44th Parl. 1st Sess.
February 16, 2023 10:00AM
- Feb/16/23 10:19:21 a.m.
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moved:
That, given that, (i) during the 2021 federal election campaign, the prime minister was harshly critical of the Conservative Party of Canada proposal to encourage “innovation” in the health care sector by expanding for-profit provision of publicly funded services, (ii) the prime minister has now dramatically changed his position and has lauded as ‘’innovation” Ontario Premier Doug Ford’s proposed expansion of for-profit clinics, (iii) for-profit clinics would poach workers from the public system and lead to longer wait times, (iv) there are multiple public reports of two-tier health care in Canada, where people are charged for faster access to care, such as family doctors or surgery, the House call on the government to: (a) express disappointment that the prime minister has promoted Ontario’s for-profit health plans as “innovation”; (b) ensure that recently announced health care funding is not used for the expansion of for-profit health care, but instead used to rebuild and innovate within the public system by hiring more staff and reducing wait times; and (c) enforce the Canada Health Act and immediately move to close loopholes that allow for the growth of two-tier health care in Canada.
He said: Mr. Speaker, Canada's health care system is based on the principle of access to care based on need rather than ability to pay. A well-designed, well-funded single-payer system can provide fair, effective and high-quality care to make this a reality.
Our public health care system is certainly facing some challenges, but the solution lies in strengthening our public health care system, not weakening it.
If we introduce private funding, then need will come second to ability to pay. That would result in less accessibility, longer wait times and higher costs in the public system. It would also lead to increased administrative costs, in other words, more money for insurance companies and less money for health care.
Introducing private payment prioritizes care based on ability to pay, not need. It leads to worse access and wait times, as well as higher costs in the public system. It also leads to higher administrative costs, which means less money for patient care.
There is not only little evidence that private, for-profit investor-owned corporations can provide better quality care or reduce costs. In fact, there are many examples that show precisely the opposite. Those seeking to improve the quality, equality, access, efficiency and equity of health care services in Canada can do so by focusing on strengthening our public system rather than dismantling it.
Proponents of privatization claim that increasing private pay and/or private for-profit delivery will reduce wait times, either overall or for those in the publicly funded system specifically; reduce costs to the public system; and lead to better health outcomes. There is perhaps no more serious and dangerous myth in Canadian politics today than that statement. I want to review the situation today and some of the factors that show this is not the case.
Everyone deserves health care when they need it, no matter the size of their wallet. No one should need to wait in pain because there are not enough health care workers or because the wealthiest jump the queue.
However, under successive Liberal and Conservative governments, today people are waiting in pain for hours, days or weeks, and sometimes months or years. Folks are losing their quality of life while they wait for surgery. In addition, health care workers are run off their feet, burned out and exhausted in every corner of this country.
The Prime Minister could make things better for patients by hiring and rebuilding the public health system. Otherwise, he can contribute to making the crisis even worse by helping to fund for-profit schemes that will poach staff from the public system.
We are not surprised the Conservative Party loves for-profit care. It will make billions for corporations and rich CEOs. This is right out of the Conservative playbook: starve a public service and use that as an excuse to hand it off to the private sector.
A condition of federal health care funding should be investing to fix public universal Canadian health care, not funnelling funds and staff into for-profit facilities. New Democrats want health care to move towards more public delivery, not farther away from it.
If new bilateral health agreements do not result in thousands of new health care workers in our public system, it will fail. Ottawa urgently needs to partner with the provinces and territories to help provinces train and hire more health care workers, respect current health care workers and pay them better, and recognize the international training of thousands of health care workers who are already in Canada and ready to work.
During the 2021 election, the former Conservative leader said that “he would support provinces in introducing privately led health care ‘innovations’”. At that time, our current Prime Minister told Canadians this was evidence that a Conservative government would threaten Canada's public health care system, saying that the Conservative leader “believes in a for-profit, private health care system and he will not tell people what exactly he wants to do with that.”
My, how things change once one is in office. The Prime Minister recently reversed his position by calling Ontario premier Doug Ford's private for-profit clinic scheme an example of “innovation”.
Let us just quickly review the privatization plans by Conservative premiers across the country. Doug Ford has said that he wants to divert funding from his province's hospitals towards for-profit surgical clinics.
His plan includes an expansion of private cataract surgeries, MRI and CT scans, minimally invasive gynecological surgeries, and knee and hip replacements. Ontario's plans to contract out to private for-profit clinics for cataract surgeries is expected to cost the government 25% more per surgery. Moving only hip and knee replacements to for-profit clinics will benefit owners, with an estimated windfall of half a billion dollars annually. The owners of Herzig Eye Institute, one of the top private surgery clinics that lobbied the Ford government to expand private cataract surgeries, have donated thousands of dollars to the Ontario Conservatives.
In a recent throne speech, Manitoba premier Heather Stefanson announced her government's intention to seek out private partnerships to deliver health care.
Saskatchewan is moving forward with plans to reduce its backlog of surgeries by privatizing certain procedures.
In January, Alberta announced that it is contracting Canadian Surgery Solutions to perform more than 3,000 orthopaedic surgeries covered by the provincial medicare plan.
Why are they doing this, and how are they getting away with it?
There are several loopholes here, but I want to itemize one of them. There is a serious loophole in the Canada Health Act. As we speak, private clinics across Canada are advertising to prospective patients that within weeks they can get surgeries that typically take six months or more under provincial health plans. All the patient has to do is pay them $20,000 to $30,000, depending on the clinic.
CIHI estimates that the average cost per joint replacement operation in public hospitals in Canada is $12,223, which means that the private clinics are charging patients roughly double what the surgery costs the provincial medicare system.
To those who claim that private surgery is cheaper, one can tell right away that when one adds profit and extra administrative costs, diverting money to the private system will cost our public system more.
Doug Ford says, “Oh, that is okay. We are still paying for it with public dollars”. Why would Canadians ever tolerate paying twice as much for surgery in a private system than they would in the public system?
The Canada Health Act prohibits extra billing. This means that doctors are banned from charging patients more than the medicare rate for an insured service. However, private clinics are getting around that by operating only on patients from other provinces.
Imagine the loophole in this country where, if one is in Manitoba, one can sell a private surgery to someone from Ontario but not somebody in Manitoba.
This violates the fundamental principle of the Canada Health Act. It is a gaping loophole in our system. We are calling on the government to close that loophole right now if it truly cares about public health care as it says.
It is not only those kinds of surgeries, though. Maple, a Loblaws-funded virtual care business based in Toronto, is charging patients $69 per doctor's visit or $30 per month for 30 visits per year if one wants to go bulk. In-person service would be covered by Ontario's public insurance plan.
Ontario has insured virtual visits under OHIP, but Maple has found a way around the province's rules by connecting patients with a nurse practitioner or physician outside of the province. This is another gaping loophole.
That is not to mention the odious practice that has been going on in this country for years, where people appear at private clinics only to be upsold. They come for cataract surgery but are told that if they want a better lens, they have to pay more. That kind of introduction of private pay and access to health care is a fundamental violation of the medicare system that Canadians hold so dear in this country.
Let us talk about the evidence against privatization. A recent study led by Dr. Shoo Lee, a professor emeritus at the University of Toronto and former pediatrician-in-chief at Mount Sinai Hospital, looked at international experiences to determine what impact private financing would have on Canada's health system. That study found that private financing, both private for-profit insurance and private out-of-pocket financing, negatively affects the universality, equity, accessibility and quality of care.
It is not just that study. A recent study of England's National Health Service found that as outsourcing to the private for-profit sector increased from 2013 to 2020, so did the rates of death from treatable conditions.
I look forward to hearing any questions. Let us stand up for public health care in this country and make sure that every dollar of public funding goes to public health care in Canada.
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- Feb/16/23 10:32:17 a.m.
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Madam Speaker, we absolutely need to open up the Canada Health Act, but we need to do it for the purpose that the NDP is talking about today. This is to close the loopholes that are allowing private, for-profit care to creep into our system. Right now, we have a shortage of doctors in our hospitals. We have a shortage of nurses in this country. Staff are burnt out at every hospital. How can it possibly be a positive development to allow private clinics to drain people from that system and then allow access based on private access to care?
We have to add profit and administrative costs to the system. By the way, the United States pays 31¢ out of every dollar to administration. In Canada, we pay under 2%. Administrative costs are much higher in the private system. If we drain those workers, what is going to happen to the wait times in the public system? Obviously, they will get longer.
We need to close the loopholes to make it clear that all publicly insured services in this country are delivered in the public health care system. Let us build up our public system. Canadians deserve to have timely access to world-class care. They are not getting it now. New Democrats will continue to make proposals so they can get that.
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- Feb/16/23 11:15:23 a.m.
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Madam Speaker, my hon. colleague was relying on quotes, so I am going to share some quotes with him.
Bernie Robinson, from the Ontario Nurses Association, said, “I fail to understand where the government thinks it's going to get the human resources to staff these private clinics other than by draining our already-taxed public system.”
J.P. Hornick, from the Ontario Public Service Employees Union, said, “To improve access to care, public hospitals require staff and funding, both of which will be even further depleted with increased reliance on private clinics.”
Finally, Dr. Bob Bell, former deputy minister of health in Ontario, said, “I totally agree with their desire to do more surgery by moving it out of the hospital into the community. But moving it to a for-profit model is simply dumb.”
This is not about upholding the Canada Health Act. Why is the federal government not stepping in to make sure that the additional funds are not diverted by the provinces to private clinics, even if they are publicly paid for?
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- Feb/16/23 1:32:19 p.m.
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First, Liberals need to stop the loopholes, Madam Speaker. They need to stop provinces from circumnavigating the Canada Health Act and offering privatization. This is creating a two-tiered system that we know is going to harm our ability to attract doctors and nurses to the universal public system and is not going to be affordable for others. They promised a mental health transfer of $5.3 billion, and that has not happened. There are no assurances in their agreements with the provinces that it is going to be delivered.
All the member has to do is talk to the national organizations that are delivering mental health services in the two-tiered mental health care system, because that is what is going on. He also needs to maybe talk to some of the parents who have lost loved ones, who were in treatment or in the hospital and were punted because there were not enough beds for them. Maybe they took their own lives. Maybe he should talk to Moms Stop the Harm. The government needs to talk to them before it pats itself on the back. It needs to listen to them because that is who is calling for this action right now.
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- Feb/16/23 1:33:20 p.m.
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Madam Speaker, I feel so sorry for my friend, who was trotted out like a slaughtered lamb for this speech. To give a speech about health care and being a New Democrat is ludicrous in my province.
New Democrats actually ushered in the two-tiered health care system under Roy Romanow when they closed 52 hospitals in my province, and every hospital they closed was in an opposition member's riding. They fired 1,000 nurses and 500 doctors in the 1990s. Therefore, when they talk about two-tiered health care in Canada, they are the ones who brought it in. People could never get the same service in rural and remote Saskatchewan as they could in urban Saskatchewan. They closed the Plains hospital, which was one of the first hospitals built in the province in 100 years. They did not like the people who were going to it because those people did not vote NDP.
The NDP has nothing to stand on when it comes to two-tiered health care in my province. They eviscerated Saskatchewan's health care system. That is why they will never be in government in Saskatchewan and why they will never be trusted to be the government of Canada.
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- Feb/16/23 1:51:49 p.m.
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Madam Speaker, I will be sharing my time with the member for London West.
I am very pleased to rise today to speak about health care. This has been a really important issue for my constituents and all Canadians, especially after the pandemic and the strain we saw in our health care system. All Canadians are focused on health care right now and are thinking about health care. The strain on our health care workers has been enormous. I am therefore pleased to rise in this House to talk about the plan that our Prime Minister announced.
My minister, the Minister of Intergovernmental Affairs, and the health minister have been travelling across the country meeting with premiers and their ministerial counterparts to discuss health care needs in each and every province and territory. We know that the needs in each province and territory differ, and that is precisely why these conversations about the priorities in each place are so crucial. There is not a one-size-fits-all solution, but what we can do as a federal government is lead and support.
We can talk about the areas of health care that we all know are under pressure, including emergency rooms. I have mentioned the strain on health care workers in the sector, who are overworked and whom we all regarded as our heroes. They are still our heroes but are not getting the attention and care they need during this difficult time. That is what the funding announced on February 7 is about. The Prime Minister announced almost $200 billion over the next 10 years to help support the critical areas that are under pressure. It includes better wages for health care workers, which is incredibly important.
In my riding, issues regarding mental health are raised all the time. Countless constituents have come to me talking about the mental health needs of a family member, for example. In my region, there seem to be some challenges in getting support for people with eating disorders, a specialized mental health area. It is also really hard to get supports for young people, and that is crucial for their recovery.
There are other areas I have met with constituents on. One is the area of stroke survivors getting the adequate rehab they need post-stroke. Another area we have heard about in my constituency is the need for family doctors and access to family doctors, especially for newcomers in my community who need family doctors or specialist appointments. It is becoming increasingly difficult.
I would be remiss if I did not speak about the need for long-term care and the supports there. Our government previously announced $4 billion to support long-term care. Sadly, during the pandemic, one of the long-term care homes in my riding lost many residents. I think we had among the most fatalities of anywhere in the country, which was devastating and only served to prove the breaking point that some of these facilities were already under. The measures and the supports needed during COVID highlighted that. We have committed to doing better. We owe these families and our seniors the dignity they deserve later in life.
I have spoken about emergency room wait times. I have heard from constituents who, if they do not have a family doctor, are putting more strain on emergency rooms because they have nowhere to turn, even if there might not be an emergency situation. That is also adding to the strain and pressures on our system.
These are all things that Canadians are extremely focused on. That is why, with this announcement, I was so pleased that the proposed funding addresses so many of the key points that my constituents have raised directly. One of those things is an immediate $2-billion top-up to deal with the pressures on pediatric hospitals and emergency rooms and with long wait times for surgeries. Those specialty appointments are becoming harder for constituents to receive, and many times it is a quality of life issue.
We have also committed to additional bilateral agreements because, as I said earlier, there is no one-size-fits-all solution. The priorities of each province and territory might be different. The needs of the residents there might be different. It is important that we are listening to those needs and where those priorities should be.
I spoke about support for our hospital workers, which includes $1.7 billion over five years to increase the wages of personal support workers. This is additional funding to help keep seniors, or those who need a bit of help, in their homes longer. I have personal friends and constituents who are in desperate need of that additional care. We will help them by injecting some of the funding into that system. In addition, there is $2 billion over 10 years to support indigenous priorities.
There is a lot of work to be done, but I think what is crucial is that we have identified what Canadians have been telling us about where the injection of funding is needed.
One of the most important things I can say, which constituents in my riding in Ontario have said time and time again, is that there has to be accountability. We cannot just send cash to the provinces without knowing where it is going or if it is actually hitting the services needed. My constituents and residents who have been asking for this influx of funding want to be able to hold their provincial governments accountable if the funding is not going there.
What I do not want to see after an injection of federal funding, which I have also heard from my constituents, is the provinces taking out their share while we end up in no better a place than we were before. Therefore, for accountability and transparency, the requirement to have data is important. The Prime Minister has talked about this. I find it difficult to talk to Canadians about the fact that if they require an ambulance and provide their health care, the ambulance staff do not know if they are allergic to anything.
I think I am running out of time since question period is about to start, but I would like to continue after that because this is a crucial moment for our health care system in Canada.
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- Feb/16/23 4:54:46 p.m.
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Madam Speaker, I appreciate my colleague's work on this file and others.
This is an interesting thing. We can ask the people who are lined up and cannot get out of the ambulance and into the hospital I represent, Hôtel-Dieu Grace. There are ambulances lined up and people cannot get in there because it cannot get the proper staffing. That is the real test.
We can say all this money is out there. Members brag about how much money they gave and announce things over and over, but this is a famous Conservative Mike Harris trick. The Conservatives talked about having the $1-million dump truck that would go around and announce money all over Ontario, but no one could get the money because of the complications and the way it was laid out. We never actually saw the money, and it is the same thing with this.
What people really care about right now is getting access to proper medicare and not to be starved from it. Again, the numbers do not really lie in terms of what the reality is. We do not have enough money right now because we starved the system. When someone is sitting in an ambulance and cannot get into the hospital because it does not have the proper staffing, it is not acceptable.
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- Feb/16/23 4:57:04 p.m.
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Madam Speaker, I am very proud to be here to talk about this bill. I appreciate that it is a difficult subject.
As a New Democrat, I am incredibly proud of the fact that in 2004, Canadians overwhelmingly voted for Tommy Douglas as the greatest Canadian because he was the father of medicare. When we think about medicare, it is right in our blood. We believe in it foundationally, and it is something we all want to see continue to grow and progress in this country. However, we know the reality is that it is in crisis. I know this very well. I know this because of the realities in my riding.
In my riding, there are currently two hospitals that have no emergency room at night. They shut down. One of those communities is on Corman Island. It is an island, so if something happens to someone at a time when the hospital is closed, they have to find a way off of the island to get help.
I think of Port Hardy, which was very much in the news. One time, someone who was going to the emergency room at the hospital with a very serious issue arrived to find it closed. He collapsed and an ambulance had to drive him over 30 minutes to the nearest hospital. He was lucky because he was not on an island. He was lucky because when he got there, the hospital was not closed that day.
The reality is that during a period of time, we had sudden emergency room closures. Often there were Facebook posts just to let people in the community know their hospital was not open for emergencies that evening. This is devastating. It is devastating to communities. I have had so many constituents contact me to let me know how afraid they are. The hospitals are having such a hard time attracting doctors, staff and nurses because they are burning out. It is huge.
We have to continue to talk about this. When it happens, especially for rural and remote communities that have a very unique experience in this country, people lose emergency access, and they often have to travel far to get any kind of specialist appointment. Now when hospitals are looking at strategies to attract and retain people, it is harder for them. Some are trying to rebuild their communities and economies, but they cannot tell people that if they come to the community to work and live, there is going to be an emergency room open if something happens to them.
Recently, the B.C. NDP government stepped up with $30 million to help. Part of that help meant that two hospitals had to close their emergency services at night. However, what was different is it was not happening all the time. Now they have some resources to start an attraction and retention strategy to get more of the health care providers they desperately need in that region.
The reality is that in Port Hardy, between 7 a.m. and 5 p.m. there are emergency services, but from 5 p.m. to 7 a.m. there are none. On Corman Island, between 8 a.m. and 7 p.m. there are emergency services, but after 7 p.m. there are none. Let us remember that people have to take a ferry to get help or take a helicopter off the island.
I am here and will support this bill because my constituents are pleading for help, and I do not believe the government is standing up to support them. We need the resources flowing. We know something has fundamentally changed in this country, and medicare is worth fighting for.
We need to see that this crisis is happening and that privatization is growing in this country. Why should we be afraid of privatization? Why should we be concerned when the Prime Minister, during an election, made fun of the Conservative leader for saying that privatization is innovation? The Prime Minister said it was wrong, but a little while later he told Doug Ford that it was innovation and good for him. That is the discrepancy here. I really hope members in this House listen to that, because it is a clear discrepancy. All Canadians need to be aware of that.
One of my riding's biggest public health advocates is Lois Jarvis. She is relentless. This woman fights every day for public health care, and I appreciate and respect her so much.
When the communities of Campbell River and Comox Valley were getting hospitals built, she fought like hell to make sure they would have free parking. Do members know why she fought for free parking? It is because those two hospitals serve communities from all around, and people have to come a far distance to get health care. She did not want them to drive for hours, take ferries and then have to pay for parking on top of it, so she fought for it. She fought for public health care, and I will as well.
We know for a fact that private clinics across Canada are advertising that procedures can be done there so much faster and would cost $20,000 to $28,000. We also know that medicare in Canada does the same service for just over $12,000. Privatization is always about making profit; it is not about helping people. That is why the NDP will get up every single day and fight for this system.
Tommy Douglas built it. We all know what he went through to make it happen. It is shameful for the Liberals to take credit for somebody's hard work and inspiration in this country, as if finally the federal government listened and is making sure it happens for every Canadian.
I will stand up for this every day, and I will say that if it does not pass the Lois Jarvis smell test, then I will not have it. Right now, what is happening in this country does not pass her smell test. She knows that privatization is creeping and creeping. Do members know what that means? It means indigenous communities will have even worse health outcomes. It means people who are economically marginalized will be more and more ridden with disease. Our system will fail them. It is already failing too many Canadians.
I will stand up in this House to fight for health care. I certainly hope that everybody in this House has the bravery to do the same.
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