delivering health care for profit have greatly increased the total cost of health care and damaged--not helped--their public and private non-profit competitors.
He pointed to the example of the failure of the commercial HMOs in the United States, an insurance system that was seen a few years ago. Senior citizens covered by medicare in that country were encouraged to obtain their care from private for profit HMOs that would be paid by the government. It soon became obvious that the costs of care out of the private system were much greater and that senior citizens were dissatisfied with the care they received. A wholesale exit of senior citizens from the private system ensued. They voted with their feet, in other words, for the public system. He concluded by saying:
--the U.S. experience has shown that private markets and commercial competition have made things worse, not better, for our health care system. That could have been predicted, because health care is clearly a public concern and a personal right of all citizens. By its very nature, it is fundamentally different from most other good[s] and services distributed in commercial markets. Markets simply are not designed to deal effectively with the delivery of medical care--which is a social function that needs to be addressed in the public sector.
We submit that there is a very significant difference in how health care is delivered. We want to see it delivered in the public domain. Our party's point is that there is really very little difference between the Liberal and Conservative parties on this subject. I know the government and the Prime Minister have been trying to suggest that there is a vast difference between what they would do and what a Conservative Party in power would do on the delivery of private for profit health care. We know there is very little difference.
Over the weekend and yesterday it was interesting to hear some comments by Tom Kent who has played a very significant role in this country, particularly in the federal government and in the Liberal Party over many years. He was talking about Paul Martin Sr. and the role that he played in health care after the Prime Minister's apparent outburst in caucus last week about how his father's party was not going to give up on this. Mr. Kent's recollection, as substantiated by Paul Hellyer who was in cabinet at the time, was that Paul Martin Sr. had a relatively minor role to play in all of that.
More important and in regard to today's debate, Mr. Kent was passionate in his complaints about what he felt the present Prime Minister did to undermine medicare when he was finance minister between 1993 and 2002. Mr. Kent said:
[The] 1995 budget...ended all pretense of a commitment [to medicare] and substituted just the [Canada Health and Social Transfer], which is an arbitrary amount...as distinct from a commitment to a share in provincial costs.... The contract for medicare was already tattered. In 1995, it was unilaterally and unceremoniously thrown out.
In conclusion, our position in this party is that there is very little difference between those two parties on the issue of private for profit delivery of health care. We think it is the New Democratic Party that will stand to speak on this issue and to benefit from the lack of direction from the government and the official opposition on this very important matter.