Mr. Speaker, it is a pleasure to give my comments on the motion before the House and to discuss it with some sort of intelligence, hopefully.
When looking at the problem with health care, we have to ask ourselves how we have found ourselves in such a mess. Health care is the number one priority of Canadians. There is no question about that.
The real challenge in health care is to look ahead at the next 40 years and discern very intelligently and soberly how we are going to sustain the system. In a few minutes I will talk about the kind of shape the system is in right now. In looking ahead, how are we going to sustain it over the next 40 years? A demographic bubble is about to hit the system. The population is aging and is crowding in on the 65 years of age range. We understand the difference in health care costs. The health care costs of someone between 40 and 65 years old are about $4,000 or $4,400 a year. When we compare that to the health care costs of someone between 75 and 85 years old, which are about $14,000 a year, we understand that a massive problem is going to hit our system.
Consider the costs to our health care system in the next 30 or 40 years because of the demographics of our nation. One might ask when that is going to change. When we look at the numbers and do the math, we will see that the bubble does not start breaking until the year 2041. That is when it will really start to break, where there will be some sort of relief and we will start going down the other side of the bubble. It is a large bubble and it is going to be there for a long time. The intense pressure on our system will increase progressively over that 40 year period. We have to understand that in the context of this motion and where we are going in health care.
For a realistic look at where we are in Canada, we must couple that problem with the massive obesity problem in our youth right now. One-third of our youth are obese. We understand from the Heart and Stroke Foundation that those same individuals will have heart and stroke problems between the ages of 30 and 45 years instead of between the ages of 50 and 65 years. That problem will hit the system and double the problem created by demographics.
There is also the diabetes problem in first nations and right across the country. It is expected to double over the next decade.
We could go on and on and point to the problems in the health care system in Canada. I am trying to lay before the House an idea of what we are heading into in the next 40 years. I implore every member of the House to soberly look at how we can solve this problem. How can we sustain a publicly funded system where, regardless of ability to pay, we will have services for every man, woman and child in this country? That is the question. That is the problem. That is the challenge before the House. In light of that, let us look at where we are today and how we got here.
There are one million people on waitlists in this country. One million people cannot get in to have services. Many people die while on those waitlists. For many people, their muscles atrophy and degenerate to a state where they cannot have the operation or the service when the time comes.
There is a serious problem when we look at the number of doctors and nurses who are able to look after a society of 31 million people. A study within the last year revealed that 75% of general practitioners are not taking on any more patients. They are strapped and will not look after any more patients. In fact a survey within the last year said that 45% of those physicians are at an advanced burnout stage. They are burnt out to the point where not only are they not taking on any more patients, but they are ready to throw their hands in the air and walk away from their practice. There is emotional exhaustion within our health care system.
Those are just the doctors. Let us look at the nurses and see how they are doing. The stats indicate that we need 110,000 new nurses within the next decade to fulfill the needs of Canada. The sickest workplaces in our nation are within our hospitals. They are the ones who take the most amount of sick time. They take the most time off because of the emotional strains in their workplace and the amount of time they are stretched.
How did we get here? We got here because of a prime minister and a finance minister, who is now the Prime Minister. He was the finance minister in the early and mid-1990s. In the four year period 1994-95 to 1998-99, he sucked $25 billion out of the health care system alone.
We see what that caused. At the time it caused massive reductions in the health care system. The provinces have the mandate to deliver health care. They have the actual obligation to deliver health care.
I know quite a bit about that because at that time I was chair of a hospital board and went on to sit on the regional health authority. I remember going to a round table where we sat for 30 hours discussing how we were going to be able to deliver on health care provincially. We had to remove $900 million out of the budget in one single year and we were debating how we were going to do that and still sustain a system where 80% of the system was made up of human resources.
In Alberta at that time, which was unprecedented, the recommendation was to lower every salary within the system by 5%. That is what happened in Alberta during that period of time. We saved the system, we saved the budget on the backs of those health care workers.
It is a deplorable situation when we see where we are at and why we are there. It comes down to one individual. It comes down to a finance minister who is now the Prime Minister. Unilaterally, which means without discussion, without consultation with the provinces or any of the health care professionals, he decided to pull that money out of the health care system. We have wandered that way for a decade and here we are in a situation where the health care system is in crisis.
It is unprecedented when the premiers of the provinces get together and collectively pool their resources to put $1.5 million into advertising that the federal government is not putting its fair share into the health care system. It is unprecedented that taxpayer dollars from one order of government have been used to advertise and push another level of government politically. I do not think we have ever seen that before in the history of Canada. That gives us an indication of how things are stretched.
Before the House gets the idea that all we need to do is add more money to the health care system and all things will be well, we should understand a little about how we compare with other nations. Of the 24 developed nations in the world, of which Canada is one, we rank third in the amount of money per capita we spend on health care. If we factor in the age of Canadians, which is actually quite young in comparison to some of the other countries, we rank number one as far as the number of dollars put into health care per capita.
If we think that we can just throw money into the health care system and we will solve all of its woes, we are fooling ourselves. That is not the case.
That is why I get so upset when I see things such as the last throne speech. There was not any reference to the Romanow report. Perhaps we can understand why that was not there. Studies were done over the last decade by the government. By the way, there was $143 million worth of studying of health care in the last decade. It is not so important that we did the studies, but what is important is what came out of those studies. What did we really do?
A little over a year ago the premiers and the Prime Minister signed a health accord to deal with the problems that are plaguing our health care system and how to put it on a sustainable path. It is really interesting that what we hear right now from the provinces and the federal government is that it is all about the dollars, it is all about the money.
This motion is all about the money. It does not talk about all the failures in the health accord. I would like to look at some of the things that were talked about in the health accord because some of it was pretty good. It talked about restoring funding to the core health services, which we agree with. We should restore that. In fact, we fought the last election on adding a sixth principle to health care, which is stable funding.
Actually that should be deemed the former finance minister's principle and the present Prime Minister's accord. That is what it really should have been called, because that is who pulled the money out of health care and removed the stable funding so the provinces were not able to deal with their budgets. The money that goes to health care is now crowding in on 50% of their budgets. We wanted to restore that.
The second thing we wanted was flexibility for the provinces so they could implement the new services that were coming in with the health accord: catastrophic drug coverage, home care and palliative care. We have to understand that there is a lot of difference between home care in downtown Toronto and home care in the outback of Saskatchewan. Provinces need to have the flexibility within the system to be able to deal with those differences. We were able to achieve that in the health accord.
We had to deal with the flexibility of delivery within the public health care system. The system itself has to have enough flexibility within a public umbrella. If we are going to have a single payer system we must have the flexibility to be able to create competition within that system to make it sharp and accountable and to make sure we are getting the best bang for the dollar, because we are investing a tremendous number of dollars in health care, $121 billion a year. We have to somehow make sure that we are using those dollars, that we are policing those dollars, in the most efficient way that we possibly can.
We have to stop this nonsense of talking about who is giving what. We have to clear up the numbers on the dollars in health care. In the health accord, it was a dedicated health transfer rather than the CHST, which means health care and social services as well as education under that umbrella. Everyone was accusing the provinces of using different numbers for health care, social services and education. Let us clear up those numbers. We got that and we are really interested in seeing how it breaks down in next year's budget as we see the split between health care and social services and education.
Those are the things we asked for and got in the health accord, and with which we agree, but there are some other things they have missed in the health accord. It is really interesting that when the premiers sat down on the Friday just before the Monday of the throne speech, the discussion was all about the $2 billion. It was not about the things that were promised in the health accord over the last year and were not accomplished. I would like us to consider some of those things because that should have been part of the discussion. That should be the discussion here now.
Why is it that one order of government sits down with another order of government and they agree on an accord, do not accomplish what they say they were going to do, and yet there is no debate and no discussion about it a year later? One of those things was a minimum basket of services for health care. That was supposed to be done by September of last year. We have to ask ourselves why we are not discussing that. Where is it? What happened to it? We still do not see it.
What happened to the common health services performance indicators that were promised for September of last year? How come that did not take place? There is no reporting of that out of discussions at the first ministers meeting with the Prime Minister here a few weeks ago. There was no discussion whatsoever about some of those failures.
There was no discussion about the Health Council that was supposed to be set up last May. It finally came to us in November, but two provinces are not entering into it so obviously we are not getting a lot of support for the council.
There was supposed to be some reporting on a health reporting framework for aboriginals. What we saw in this last week was a complete failure to discuss that. In fact, they pulled away from obtaining the reporting for aboriginals on their health care. We have to understand when we are looking at the aboriginals that this is 100% a federal jurisdiction. It is not that we have a problem between the provinces and the federal government on a clash about whose responsibility this is. This is 100% a federal responsibility, yet we are still not seeing that happen.
There is no progress on the catastrophic drug coverage, which was part of that health accord. In fact, if we really look at the words of the former minister of health, she said that they have not even started thinking about that whole idea of catastrophic drug coverage. That was back in November. Today there is a new Minister of Health and I am sure that has not progressed at all.
It is really interesting that we do not talk about some of those things, about the unfinished business. It really is something when we start looking at the whole dilemma in health care. When we look at the problems in health care and the challenge going ahead into the 21st century, we see how the debate is all wrapped around just the dollars and cents. We do not even get to how we have to change the paradigm in health care away from this health care system that we have almost made a sacred cow. We should be changing that focus and putting it on the patient. If we do not put the patients first and build a system around the patient's needs in the 21st century, we will fail to move forward in making the health care system sustainable.
It is very important that as we go ahead we understand some of the problems, some of the challenges and some of the opportunities we have. When we look at the motion, we see that really it just calls for more money. As has been described earlier, we need more money, and we need to have a working relationship with the provinces and the federal government. We have to make the federal government responsible for its part of the health care budget.
I am not 100% convinced that the motion is accurate when it states that we should just put in 50% of the surplus, because we do not know what the surplus is. People can manipulate dollars and cents and money in budgets very easily, so I am a little nervous when I see that this is the way we are supposed to proceed in the future with regard to health care funding. We believe in stable funding so that provinces know exactly what they are getting and why, and what we expect them to achieve with that money.
This is the other link that is not part of this motion and discussion. The discussion is just about how to throw more money at the system and that will fix it. That is an illusion. That will not happen. That will not solve the problems as we look ahead into the 21st century. When we look at some of the other problems with health care and the health of a nation, we have to look at some of the other solutions, not just money. We have to understand that there is a large, dark hole in health care and the more money we throw at it the more money will be consumed.
We have to put more onus on the individual patient, the individual Canadian citizen who is paying into health care. We have to look at more prevention. We have to understand that the health of a nation is wrapped up in more than just health services. A good job and the wealth of a nation are part of it, as is how we educate people on how to eat and exercise.
We need to look upstream, we might say. This has been talked about a lot in our health care debate. We need to look upstream so that we catch people before they become ill, so that we prevent them from becoming ill.
We have to look at natural food products. I am amazed when I see what is actually happening with the recent development that we will allow marijuana for medicinal purposes in this country with no research, no validation or product of choice whatsoever, yet we will stop natural food products, just vitamins and minerals, from coming in from the United States.
I cannot for the life of me understand where this government is coming from on that issue. On the one side, we see the damage that is done by marijuana use in this country and how devastating that is to our society, while on the other side natural food products have never hurt anyone. They are only for health. We have individuals who are saying they absolutely must have those products, yet Canada is determined that it will not allow them to come in.
The other problem is that the highest and rising cost driver of health care is medication. Adverse reactions to medications in this country are at an all time high. It is unbelievable. Somewhere between 15,000 and 30,000 deaths a year in Canada are due to adverse drug reactions. It is a study that the House of Commons health committee has initiated. I have pushed this in health committee. We have worked hard at it. In fact, a couple of weeks ago the House actually passed my motion asking for 48 hours' notification for adverse drug reactions so that we can actually deal with the problem of drug reactions.
Just putting more money into more medications is not the answer. A study that came out last week said that alone our seniors consume $1 billion more in medication than is necessary. They should not be using these drugs at all. That is $1 billion a year for 31 million people, but when we talk about it being just the seniors, we get a picture of just how many drugs they are consuming that they should not be.
It is said that the largest user of pharmaceutical drugs in our country is the wastebasket. We have to really get a handle on where we are going. This is the number one driver of costs in our system, so we have to look at some of these ideas as solutions and not just at the idea of throwing money at a system to solve a problem. It is much deeper than that. If that were the problem, we would have solved it a long time ago. We cannot let either order of government off the hook by just saying “let us give them more money” so that politically they are safe. That is not the solution in the long run.
