Mr. Speaker, I intend to share my speaking time.
I would like to begin by saying that I am delighted to have the opportunity to participate in the debate today on a matter of prime importance to Canadians.
What we are talking about today, Canada's health care system, represents a tangible expression of this nation's shared values. It is something that lies very close to the heart of our country's sense of self.
It seems to me that Canadians cherish medicare because to us it is about more than just doctors, hospitals and medical treatment. It is about the way we want to live. It is about being part of this country. Canadian medicare is about the promise that we make to each other as Canadians, that in times of need we will look after each other regardless of wealth or of privilege, and so it is a subject of fundamental importance to each of us.
The principles of the Canada Health Act, the principles on which Canadian medicare is built, are as sound today as they were decades ago when they were enshrined in federal law. Their soundness derives not just from the social equity, which is obvious, but also from the economic advantage that the single tier, universal coverage provides to Canadians and Canadian businesses.
Time and again the economic comparative advantage of Canadian medicare is demonstrated, and we must never lose sight of that fact. As sound as these principles are and as strong as the arguments are for preserving those principles, we have problems in practice of which every Canadian is aware. It is clear that the status quo is unacceptable. It cannot continue. There are people who are waiting too long, waiting hours in the emergency ward, waiting months for referral to a specialist, waiting a year for a long term bed, waiting what seems an eternity for someone to answer the call button in the understaffed hospital ward. The status quo is not on.
However, as we look for answers we must be careful to distinguish the real solutions from the false ones. We must resist the siren call of the private parallel system which is not the answer. Private for-profit medicine is not the intelligent or effective response. The private parallel provision of medical services is less effective, more expensive and, frankly, is inconsistent with the basic principles to which this nation is committed.
Surely the answer lies in renewing medicare, in finding new ways to provide services of quality to give Canadians and their families access to quality care in a timely fashion within the principles of medicare, within the principles of the Canada Health Act.
What is needed? I suggest two things are needed: first, the proper level of financing; and second, innovation and change, ideas and hard work to bring about the kind of structural changes that are necessary to adapt the principles to modern realities.
First, in terms of financing let us set the record straight on the contribution of the Government of Canada to our medicare system. Public spending on medicare every year approximates $60 billion. We transfer to provinces a total of about $40 billion, including equalization. If we subtract the equalization it is $30 billion in transfers this coming fiscal year through cash and tax points.
Looking historically at the utilization by provinces, just over half of that transfer is devoted to health care, about 54%, almost $17 billion. If we add the $3 billion that Canada spends directly for health care services for Canadian forces and aboriginal persons, it is over $20 billion. One-third of total public spending on health care in the country every year comes from the Government of Canada.
Let us be honest about the facts on financing. Let us tell the truth about role of the Government of Canada. One-third of all public funding on health care is contributed by the Government of Canada. The cash portion of that contribution, the cash portion of the transfers to the provinces has increased by fully 25% over the last two years as a result of the very budget measures that party is today attacking.
I said it would take two things to save and strengthen medicare. The first is the proper level of financing. The second is hard work with ideas and innovation to make the changes we must make so that services are provided and are accessible to Canadians in keeping with standards of quality.
Our objective must not be, as the NDP would seem to suggest, simply to make the health care system more expensive by spending more. Our objective must surely be to improve its quality and access to services by making the changes needed. That means long-term sustainability. It means learning from the provinces by looking at what they have done to innovate in recent years. It means sitting with the provinces, learning from their experiences and developing a shared agenda of common priorities, because one thing is certain, we will not succeed in this effort unless we work together.
I have sat with provincial ministers and I can say that year after year at the end of our meetings we produce a virtually identical list of common priorities of what has to happen to resolve the issues facing medicare. I have spoken and written about these issues at length in the past. Today is not the day to go into detail about them, but I will say, by way of summary, that the provincial priorities for innovation and change, priorities that I share, include new ways of delivering primary health care, that is to say the first line of family health services in communities.
Changing the way the primary health care is delivered is fundamental to restoring accessibility to medical services in the country. The second is broadening the availability of home and community care to reflect the reality of what happened with the downsizing of the hospital sector and the increased reliance on care outside hospitals. Provinces are moving in that direction as well. Many of them have made very significant investments in home and community care.
The time has now come to broaden that effort and to weave home and community care into medicare as an integral part of health services. In reality it is needed.
The third is a focus on quality care. The Canada Health Act does not speak of quality or standards of care. It talks about principles.
For the first time this spring we will produce a comprehensive report on outcuts in the health care system, measuring how it performs and with that measurement, which will allow us to manage better, we can work toward public discussions of quality in health care in Canada using information technology to monitor it, to track it and to integrate the various parts of our health care system so we can give better service to Canadians.
The Government of Canada has a crucial role to play in all this. It is a role of leadership. It is a role of co-ordination. It is a role of bringing constructive ideas to the table and of supporting the provinces in their own efforts to innovate and resolve these difficult issues.
I make no apology for the fact that some weeks ago I put some ideas on the table. I think it is my responsibility to lead a national discussion about where we go from here. The Government of Canada will be there throughout to do its part. I proposed meetings in the near future with my provincial counterparts so that we can work toward a plan of action, implementing the changes that we have all recognized for some time are necessary.
Let us now move from resolution to action. That is what I think we must do on behalf of the people of Canada. If that action requires a greater contribution from the government, if it requires a long term financial commitment from the government, as the Minister of Finance has said and the Prime Minister has always said, the Government of Canada will be there to do its part.
Let me conclude by saying that the status quo is not acceptable. We have to change in order to preserve medicare, to save and strengthen its principles. The choice is not between the status quo and a private for profit system of medicare. That is not the choice we face. The choice is between the status quo, which is unacceptable, and a renewed medicare operating within the principles of the Canada Health Act to do a better job. A country that had the wit to invent it can surely find the will and the ways to preserve it.
