Mr. Speaker, I thank you for giving me the opportunity to speak to this motion. The main thrust of the motion is that, since the federal government’s contribution to health care spending has fallen to 16%, which is considered clearly inadequate by the Premier of Quebec and ministers in the other provinces, it would be very important for the government to invest at least half the current year’s surplus in health care in order to achieve as rapidly as possible stable funding at 25%.
I always try to find out why we are having debates in the House of Commons, because some of them are meaningless, especially when members of the Liberal government opposite turn a deaf ear to the demands of the provinces, particularly Quebec. I will keep trying to find out why these people say no to any request coming from the Bloc Quebecois or from Quebec in this House.
I would like to remind members why we are having this debate today. Under certain provisions of the Constitution of 1867, health and social services are exclusive jurisdictions of Quebec and the other provinces. This worked well until about 1920, when the federal government tried to intrude in areas of provincial jurisdiction with regard to health. It succeeded somewhat.
The real intrusion, the real power grab on the part of the federal government was in 1942, when Ottawa used the war effort as an excuse to impose fiscal arrangements on the provinces. That is the idea it came up with to take control of the country's finances. At that time, taxation was supposed to be temporary. However, after the war, the federal government did not give this taxing power back to the provinces. It kept it. The provinces had to acquire their own taxing power.
The federal government took financial power away from the provinces, appropriated a good portion of their fiscal resources and unilaterally conferred upon itself a serious ability to interfere in every provincial jurisdiction.
What then happened? There has been duplication of services. That is how, in 1957, we ended up with the federal Hospital Insurance and Diagnostic Services Act. In Quebec, we had to counter with our own hospital insurance plan. In 1966, the Medical Care Act was implemented. In 1970, we had to have our own Health Insurance Act. And on it goes.
When the federal government saw that the provinces were making their own arrangements, it formally committed to pay 50% of costs related to the health care system in Quebec and the provinces. It made a formal commitment. In exchange for this funding, Quebec and the provinces had to agree to some minimal rules, namely universality, accessibility, comprehensiveness, portability and public management of the health insurance system. In the beginning, the federal government was to pay 50%.
Currently, according to the Conference Board and various studies, the federal government is paying only 16% of health costs. For its part, the federal government claims that it is paying 40% to 41%. We will look at whether in fact it is paying 40% to 41%.
First, it must be said that Quebec and the provinces are facing major challenges with respect to health care and it is important for the federal government to increase funding in this area.
It must also be said that health spending represents the biggest part of the budgets of each province and territory in Canada, and the costs continue to climb. The population, as we have been saying since this morning, is aging, the cost of drugs continues to increase and there is a growing demand for advanced medical technology, hospital care and home care, which contributes to the constant pressure the health care system is under.
At the same time, the federal government contribution to health care has not progressed at the same rate as the endlessly growing needs of the population.
For 2003-04, it is estimated that the federal surplus will be in the order of $8 billion. If we subtract the $2 billion already committed for health, based on a promise by the former member for Saint-Maurice and prime minister of Canada, Jean Chrétien, that leaves $6 billion.
The Bloc Quebecois proposes taking this $6 billion, dividing it in two and giving $3 billion to Quebec and the provinces to provide additional health services.
Once again, as I said before, there is great disagreement between the federal government and the provinces as to the real size of the federal transfer. We estimate that if we could have access to the $3 billion surplus, that would be of help to the provinces. It could raise the funding of health care in Canada from 16% to 25%.
Our colleagues on the government benches opposite believe they are already giving 40% because they include the equalization payments in the federal contribution for health, education and social programs. And they also include tax points.
Now, tax points are not part of the federal transfer payments for health. Looking at tax points, they are a historical tax balancing program of the federation and have absolutely nothing to do with the cash component of the Canada Health and Social Transfer. Moreover, the transfer happens just once and that is that. It is not calculated later.
And as for equalization payments, we can not count them either, since the equalization formula is independent of the other transfers and therefore cannot be associated with the Canada Health and Social Transfer. Moreover, with respect to equalization, there are two provinces that cannot receive payments, and they are Alberta and Ontario.
The CHST has been slashed, lowered and reduced in increasing amounts and it is block funding. This means that there are no amounts earmarked for the various programs the federal government helps fund.
In closing, I want to say that, currently, health, social services and education represent two-thirds of all program spending in Quebec. If we factor in inflation, the aging of the population and new technologies in health care, it is clear that program spending will increase significantly over the coming years. Program spending in health care will prevent Quebec and the provinces from investing elsewhere.
Currently, there is a power struggle. The federal government has the money and the provinces need the money. The federal government has taken a power it did not have initially and does not want to return it to the provinces. That is what is happening. At the same time, people in the provinces need health care.
It is unfortunate that this struggle for power and money—because money equals power—means that, “the provinces must all be the same and operate the same way everywhere”. This is a terrible vision to have, and this terrible power and terrible vision has terrible repercussions on health care services throughout Canada. It shows a lack of respect.