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Decentralized Democracy

House Hansard - 236

44th Parl. 1st Sess.
October 20, 2023 10:00AM
Context: House Hansard - 236 - Oct/20/23
Ms. Nathalie Sinclair-Desgagné (Terrebonne, BQ)
  • Oct/20/23 10:58:11 a.m.
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  • Re: Bill C-38 
Mr. Speaker, the foundation of a solid house cannot be built on sand. Unfortunately, this bill is yet another pillar or beam in a house that the government is trying to build on a very shaky foundation, namely the Indian Act. After hearing my colleague's speech, I would like to ask him a question that reflects the Bloc Québécois's position. Why not simply abolish the Indian Act itself, which is so problematic?
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Context: House Hansard - 236 - Oct/20/23
Ms. Nathalie Sinclair-Desgagné (Terrebonne, BQ)
Mr. Speaker, the bill before us seeks to establish a federal eye care policy. The federal government fails at almost every one of its basic mandates, like having a half-decent foreign policy and a border that is not a firearms drive-through. I will not even mention passports. It is therefore not surprising for the government to try to change the channel by undertaking something outside of its jurisdiction. However, the Bloc Québécois, as always, will participate in good faith in the study of this bill. Even if it is hard to fathom what the federal government has to do with eye care, one cannot be against motherhood and apple pie. Losing one's eyesight is a curse that affects too many of our constituents. Let us examine the issue together, look at what the government is doing—or rather not doing—and try to find ways to minimize the damage. As an economist, I will start with some raw numbers. I know the Speaker will like that. Call it occupational conditioning. It is important to remember the impact that these problems can have on everyday life. When a person experiences sensory loss, it compromises their safety and their relationship with the world. They lose their main connection with the world. That is not something that I would wish on anyone, even my worst enemy. The population of Quebec is growing older and that is causing an increase in health care needs. The demand for care for eye conditions and diseases is no exception. In fact, there are already huge economic and financial costs associated with that. In 2019, Canadian society paid close to $9.5 billion in direct costs and $4.3 billion in productivity losses directly related to vision loss. According to the Canadian Council of the Blind, these costs, particularly those related to vision loss in Canada, will only increase and could go from $32.9 billion in 2019 to $56 billion in 2050, which represents an increase of 70% in 30 years. In addition to this growth in the demand for health care, which is expected to continue, the Canadian health care system has been institutionalizing a fiscal imbalance between the federal and provincial levels of governments since the 1990s. That was when major cuts were made to the Canada health and social transfer. In other words, Quebec has no authority to raise enough taxes to cover the growing costs of health care, while the federal government is collecting far too much considering the services it offers and their dismal quality. The causes, as we know, are the so-called federal spending power, which allows the government to interfere in areas of provincial jurisdiction, along with inadequate intergovernmental transfers, the most problematic of them being the Canada health transfer. According to the 2002 report of the commission on fiscal imbalance, this federal transfer not only applies to areas under provincial jurisdiction, it includes terms and conditions that unquestionably limit the provinces' decision-making and fiscal autonomy. Unless and until health transfers become more generous and more flexible, Quebec's health care system will struggle to provide care to all Quebeckers who need it, including, of course, those having problems as a result of eye disease. Bill C‑284 certainly is a step in the right direction. Overall, it does respect provincial jurisdictions. However, there is one exception, namely the first of the four pillars of the proposed national strategy, which interferes in an area of provincial jurisdiction. I believe that it is always important to remind the federal government that anything having to do with hospitals or clinical practice is the responsibility of the Government of Quebec and the other provincial governments. Nevertheless, bringing in a federal strategy for eye care, especially when the time comes to play a role in funding research and approving drugs or devices, was more than necessary for advancing treatment in this field. That is why the Bloc Québécois will join the Canadian Ophthalmological Society and the Canadian Association of Optometrists in supporting Bill C‑284. Eye disease will become an increasingly bigger problem over the years, as I mentioned earlier. We are pleased that a bill addressing the issue has been introduced to move forward on this important issue, although we will reiterate again and again that provincial jurisdictions must be respected. Although we do support the bill, it would have been nice if it had been more ambitious, while still respecting provincial jurisdictions. No one can be against developing national strategies and designating certain months to raise awareness, as the bill plans to do with the month of February, but sooner or later, the Quebec health care system will need transfers. Once this bill passes, it will be high time for the federal government to finally provide the health transfers that will allow for meaningful investments to make concrete improvements to eye care services in Quebec. For example, these transfers could make it possible to adapt online government resources or offer people enhanced coverage under the Quebec health insurance plan, RAMQ. Quebec's department of health and social services is already doing a lot through RAMQ. Quebec has one of the best provincial eye care plans in Canada, but it costs money. Indeed, on March 9, Quebec increased its coverage for ocular prostheses, something that had not been done in at least 30 years. The rest of the provinces offer eye care coverage that varies from government to government. The provinces have already done a great deal of work, but there is still a lot to do. Of course, that requires investment. All in all, we agree with the spirit of the bill, and we will ensure that future bills addressing eye care get more and more ambitious, especially when it comes to health transfers. When examining this bill, the Bloc Québécois will obviously take the time necessary to ensure that provincial jurisdictions are respected, as I mentioned, and that the federal strategy complements what is already being done in Quebec. Doing no harm is the least the federal government can do. The Bloc Québécois will always be there to support measures that will enable Quebec to take better care of its people. Let us remember that the road to hell is paved with good intentions, and the Liberal government has a lot of good intentions. We will simply ensure that the initiative, which is commendable overall, does not turn into yet another headache for those in Quebec who are actually taking care of our citizens.
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