44th Parl. 1st Sess.
October 20, 2023 10:00AM
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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Mr. Speaker, I am thankful for the opportunity to speak to Bill C-284. I will only take a few minutes to express my support for it.
I want to congratulate the member for Humber River—Black Creek for bringing the bill forward. She has championed it at every stage. I know she has been here in the House to listen to the debate and has heard what members have had to say as it made its way through committee and back to us now for its final hour of debate.
I thought it would be important to point out some striking statistics that relate to the eye health of Canadians. In 2019, the year for which we have data, $38.2 billion was lost in the Canadian economy, 1.2 million Canadians were blind or partially sighted, eight million Canadians were at risk of blindness and 1,292 deaths were associated with vision loss.
About 75% of individuals can be prevented from going blind if diagnosed early. Unfortunately, we all take our eyesight for granted until it is often too late. Bill C-284 attempts to raise awareness of the impacts of vision loss and blindness, improve eye health care and support, and foster innovative research to advance new therapies for vision loss.
It is important to try to put ourselves in the shoes of others. A close friend of mine, whom of course I will not name as I do not want to embarrass him, is slowly starting to lose his vision as a result of a genetic problem with his eyes. He is an individual who works in a technical field that requires him to always look at what he is doing and use his hands, sometimes on very small instruments. I think quite often about what will happen when he gets to the point his father did and he does not have the vision he requires to do his job.
Let us for a second think of the impact that has on people, not just from an economic perspective, because obviously they would be at a disadvantage, but also from the perspective of how it affects them psychologically. Having a strategy for how we will address issues like this, how we will support Canadians like this and how we can do more research and education around strategies related to the vision of individuals and the deterioration of it is incredibly important.
I want to again congratulate the member for Humber River—Black Creek for bringing forward this very important piece of legislation. I express my support for it and have heard around the House of others who support it. I really hope it will pass and make its way over to the Senate, where it can be adopted and then become law.
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Mr. Speaker, I rise today to speak on an important matter, the future of eye care in Canada, Bill C-284, which was presented by the hon. member for Humber River—Black Creek and addresses a matter of national concern and would ensure Canadians have access to a coordinated and comprehensive eye care response.
I thank the member opposite for bringing this bill forward. I am happy we have had some productive discussions over its content. One of my first concerns when I heard about the bill was the possible overreaching of power between the federal and the provincial government, because this does end up in the hands of health care, which is the responsibility of provinces, but I am so glad this bill would not do this. It is more about collaboration and what we can do to make sure we have national eye care and health for all Canadians.
I am surprised by one of the statistics I found, which is that 75% of Canadians have some type of vision loss or eye impediment. I am a prime example; I wear glasses. It is no surprise that a lot of us, as we get a bit more mature, start having eye difficulties. The other side of this is the fact there are a lot of diseases, such as macular degeneration, which are very hard to deal with. Any time one has loss of vision, it becomes quite incapacitating.
I will go off topic a little. I was at a conference a couple of years ago, and one of the guest speakers was a motivational speaker. He was a thalidomide baby and was born without arms. He said that every time he went to a classroom, the first question people always asked was how he lived without arms and whether he missed them. He would reply that he never had them so never missed them.
For most Canadians, it is the exact opposite when it comes to eyesight. Most of us are born with healthy eyesight and we take for granted the fact that we have good eyesight and we never think about losing it. We do not wake up and say, “Wow, I can see this morning.” It is not until one has a disease or injury and loses their eyesight, or until one has an impediment to their eyesight, that people think about it.
I think it is very important we bring recognition to this. We also want to make sure there is a good strategy in place for Canadians and that we do not go after any vulnerable or marginalized communities. We need to ensure every Canadian, regardless of their social or economic background, has equal access to quality eye care. One's eyesight is very important. It is the number one sense that people are most afraid of losing. However, like I say, every day we take it for granted.
My grandfather had macular degeneration, and he told me an interesting story. He was not fully blind, but he was legally blind, and he could still see out of the corners of his eyes. He was legally blind and hard of hearing in his early 90s, and he said it made for a very long day. He still lived on a farm and he looked forward to cutting the grass in the summer, but he would cut the grass every day. I asked him how he saw to cut the grass, and he said that he could still see out of the corners of his eyes. He figured that if he cut it every day, he would cut every piece of grass at least once in a week, because he did not think he would miss the exact same piece of grass seven days in a row. This was something he did to keep his mind active and keep busy throughout the whole summer. This was one of the things he lived for. Unfortunately, he passed away a number of years ago, but that is life. At least he tried to live his life as best as he could with the impairment he had.
The big challenge when one has an eye impacted, whether it is through disease or injury, is to try to make the best of the situation. It is so easy to get down and ask what we can do now and think that because we cannot see then we cannot do anything. However, as we have seen through many different types of programs for Canadians, such as service dogs for the blind, Canadians can lead a functioning life.
We know that on every street corner, there are beepers to make sure they know when to cross the street. There are many things we try to do, but the main thing is hoping that Canadians do not have to go through this type of situation of losing their vision. A very important thing about this situation is that we want to make sure Canadians have a great eye care service.
Something else I found out are the studies on exposure to blue light. One might think, “What is a blue light?” Every one of us looks at our cell phone at least once or twice a day, or we look at computer screens. This is actually starting to have an impact on our vision. It is quite a horrible thing, when we start thinking that it could cause earlier macular degeneration in our children or our young adults. We need to start looking at what kinds of opportunities there are so we do not have these kinds of things affecting our eyesight.
For myself, the glasses I have right now do have a blue light filter on them so that it is not as hard for me to look at computer screens. People are already starting to use technology in place to offset some of the things that are affecting our eyesight.
I have to admit that, even growing up, I was one of those people who probably did not take care of my eyes as well as I could have, because, being on a farm, it is quite easy to be in dusty conditions. When someone is using a grinder and not using goggles, they might even get a bit of a grinding file in their eyes. I have experienced a few horrible situations, yet one does not think about it and how it could impact one's life later on. As with any injury, all of the issues that could potentially happen seem to materialize the most later in one's life.
The thing with vision loss is that it is not just about how it impedes a person's life. It is also about their abilities, their mental health and the social integration and productivity they have. I talked about how one can have service dogs for the blind. Someone can have a cane to monitor where they are, but we want to make sure that people do not get to that stage. That is the one thing about this whole bill: making sure we have a structure in place between national and provincial jurisdictions to make sure that Canadians are taken care of the best they can be.
I did talk a little bit about how modern technology, such as the blue light filter, can help with eyesight, but there is also laser eye surgery. I know that the first time I heard about this, I was quite young, and I was wondering why anyone would want to cut the cornea of their eye to shape it so that they do not have to wear glasses. However, if someone wore glasses with very thick lenses, it was actually quite liberating to not have a heavy pair of glasses on their eyes. People were always concerned, wondering whether the scar tissue would be as strong as the original skin cells themselves. I think, as time has progressed, laser surgery has really materialized into a safe procedure.
Another thing is cataracts. People did not think about them. In the past, cataracts would go across one's eyes, basically like wax paper, and there was not much that could be done. Now, however, not only can doctors reverse that process, but they can also actually, when the lens is changed, get people back to 20/20 eyesight.
There are a lot of technologies out there that are helping with eye research and how it can advance Canadians, to make sure that they do not lose their vision. Technology is one of the biggest ways through which I am hoping we can solve a lot of our problems around the world, but more so with eye care, so it is very important that we have brought this forward.
In many cases, we can talk about how good technology is. At the same time, there are always limitations. One of the limitations I learned about regarding macular degeneration is that there is some new technology that was proposed that it is still in the final testing phases with Health Canada. How can that be rectified? I think, bureaucratically, there are some opportunities that need to be looked at so we can address that. That is something we need to start looking forward to. What kind of new technologies are out there that can save our vision?
I think it is very good that the member did bring this bill forward. Hopefully, we can actually get a better case for our health care for our eyes, and in the future, work collaboratively with the Government of Canada as well as with all the provinces.
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