Health Care Funding -Bloc Oppostion Motion

Tuesday February 19, 2002

 

    Mr. Bill Blaikie (Winnipeg--Transcona, NDP): Mr. Speaker, today we are debating a very strange motion.

[English]

    I do not know how to say weird in French, but what we have here is a motion in which the Bloc finds itself in strange alliance with both the government and the Alliance. It has given the Liberals far too much credit by suggesting that the Liberals have a national vision of health care which they want to impose on the rest of the country--and here is where it gets really strange--through the preliminary report of the Romanow commission.

    I have not read it from cover to cover but it seems to me what I remember of the Romanow commission report was that it laid out a bunch of options for dealing with the problems in health care. How laying out options can be construed as imposing a particular vision on the provinces is strange to me.

    The other aspect of the strange situation I think the Bloc members find themselves in is that the Alliance supports their motion. It would seem to me that the Alliance vision of health care is a far cry from the more social democratic view of how health care should be provided that we find in Quebec and which presumably the Bloc in some way or another supports.

    If I were the Bloc mover of the motion, I would go back to the drawing board and ask myself how it is that I could have devised a motion which gave so much credit to the Liberals and which drew so much support from the Alliance. However, enough of that.

    Today we have the opportunity to debate future health care in this country. There are a few things I would like to say; in fact, there are many things I would like to say but I will not have time for them all.

    The fundamental thing that is being overlooked by the government is its own culpability in terms of not living up to the commitment the federal government made at the time of the establishment of medicare. It was federal money that was the midwife, that gave birth to medicare in Canada. It was the federal spending power which said to various provinces, even those that were ideologically reluctant, that it would offer the spending of 50 cent dollars on health care if they would agree to become part of the national medicare system.

    It is those 50 cent dollars that are absent today. It is the absence of those 50 cent dollars that gives the provinces, even those which are lacking in any other moral high ground, a certain kind of fiscal high ground when they are talking to the federal government about health care. I am thinking in particular of Alberta. It has a point, as do all the other provinces, about federal dilution of its commitment to cost sharing health care.

    I find it passing strange, and it points to the ideological dimension of this debate, that it is the province of Alberta which claims that it is under such pressure that it has to experiment and innovate even before the Romanow commission reports. Is it just a coincidence that all the experimenting and the innovation points toward the corporate sector and the private sector being more involved in health care? Why is it that Alberta feels so much pressure? Alberta does not even have a sales tax. Alberta has oil. Alberta has 100 different reasons that it does not have to feel the kind of pressure it claims to feel.

    Poorer provinces like Manitoba, Saskatchewan and the maritime provinces are the ones that are under pressure. However because they are more committed ideologically than Alberta is to the principles of medicare, and appropriately so because so are the Canadian people, they are trying to make do with what they have.

    It is the height of hypocrisy for Alberta to say “We are under pressure. We have to involve the private sector. We have to have more private clinics. We have to have more patient participation. We have to have this; we have to have that”. The fact is Alberta is the province most capable of sustaining the cost of health care in the province and it is unwilling to do so.

    The Alberta government's real agenda is not fairness between the federal government and the provincial government, or having the federal government live up to its commitment that was established at the beginning of medicare, or anything like that.

    Its real agenda is ideological. In the end it wants to turn over the health care system to the private sector so it can become another place where people make money, so that health care can become a commodity like oil. That is what is really going on here. That is totally contrary to the principles of medicare.

    That is exactly what the people who fought for medicare in this country were against; the commodification of health care, the reduction of the provision of health care to a commodity in the marketplace like any other commodity. I believe that is the underlying agenda of Premier Klein and others like him.

    However the problem is that they will not just do that in Alberta. If they succeed in doing it in Alberta, given the nature of the North American Free Trade Agreement and given the possible nature of the general agreement on trades and services that is being negotiated now at the WTO, it may well be that they could set precedents for private sector involvement in health care that will be binding on all other provinces.

    What gives Alberta the right to do this to the rest of the country? We heard the former leader of the Alliance Party, the ghost of Alliance past and perhaps maybe the ghost of Alliance future, we do not know we will find out in March or April, talking about the horrible federal government imposing national standards on provinces. Yet he does not seem to be offended at all by the notion that by acting alone and by involving the corporate sector, particularly if that corporate sector comes to be American owned and therefore would have rights under chapter 11 of the NAFTA, Alberta might, by doing what I have just described, be imposing a burden on the rest of the country. That does not bother him at all.

    I find it much more morally and politically offensive that Alberta should decide on its own to walk through this trade related minefield and at some point might step on something that will blow up not just in the face of Alberta, but in the face of the whole country.

    I share the view, only I wish the federal government would express it more strongly, that at the very least the provinces, and in particular Alberta, should wait until the report of the Romanow commission before acting. Let us see what Mr. Romanow has to say before going any further. But one thing that has to be preserved, Romanow commission or not, is the basic principle at the heart of the Canada Health Act. That is, any kind of patient participation at the moment when someone is sick and in need of treatment is unacceptable.

    Before the Canada Health Act, we had the Medical Care Act which laid out the five principles. Sometimes when we listen to the debate we think that the five principles of medicare were only established with the Canada Health Act. They go back further than that. What the Canada Health Act did was establish two new things. The practice of extra billing by physicians and the charging of user fees by provincial health care systems would be practices that would be sanctioned by the federal government by virtue of withdrawing from federal transfer payments to provinces the equivalent of what was being charged to patients in those provinces through the imposition of user fees or extra billing by physicians.

    What is unacceptable about these two things is that it is a form of patient participation; that is when a person is sick the doctor has to be paid or a user fee has to be paid. One of the things that jumps off the page at me, and which the former leader of the Alliance seemed to be recommending, is these individual medical accounts where people have so much that they can spend and beyond that they might have to spend some more of their own money. That is a form of patient participation when someone is sick. That is a form of having to pay because one is sick. That cannot be advocated and at the same time say what the former leader of the Alliance said when he said he was against having any financial barriers to being treated. That is a contradiction. Both of those things cannot be done.

    Whatever comes out of this debate, the notion that there should not be any form of patient participation on the basis of sickness or disease or need of treatment is the thing that has to be preserved if the principles of the Canada Health Act are to be preserved.

1  

[Translation]

    Mr. Réal Ménard (Hochelaga--Maisonneuve, BQ): Mr. Speaker, I am very surprised by the hon. member's comments. With all due respect to him, there seems to be a lot of confusion in his remarks.

    This is unbelievable. The hon. member does not realize that if he wants to talk about how the provinces should set up the health system, he is simply in the wrong legislature. He is surprised that there is a growing consensus in the House that the role of the federal government, based on its resources, is to restore transfer payments to the 1993-94 level.

    What we have here is a centralizing vision that is backward and outdated. I do not understand how a political party can be so insensitive to what the provinces want. This is unbelievable.

    Their party, which supported Pierre Elliott Trudeau for years, is even more centralizing than the late Prime Minister. Thank goodness there are in the House parties such as the Bloc Quebecois which care about the regions. Imagine for a moment what it would be like if this parliament was left to the Liberals and the NDP; we would find ourselves in a most unacceptable centralizing process.

    Again, I am telling the hon. member in all friendship that if he wants to decide for the provinces how health care should be organized, he is in the wrong legislature.

    I believe that such centralization is totally out of date. No one, except the NDP, believes in it. Could the hon. member name a single premier who asked that the Romanow commission rule on how health care should be set up? I am extremely disappointed.

    Incidentally, I attended the NDP convention. They even adopted a motion to create a department of urban affairs. Denis Marion had asked me to attend and I spent the whole weekend there. I followed the work being done. I am telling NDP members that such centralization is unacceptable; they are offbeat and are living in a world which no one wants, and certainly not Quebecers.

[English]

    Mr. Bill Blaikie: Mr. Speaker, we certainly seem to have gotten the attention of the hon. member. He has awoken from the lethargy that the Alliance members imposed on him when they were speaking.

    In any event, I do not see the problem that the hon. member sees with the federal government putting conditions on the spending of its own money. If I was going to give him money to be spent on health care would he want me to just say “here's the money, do with it what you would like. Set up private clinics, give it to corporations and do whatever you like”. If it is my money, and in this case it is the federal government's money, the federal government has every right to put conditions on the spending.

    That makes it constitutional. That is not an invasion of provincial jurisdiction. That is why the Canada Health Act was devised the way it was. That is why it took years to bring it in. The minions down in the Department of Justice took a couple of years to figure out how they could do this after the Hall commission report. Action on extra billing and user fees was recommended in 1981 or 1982 and it took until 1984 to get the Canada Health Act because the federal government was worried about intruding on provincial jurisdiction. In the end what did the act say it could do? It could put conditions on the spending of its own money and that is what it did with the Canada Health Act.

    The government said that it was its money and it would give it to the provinces under following conditions. That is appropriate. I can understand why the Bloc is against it, but to suggest that it is somehow not within the power of the federal government or that it somehow intrudes on provincial jurisdiction is wrong. It may have an effect on provincial policy; that is the choices of provincial governments when it comes to the provision of health care services.

    However, if the member wants to stand in his place and make a defence of extra billing and user fees and why the federal government should allow them to proliferate across the country or anything else that amounts to a form of patient participation, I would be glad to hear his defence of that particular policy.

    Mr. Peter Stoffer (Sackville--Musquodoboit Valley--Eastern Shore, NDP): Mr. Speaker, it is obvious that when it comes to health care the Alliance and the Bloc think alike in allowing the provinces to do whatever they please and damn the federal government or a national coast to coast to coast medicare system.

    My question for my hon. colleague is this. Regarding the NAFTA trade deal the Conservatives and Liberals signed with the Americans and Mexico and regarding the concerns they have on the health care crisis, it is a coincidence that we have the drug patent law, which was passed in the eighties, along with these trade deals, yet the financial burden has been placed on health care. Would he elaborate a bit more on that?

    Mr. Bill Blaikie: Mr. Speaker, clearly the hon. member points out a real problem with the health care system. One is called cost drivers by those who analyze our health care system and that is the price of drugs. One of the reasons the price of drugs has gone up is because it has been turned over completely to the marketplace through the gutting of the generic drug legislation that we had up until the 1990s. What has happened to the price of drugs is a good indicator of what will happen to the price of health care if we turn it over to the private sector.