Madam Speaker, health care is too important to be left to politicians.
I would like to quote the Prime Minister, as I did in the question and comment portion of the debate. The Prime Minister has said to all Canadians, in a public forum, that we must go back to basics. I would also like to quote the health minister when she said, in reference to the Canada Health Act, that we will enforce the provisions of the Canada Health Act but we will be very, very flexible.
On those two comments and those two reflections on health care I am in wholehearted agreement. That statement will come back to haunt me. I know I will be quoted as saying that I wholeheartedly agree with the Prime Minister and the health minister on all issues of health care. I agree with those statements in particular.
When I say that health care is too important to be left to politicians, how would I determine where health care should go? I would line up in these halls 100 high school students and I would make a speech in this Chamber, much as I am doing today. I would ask the health minister to do the same, and I would ask for the old-fashioned thumbs up or thumbs down on the proposals of the health minister and my proposals. I would determine whether or not I was on base with health care reform or whether the health minister had it right. It is the old Roman up or down. Maybe the pages could do it for me today.
If the Prime Minister and the health minister and I are so close on the issue of health care reform-those were basic statements, brand new statements, statements that have not been made in our country for some years-where do we differ? Frankly, we differ on the cause of the need for health care reform.
I will now go to a brand new survey from Statistics Canada on government spending. The figures I am quoting do not come from the Reform Party, they do not come from a strange source, they come directly from StatsCan.
In 1994-95 the federal government will spend $1,522 per person on servicing the debt. What will the federal government spend on health care per person that same year? Two hundred and sixty-eight dollars. That is the reason we stand in the House today debating the future of the health care system. Anyone who stands up and says that is not the reason is an ostrich, hiding his or her head in the sand, ready to be plucked.
Teenagers in Canada will not listen to that kind of nonsense any longer. Fifteen hundred and twenty-two dollars per person on debt servicing is squeezing the heart out of the $268 left for health care.
Reformers are looking for specific, positive solutions. To do what? To rip the heart out of health care? Not a chance. To preserve and save this most valuable of our social programs. Therein lies the problem. Therein lies the anchor. Therein lies the noose for health care.
My focus with these words will be the Canada Health Act itself. The health minister said: "I want Canadians to know that the Canada Health Act is alive and well and able to take on the challenges of the future".
I have another quote from Dr. Steven Stern of Ajax, Ontario: "We must recognize the financial crisis in most provinces that has rendered the Canada Health Act hopelessly obsolete and the fantasy of supplying all medical services to all of the people all of the time from ever escalating middle class taxation is a futile hallucination".
I believe the Canada Health Act is in trouble. I believe the Canada Health Act needs help. I believe Canadians will no longer allow rhetoric to judge whether the Canada Health Act will survive.
What has broken down in the act? I will talk specifically about provisions in the act that are failing. First, on portability, the act guarantees services provided to Canadians outside the country will be paid for at the same rate as if a person got sick in Canada. That is broken. Snowbirds who travel to Florida and come back to Ontario are paid $100 per day per hospital visit. There is not a hospital in Canada that can provide $100 per day service. Portability is broken.
In "la belle province", Quebec, there is a provision to the effect that each doctor is entitled to a certain portion. Here in Ontario, the portion is not the same.
Portability is broken and the minister knows it. The minister knows the Canada Health Act is falling down in portability.
On accessibility and reasonable access, where are we with reasonable access guaranteed in the Canada Health Act? One specific breakdown is that Manitobans are waiting 60 weeks for hip replacements when the norm is 12 weeks. Reasonable access is toast under the Canada Health Act.
Comprehensiveness is another plank of the Canada Health Act. How about the issue of what is medically necessary? Here we have provinces unilaterally deciding to take test tube babies off the medically necessary list and put on sex change. Those two things might be discussible under the provision of medically necessary. This is arbitrary and fragments health care across Canada.
What about the bill's provision-this is not one of the planks of health care but one of the very basic provisions of the Canada Health Act-that there will be a prevention of user fees?
In the House I have mentioned to the Minister of Health-this is not a unique thing to the province I will mention-that there is a hospital in Wolfville, Nova Scotia whose facilities were being shut down. It stated its facility was too important to be shut down. The province stated it could not afford the facility any longer but the staff was to keep it running. How were they to keep it running? By volunteer nurses, by a fee for the syringe, the local anaesthetic and the suture so that each patient who comes in with a laceration now pays for those basic facilities. Is it a user fee? Yes. Is it medically necessary? Yes. Is it the choice of the people in Wolfville, Nova Scotia? Yes. Should they be allowed to have that choice? Yes. It is their health; we should not be leaving this issue to the politicians.
The act guarantees, and this is not commonly known, reasonable compensation to practitioners who provide the services. I know of three provinces which have broken agreements with their medical practitioners unilaterally, agreements signed, sealed and delivered. Is reasonable compensation being given? The act is broken and there are no repercussions for that.
If the act is broken and I ask the minister to stand up and tell Canadians that what I have said is inaccurate or untrue, should the minister be protecting this most valuable act? I think she should. Her reaction is to reinterpret sections of the act. She has gone on to define the hospital to include private clinics. She has decided semi-private clinics do not deserve the funds they have been getting. That issue is one that we may argue a lot but this does not sound like going after the basic principles of the act to me at all.
We have been over funding provisions. I hear members of the Bloc say the federal government should not be withdrawing funding. There is no question in my mind the federal government has no choice. I do not think there is any point in going back and deciding the reasons for these choices. The federal government has no choice.
I listened to more rhetoric not so long ago in my province of Alberta. The Prime Minister says the Canada Health Act does not allow private health care. I shook my head when I heard that,
recognizing that almost 30 per cent of what is provided in Canadian health care is private.
I asked the Prime Minister about the Shouldice Hospital in Ontario for hernias, about totally private laser eye surgery, about physiosports medicine clinics, about chiropractic, about cosmetic surgery that has been taken out of the fee schedule, about laser treatment for snoring, sleep apnea and bad breath. All these things are available so close to the House of Commons privately and there is no room under the Canada Health Act for private health?
We have two tier health in Canada now. We will end up if we ignore the Canada Health Act, if we do not improve the Canada Health Act, with universal access to nothing. The $1,522 of debt servicing will choke that $268 and we will kiss it goodbye, and that will be wrong.
This is not an answer that comes from me but I am now elucidating the answer from my colleagues. My answer is to give sensible Canadians choice over their most important resource, their own health. That is why I would line up the 100 high school students.
A journalist phoned me the other day. He said: "I will ask you what you mean by your core essential services because I have asked a whole host of other individuals in Canada and none of them will tell me what they would take out of the core essentials. I know you will do it because you Reformers are not filled with political rhetoric yet". I had the opportunity to tell him some of the things I would take out.
For members opposite I will give a specific example of one thing I would take out of our broad health care coverage and put beyond the core essentials. This is actually being done in Quebec. The members of the Bloc will not be interested in this. Quebec has decided that psychoanalysis is no longer coverable under health care. Psychoanalysis is the treatment where one lies on the bed, the psychiatrist sits there and one comes in week after week for years on end to figure out what was the matter with one's psyche.
Quebecers in their wisdom, I give them credit, have said psychoanalysis is not something that should be covered under our core essential health care budget. They pay for psychotherapy which is much tighter, better controlled, involves looking after something like anxiety or suicide, possibly giving medication and a fairly rapid return to the workplace.
Outpatient psychotherapy is covered and with outpatient psychoanalysis you are on your own. You can either get insurance coverage or pay for it out of your own pocket. In their wisdom they are doing what Reformers are suggesting.
Will this be a big bureaucratic process? Not on your life. This is a process that will also be flexible. This is surely a process that our national forum on health should have and could have addressed.
I listened last night to the minister make a very good speech. It was tight and controlled. I really credit her for this. She said, using different words and phrases, virtually the same thing I am saying. There are things we are doing today in health care that are ineffective.
She said we must look at those things. That is what we are talking about. Define the essential core. Look at the things that are ineffective and set them aside. They are discretionary. They may well be covered by private sources, insurance or other sources.
We are not so far off. The rhetoric may put us a long way apart but we are not so far off. Evidence based issues, let us call them what I call them or call them what the minister calls them, core essential, evidence based; not so far off.
The national forum on health, which has people with vast experience from all over the country, should and could be doing this very thing today.
My time is rapidly drawing to a close. I hear delight from across the way. It is a shame because this debate in the House is so important and has not been done for so long. I will be disappointed if there is not a frank and open interchange on this.
There are other problems with health care beyond the federal portion. There are problems with accountability. There are problems with abuse. There are problems with our medical legal system and there are big problems with our drug costs.
Each one of those deserves a good, frank expose as well. I have colleagues who will talk about other innovations we think might have some benefit for health care, funding changes that might well be present. I ask each member to consider what will happen if we ignore the $1,522 for debt servicing versus the $268 being spent on our health.
