Mr. Speaker, Canadians cherish public health care. It is part of our national identity, a social contract that ensures we will be cared for when we are vulnerable, regardless of the size of our bank account. It is an affirmation of our collective commitment to equality and justice.
However, our health care system is in crisis. Emergency rooms are overwhelmed; health care workers are burning out; millions of Canadians lack access to a primary care provider, and patients are facing massive backlogs for surgeries, diagnostics and other procedures.
Although the COVID-19 pandemic has undeniably placed enormous strain on our health care system, it did not cause the current crisis; it exposed it. In fact, its roots can be traced back to decades of poor policy choices and underfunding by successive Conservative and Liberal governments.
When our health system was first created, it was based on a fifty-fifty cost-sharing partnership between Ottawa and the provinces, but over the years the federal government’s contribution has declined far below that. This has profoundly shifted the fiscal burden for health care delivery and exacerbated pressures caused by an aging population, technology advances and increasingly expensive treatments and pharmaceutical drugs.
The results of this are clear to see on the front lines of care. Where Canada used to have 6.9 hospital beds per 1,000 people, we now have just 2.5. One in five Canadians cannot access a family doctor, the primary portal into our health care system, and Canada now ranks near the very bottom of the OECD in the number of physicians per 1,000 and wait times for essential care.
Tommy Douglas warned Canadians about the threat posed by this “subtle strangulation” strategy. He understood that opponents of public health care would attempt to starve our system of resources to lay the groundwork for private, for-profit care.
Unfortunately, his prediction appears dangerously accurate. Across Canada, Conservative premiers are exploiting the current crisis to pursue privatization, with the tacit approval of the federal government.
Alberta premier Danielle Smith has brazenly called for patients to fundraise for their own health care needs. Her government is implementing health spending accounts, a Trojan horse to inject user fees and private care into Alberta’s health system.
In a recent throne speech, Manitoba premier Heather Stefanson announced her government’s intention to expand private partnerships to deliver health care.
Ontario premier Doug Ford is planning to divert funding from his province’s hospitals toward for-profit surgical clinics. This move is expected to benefit clinic owners with a windfall of over $500 million.
We know this approach is a false solution that will exacerbate the current crisis. Just last year, in an exhaustive review of the evidence in the Cambie Surgeries case, the B.C. Court of Appeal unanimously ruled that allowing more private care in a parallel system is more expensive, fundamentally unfair and ultimately counterproductive. It found what experts and patients have long known: Privatization means line skipping for the rich, a drain on workers from a public system already short of staff and longer wait times for everyone else.
It is also poor economic policy. For-profit delivery drives up costs in the short term and make us dangerously vulnerable to corporate ransom in the long term. It is a frontal assault on our public health care system, and it must be stopped in its tracks.
Unfortunately, the government has demonstrated a troubling lack of concern in the face of this privatization agenda. The Prime Minister has even called Doug Ford’s for-profit clinics scheme an example of “innovation.” This should come as no surprise. While the Liberals may claim to defend public health care, their record demonstrates otherwise.
After promising to negotiate a new health accord in the 2015 election, the Liberal government instead adopted the very health transfer formula imposed by Stephen Harper. By unilaterally cutting annual federal transfer increases from 6% to 3%, when the need to tread water was 5.2%, Harper had baked in a recipe for systemic decay. The Liberals’ decision to adopt that funding formula has deprived our health care system of over $30 billion to date.
Now, after years of inaction in the face of a growing crisis, the Liberal government has come forward with the bare minimum needed to address this deliberate underfunding.
While initially indicating that it was offering nearly $200 billion for health care over the next decade, a claim repeated by the Prime Minister today in this chamber, it turns out that three-quarters of that money is existing Canada health transfer funding that would have flowed to the provinces and territories without any new agreement. In reality, there is only $4.6 billion per year in new federal spending on the table, and that has to be split among 10 provinces and three territories. To put this in perspective, total health care spending in Canada for 2022 was $331 billion, according to the Canadian Institute for Health Information.
While this additional federal funding is urgently needed to help stabilize our health care system, it is far from sufficient to provide the generational fix that we need to the current crisis. It is a band-aid solution for a gaping wound. As Dr. Kevin Smith, president of Toronto’s University Health Network, just noted, “If we look at the demands—the number of new Canadians we’re expecting a year and the aging of the population—it’ll come close to addressing inflation. It won’t come close to addressing massive transformation.” Canada’s nurses are already expressing discouragement.
Most troubling of all, the federal proposal leaves the door wide open for premiers who are pursuing private, for-profit health care schemes. New Democrats have strongly asserted the condition that additional public dollars must go to public care, and yet the Prime Minister did not raise a single concern with the premiers about their privatization plans at yesterday’s summit, nor did he attach a single condition of his funding proposal to prevent it.
Canadians need their federal government to champion public health care, instead of standing back while Conservative premiers and others seek to systematically dismantle it. Real innovation is better support for health professionals, shorter wait times in hospitals and access to care based on need. It is expanded team-based care, preventative care and supports for aging at home. It is universal access to prescription drugs, dental care and mental health care.
New Democrats will never stop fighting to protect, strengthen and expand public health care across Canada. We know that we can deliver a public health care system that is world-class, timely and accessible for all, but this will not happen without national leadership, a full financial partnership and unwavering commitment to equity. The government’s offer yesterday is but a start to what needs to be done.
New Democrats will continue to do our part to build the high-quality public health care system that Canadians want, need and deserve.