SoVote

Decentralized Democracy

Ontario Assembly

43rd Parl. 1st Sess.
August 24, 2022 09:00AM
  • Aug/24/22 5:10:00 p.m.
  • Re: Bill 7 

Thank you to the member from Spadina–Fort York for the question. Listen, it’s important if we’re going to look back in history to understand that it’s really great that maybe the NDP government—and I will say again, the one and only time there has been an NDP government here in the province of Ontario—put those things into place, but quite frankly, they contributed to the problem that we have now. They developed no new spaces, and it has put us into a position where the Conservative government that followed that up had to scramble and try and do what they could to move that forward, in building 27,000 new beds and contributing $1.2 billion. At the time, that, quite frankly—and it still is a lot of money. So for that member to get up and say that we should be taking lessons from the NDP—I just don’t think it’s the case.

Interjection: What was that called?

Thank you very much to the member for raising that, because I think it is very important for people to understand, and, well, as we’ve seen, the caucus keeps shrinking on the other side of the House.

We need to build more long-term-care beds here in the province of Ontario. We also need to be able to free up as much space in our hospitals as possible, especially when we look at what—

Interjections.

If you’ll let me continue, when we look at we look at what’s happening across the province, we still have an opportunity to really bolster what we’re doing with our health care system. If we continue down the same path that we’ve continued down for the last 20-plus years, we’re going to end up having the same results. We need to be innovative. We need to make sure that we’re doing the best that we can for the people of Ontario, and this Doug Ford government will continue to do that every single day.

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  • Aug/24/22 5:10:00 p.m.
  • Re: Bill 7 

Thank you, Madam Speaker. It’s a pleasure to see you in the chair.

I just want to comment on the remarks from my friend from Kitchener–Conestoga—very thoughtful remarks, looking back into history.

We’ve just heard a member of the NDP talk about the legacy, from his eyes, on what the one NDP government was able to accomplish. But I know that the member from Kitchener–Conestoga would probably have his own version of the legacy that the NDP government of Bob Rae left on our province. I was just wondering maybe if he’d be interested in enlightening us with the real story behind Bob Rae and that government and the mess that they left for the Premier to fix back in those days.

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  • Aug/24/22 5:10:00 p.m.
  • Re: Bill 7 

Question?

The member from Davenport—thank you.

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  • Aug/24/22 5:10:00 p.m.
  • Re: Bill 7 

I appreciate the comments from the member for Kitchener–Conestoga. But his history is selective, because the NDP government—the last time we were in power, we actually brought in a seniors’ bill of rights, we brought in mandated residents’ councils in all long-term-care homes to represent the rights of residents, and we also mandated hours of care and also inspections. The Conservative government that came in in 1995 stripped all of that away, including the seniors’ bill of rights.

This bill goes even further. This bill is about “without consent.” It uses the term “without consent” six times, and it has a list. Some 20% of the text of this bill is a list of 13 items or things that this government is empowering people to do without the consent of the resident seniors. So will this member admit that his government is not at all interested in protecting the rights of seniors in long-term-care homes?

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  • Aug/24/22 5:10:00 p.m.
  • Re: Bill 7 

I’ve been listening to the member from Kitchener–Conestoga’s comments. The member wants the official opposition to support this legislation. Earlier today, the interim leader of the official opposition asked the Minister of Long-Term Care in this place if he would ban hospitals from billing for hospital beds for people who continue to stay there. And the member opposite talked about if people prefer to stay, they won’t—the long-term-care minister refused to answer that question. It was very notable.

Afterwards, in scrums—and I want to just share this with everybody here, because it’s coming out in the news reports as we sit here—the minister has been quoted as saying now, “If they refuse to move into their home of preferred choice, then yes, absolutely,” the hospital will charge them, “because we need those spaces for patients who need acute care.” The Minister of Long-Term Care has confirmed that those patients will be billed if they don’t take the spaces that are immediately offered to them. I’d like to know the member’s response. Please, give me a reason to support this terrible piece of legislation.

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  • Aug/24/22 5:20:00 p.m.
  • Re: Bill 7 

Thank you, Speaker, and congratulations on your appointment to the chair.

I just want to thank my colleague from Kitchener–Conestoga for those wise words that we heard today, going back in time. We all have parents who are aging, or are at the age that our parents are aging, and you want to make sure that they have that care as they grow older and they have a place to go that is secure, that is safe. Because it’s about compassion, as we’ve said. We want to take care of our seniors and we want to make sure that they’re looked after. So I thank them.

But I want to thank the Minister of Long-Term Care for the 256 brand new beds that we’re getting in Etobicoke–Lakeshore. I know that the member for Kitchener–Conestoga mentioned the new long-term-care beds in his community, and I know, all across this province, we have all received long-term-care beds under the Doug Ford government, not under the previous government, propped up by the NDP. Zero beds were put in Etobicoke–Lakeshore. Zero beds were put in Etobicoke altogether. Very few beds were built across this province. It’s this government that got it done.

My question to the member of Kitchener–Conestoga is, how will Bill 7 play a role in supporting Ontario’s broader health care plan?

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  • Aug/24/22 5:20:00 p.m.
  • Re: Bill 7 

Again to the member: One of the things that we saw during the previous 15 years was that no beds were built across the province of Ontario—some 611—with the support of the NDP. How has that contributed to the challenges that we’re facing in acute care in the province of Ontario?

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  • Aug/24/22 5:20:00 p.m.
  • Re: Bill 7 

I appreciate the opportunity to speak to this bill, Bill 7, the More Beds, Better Care Act.

I’m also very excited to debate this bill because I have heard from quite a few of my colleagues this afternoon. It’s been an interesting afternoon—I have to agree with the member from Kitchener–Conestoga on that point—because while we were debating, I actually got an email from a constituent. This is what they wrote:

“Please try to stop this from happening!

“This is gross and atrocious! To think, I or members of my family could end up Lord knows where, ALONE, in any kind of a crappy facility, with no family to advocate for me. Please!

“And, announcement made this morning, law introduced this afternoon! What’s wrong with this picture? He should drop Bill 124 and pay staff properly, treat them properly. Don’t shuffle old people around like cattle to make the staffing situation look better. Shame on him!” That was the quote in an email that I got just while this debate has been happening.

I begin today with this legislation. I have read it carefully. I have read it multiple times. I actually left a copy in my office, so I got another copy from the Clerks here to make sure that I had all my notes correct as well, because when I look at this bill, More Beds, Better Care Act, I think what we should actually call it what it is, the warehousing seniors act, instead of the title the government has given.

What I want to do, Speaker, is start off with the explanatory note because I think everyone in Ontario—and some of my esteemed colleagues—may benefit from hearing the explanatory notes. It reads, “The bill amends the Fixing Long-Term Care Act, 2021, to add a new provision for patients who occupy a bed in a public hospital and are designated by an attending clinician as requiring an alternate level of care”—ALC. “This new provision authorizes certain actions to be carried out without the consent of these patients”—without the consent of these patients—first page.

And it goes on to say, “The actions include having a placement co-ordinator determine the patient’s eligibility for a long-term-care home, select a home and authorize their admission to the home.” This is the care coordinator. “They also include having certain persons conduct assessments for the purpose of determining a patient’s eligibility, requiring the licensee to admit the patient to the home when certain conditions have been met and allowing persons to collect, use and disclose personal health information, if it is necessary to carry out the actions.”

Let me just read the certain limitations that do apply: “The actions cannot be performed without first making reasonable efforts”—so you know what, Speaker? Yes, it does say that. It does make reasonable efforts, and we know from the way people have been treated—so many of our seniors who have been treated in long-term-care homes, the type of food they receive to the way they have been left alone for hours and days. We know that sometimes things can be a little bit muddy when we talk about “reasonable efforts” when it comes to treating seniors.

It goes on to say—“reasonable efforts to obtain the patient’s consent. If consent is later provided by an ALC process, the parts of the process that have been consented to must be in accordance with sections 49 to 54 of the act, subject to the regulations.” We don’t have this and the regulations will dictate some of that as well.

“The section does not authorize the use of restraints”—which is what we have been saying on this side of the House, Speaker. We understand that you will not tie down grandma or grandpa and force them out on a gurney, but that’s okay because you’re still forcing them by other means. “The section does not authorize the use of restraints in order to carry out the actions or the physical transfer of an ALC patient to a long-term-care home without their consent. Regulation-making powers are set out in relation to this new provision and the actions it authorizes.”

Those are the first two paragraphs of the explanatory note of this bill, Speaker.

I know some of my colleagues have been arguing back and forth, and I know people have been watching and sending us emails and messages wanting me to point that out because there has been some confusion, or an attempt to create confusion, so I wanted to get that out. I think it’s very important for us to understand what this bill actually talks about when we talk about consent, when we talk about restraints, when we talk about coercion and the types of treatment that we’re actually putting our seniors up to and what it really means for so many of our loved ones who may be in this situation and how they may be treated—not to mention the financial barriers that they will face.

Speaker, this bill essentially allows hospitals and long-term-care homes to use and disclose ALC patients’ health information as needed to facilitate the transfer, and it’s very important to point out because hospitals—even though the whole idea of patient consent, and as the Minister of Long-Term Care pointed out, that provision of keeping patients and if they’re charged is part of a different bill, different legislation, from years and years ago. That was used as a last resort. But unfortunately, what happens is that now we’re at a point where they’re actually giving a bill which allows for it to be used any time, as necessary. So when we look at this legislation and the impact of it, it will have just disastrous results, especially when we look at the profit-making aspect of so many long-term-care homes.

I can’t believe I have three minutes left. What I want to do is just point out a few things. In this bill, while we take away rights of patients, we’re giving more rights to long-term-care homes to actually refuse patients if they want to. What does that mean? We are telling patients that if they, for example, by the staff coordinator—and by the way, they’re not assessed by the doctors or the nurses; they’re assessed by the coordinators. If they’re determined to be placed in a home but the home refuses them, then they will not be placed.

One of the biggest issues that we are going to face is that so many of these patients will end up in homes that are not close to their family members, which is one of the biggest issues that they may face.

We have also heard from people who have been charged already. This morning, my colleague talked about someone who has been charged almost a quarter of a million dollars. One of the things that the government talks about is how this side of the House is fearmongering when it comes to this legislation. But what about the fact that so many people—it’s from, let’s say, $60 to about $1,500 per night if they refuse to go to the home that was determined for them.

I realize that I’m running out of time. I want to quote—because it’s not just coming from me; there are people across the province, there are advocates across the province who are terrified of this legislation. I want to quote Natalie Mehra from the Ontario Health Coalition, an organization that I had the opportunity to work with before I became an MPP. She says, “The bottom line is the Ford government is using the health care crisis to privatize Ontario’s public hospital services and to push seniors out to fill long-term-care beds in the worst nursing homes that no one wants to go to because they have terrible reputations, most of them for-profit. It is all couched in very carefully selected and manipulative language, but the actual policy changes they are proposing are clear and they clearly benefit for-profit companies at the expense of patients, particularly seniors.”

Speaker, we have seen how many for-profit homes benefited throughout the crisis when their CEOs, for example, got bonuses and yet PSWs and nurses did not get the support that they needed or paid sick days, or the fact that they are still fighting for their rights in their workplaces and yet we’re talking about these for-profit homes benefiting.

Unfortunately, I’m out of time, so I just want to say thank you very much. I hope that all members in this House read this legislation carefully and understand how dangerous these provisions are and what they mean for our loved ones, especially our seniors, who are the most vulnerable people in this province. We have lost more than 5,000 seniors throughout this crisis, and many of them didn’t die from COVID; they died from dehydration, from malnutrition, from lack of care.

And Speaker, I plead—I am begging this House to reconsider, to make sure that we’re—

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  • Aug/24/22 5:20:00 p.m.
  • Re: Bill 7 

Oh, we’re into 10-minute rotations. So it’s 10 and 10?

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  • Aug/24/22 5:20:00 p.m.
  • Re: Bill 7 

That’s a great question. I think that’s really what the crux of this bill does. When we look at what’s happened over the last couple of years with the COVID-19 pandemic, it’s really, really highlighted some of the issues that we have in our health care system here in the province of Ontario. And a lot of that revolves around alternate-level-of care, or ALC, beds. We need to be able to make sure that people that are using those beds and taking up those spaces are there for the right reasons. If there’s an opportunity to make sure, or allow, those people to move out into a long-term-care home—or perhaps it could be community care. It could be all kinds of things, colleagues. We’ve made some significant investments into the broader health care system. We’ve got a great program working with paramedics in Waterloo region.

Thank you to the Minister of Health and thank you to the Minister of Long-Term Care for really taking the bull by the horns and making sure that we’re able to bolster a very strained health care system here in the province of Ontario.

Again, thank you to the Minister of Long-Term Care for really realizing that there is work that can be done, and I’m very excited to see these things go forward.

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  • Aug/24/22 5:30:00 p.m.
  • Re: Bill 7 

Thank you.

Question? The member from Carleton.

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  • Aug/24/22 5:30:00 p.m.
  • Re: Bill 7 

I thank my colleague from Scarborough Southwest for her thoughtful comments on the topic, and I appreciate that the member read some feedback from a Scarborough resident. I have some feedback I’d like to read to the House: “Great news for Ontario hospitals.” Another quote goes on to say, “These changes will provide faster access to care, positively impact ... patient outcomes and improve the patient experience.” Of course, Madam Speaker, these are the quotes of David Graham, the interim CEO of Scarborough Health Network.

I know the member voted against the Scarborough medical school, which also had the support of the Scarborough Health Network, but I would ask the member, knowing this new information from her own hospitals in her area, will the member revise her opinion and support the government’s bill?

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  • Aug/24/22 5:30:00 p.m.
  • Re: Bill 7 

I want to thank the member for her question, because it allows me to share another bit that I didn’t have enough time to, which is that when we talk about freeing up beds, when we talk about freeing about the ability for staffing, when we talk about clearing ALC beds, this legislation actually does not free up nurses and specialized staff.

We need to talk a little bit about the types of alternate care and, when people in the hospital are in this situation, what kind of care they receive. In long-term-care homes, for example, will that actually allow for nurses and PSWs to be freed up?

And the fact that we need thousands—Speaker, thousands—of PSWs and nurses: One of the things that we could have done is to allow for internationally trained professionals and so many others who want to be nurses and PSWs in this province to become certified, and allow them to be paid better. Repeal Bill 124, so that we can retain and recruit more health care workers in our province.

If we walk back a little bit and actually talk about what happens when someone ends up in the hospital—first, no one ever wants to go to a hospital. You’re not going to a fancy hotel to stay. Let’s be clear; let’s be honest: You’re ill. You’re not well.

I have so many seniors and I know so many people who don’t want to go to the hospital even when they’re not well, especially in the crisis that we’re facing right now. So the fact that these people, when they refuse, for example, to go to the designated long-term-care home—if they refuse, then they will be charged. There is a financial hammer on this, and that means that people will feel that financial coercion in order to go to that long-term-care home.

So one of the things I would urge this member, as well as all the other members in the government—if you really care about Scarborough, show us. Come to Scarborough and provide the funding that we need, because our hospitals are some of the oldest hospitals in the province.

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  • Aug/24/22 5:30:00 p.m.
  • Re: Bill 7 

Let’s be completely clear: This bill strips away the rights of the most vulnerable people in our province, our seniors and our elders, who are in hospital, who are sick and not well. It takes away any say that they have in their future health care. It actually, in fact, makes provisions that their health care information can be shared with whomever this government chooses. These are our most vulnerable citizens.

In addition to this, if they won’t leave, if they choose not to go when they’re being forced—people around the bedside are forcing them and making these decisions for them, and if they don’t choose to go, the government can’t handcuff them; they can’t use restraints. But then what can they do? They can use a tool, the hammer of financial ruin, by charging them thousands and thousands of dollars a day while they are in hospital. This is outrageous. It’s the cruelest thing I’ve ever seen from this government, and believe me, that’s saying a lot.

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  • Aug/24/22 5:30:00 p.m.
  • Re: Bill 7 

Thank you, Madam Speaker. It’s great to see you in that chair.

I’ve heard the member opposite talk about how this bill will force patients in ALC into long-term-care beds far from their families and loved ones. I’ve heard them talk about how this bill will force them to live in ward rooms with three other residents. I would remind the members opposite that it was our government that made the investments to modernize long-term care and eliminate these ward rooms. I would also like to remind the members opposite that this bill will include regulations to ensure patients are moved to a home that is in a defined geographical distance from their preferred location. Furthermore, they will maintain their priority position on the wait-list of their preferred home and be given the choice to move when a spot becomes available.

Given that the concerns raised by the opposition have been alleviated, will the member be supporting this plan to free up capacity in hospitals?

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  • Aug/24/22 5:40:00 p.m.
  • Re: Bill 7 

Order.

Interjections.

The member from Mushkegowuk–James Bay.

Further debate?

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  • Aug/24/22 5:40:00 p.m.
  • Re: Bill 7 

Well, what does he think? Do you agree with him or not?

I appreciate the opportunity to speak to Bill 7. I want to begin by thanking Premier Ford and Minister Calandra for bringing forth this legislation, and so quickly, in this very shortened session of the 43rd Parliament, because they recognize how important it is that we actually move to do something to take the pressure off our hospitals, which are, yes, struggling with a lack of resources in order to deal with the challenges they have on an ongoing basis every single day.

When I came here in 2003, it wasn’t long after that—and I heard the NDP, just as we did, talk about alternate-level-of-care patients in our hospitals, and what a challenge that was, and how it was growing every day. The NDP screamed every day as well about, “You’ve got to do something about that.” They used to be referred to, not very nicely, as “bed blockers,” and then we became a little more cognizant that it just wasn’t appropriate to use that terminology. Instead, they’re alternate-level-of-care patients.

They want us to do something about it, so Minister Calandra, along with the folks in the Ministry of Long-Term Care, are doing exactly that: They’re bringing forth legislation. And I have to say, Speaker, it is so disappointing to hear the fearmongering and the invention of gremlins and monsters. You’d think there was a monster under every one of those beds, according to the NDP, because they’re creating all kinds of unnecessary fear in the minds of families and ALC patients themselves. There is nothing in this bill—in fact, it explicitly makes it clear that no one will be moved to a long-term-care facility without their consent.

They’re going on and on and on about how you can be assessed without your consent. People are being assessed all the time. It’s a necessary part of our health care system. Every time you go into a hospital, the chart is at the foot of the bed. The physicians come in and do assessments on a regular basis. Nurses do assessments on a regular basis. We need to know the condition of our people. That’s absolutely necessary. You need to know the level of care that is necessary. You need to be able to determine whether it’s appropriate or not to actually move that person to a long-term-care home, because in the case of some patients, it will not be appropriate; their health condition will dictate that, no, it’s not appropriate to move them to long-term care. They will have to be either stabilized, their level of health will have to improve or they may not be leaving the hospital at all, but that can’t be done without assessing the patient to determine whether it’s even feasible to move them to a long-term-care home.

But for most of my almost 20 years, we’ve had a situation where we have had beds in our hospitals occupied by people who should not be in the hospital; they should be in a long-term-care home. And what have we done to try to solve that problem? Revolutionary change: 58,000 beds, either new or redeveloped beds, in our long-term-care-home system. That is absolutely paramount. You won’t be able to solve the problem if you don’t have the places to move the patients.

So, revolutionary change: 58,000 beds, either new or redeveloped. Now we are creating the space for those people to go. Next, what do you do? Now you try to find appropriate placements for the people themselves, and try to determine who’s going to be going or who can go, who is healthy enough to leave a hospital. Nobody’s leaving a hospital if they’re not healthy enough to leave that hospital.

And then the process can begin to put people, who we care about so much—because a hospital is no place for an elderly, vulnerable person. That is not the place for them. There’s no activity area. There’s no common cafeteria or eating hall or dining hall. There’s no courtyard where they can be taken out to get some fresh air. That’s not what hospital care provides.

You know, the member for Scarborough Southwest said, “Nobody wants to be in a hospital. It’s just not a very nice place, and nobody wants to be there.” But do you know what, Speaker? We have some very nice long-term-care homes, and we’re building even more. So there will be places that have compassion, that have the facilities for those elderly people that have given so much to us, the younger generation, the younger part of society. They have given so much. Now we’ll be in a position to care for them in the appropriate housing, accommodations, buildings and institutions, or whatever we want to call them. We’re going to call them “their new home.”

So what do you want to have for your new home? Would you like to be in a hospital for your new home where—do you know what your life is? In the bed, walk the hall, in the bed, walk the hall, in the bed, walk the hall—if you’re able to. But in that long-term-care home that we are building—as I said, 58,000 new or redeveloped homes—you will have a home where you will be comfortable. You will be comfortable. And you will be, if it’s appropriate, placed in a home that matches your needs and your desire to be there, because if the home that is your choice does not have vacancy at that time, you’re still going to be on the top of the list. And when there is vacancy in that home, that’s the home you will get. It is all predicated on where you live, proximity to your family—those are the considerations that will be taken.

So I would ask the opposition—and I realize that there’s two elements here. On the one side, it says, “Hear the other side.” I know that’s supposed to be the job of the government: “Hear the other side.” And you know what? It would be really good if the opposition would practise that, as well—to actually read the bill and not try to extrapolate out of it something that you want to be able to say because that will generate the news story and that will generate the fear that you people are living on over there. That’s what’s going on. The alternative—I’ll use that word again, the alternative—what I hear from the other side is, “Scrap this bill. We don’t need this bill. This is a bad piece of legislation.”

Do you know what the alternative is, Speaker? The alternative is the status quo. The alternative is the status quo, where 5,800 people across this province are in an inappropriate setting for their care. They’re in a hospital when they shouldn’t be there. Now, anyone among those 5,800 whose health has deteriorated while they’ve been there because they’re aging out will not be moved. If it’s not appropriate that they can be moved to a long-term-care home, they will not be moved to a long-term-care home. But for those who have seen their lives limited, and, in fact, negatively affected because they’re in a setting that was never designed to support them in the condition they’re in, they will be moved, when it’s appropriate and where it’s appropriate, to a facility that will enhance their last years, their last time, so that they will be in a comfortable setting for whatever remainder of time they have on this earth. They will be in a comfortable setting, not one that was never designed to help them.

The long-term-care system, in its very infancy, was built to give care for people in those declining years. I know it’s evolved a lot over the years and it has changed, and the ages of people who are in them and the acuity levels of people who are in them has changed, as well. We understand that. I’m old enough to remember when the long-term-care system was in its infancy. It’s a different level of care. It’s a different client and different residents that’s in those homes today. But we have a responsibility as government. We have a responsibility as every citizen. And it includes the responsibility of the opposition. When they see something that will actually lead to the improvement of the lives of those people, they should not be out fearmongering. They should get behind it and support it because this is actually very good for the seniors in our province.

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  • Aug/24/22 5:40:00 p.m.
  • Re: Bill 7 

I will not be heckled about that.

Our hospitals are some of the oldest hospitals. They need to be repaired.

Interjections.

There are a lot of things that we can anticipate happening. There are a lot of advocates across the province who have been really worried about this.

I think this will answer your question. One of the quotes that I can share is from the Advocacy Centre for the Elderly. This is what they said: “We oppose today’s proposed amendments to the FLTCA revoking the right of seniors in hospital to consent to LTC which will result in them being moved far from supportive family & community, again attempting to ‘fix’ health care to the detriment of seniors. #RightsDontAge.”

Speaker, that’s what will end up happening. So many people will lose their support, will lose their community and their family because they will be forced to go to a home that may not be up to par with what they need or the care that’s necessary. Most of the beds that are empty and people don’t want to go to them—it’s because they don’t have that quality that’s necessary.

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  • Aug/24/22 5:40:00 p.m.
  • Re: Bill 7 

Thank you to the member opposite for her contribution to the debate.

I understand your compassion for seniors. As my colleague from Etobicoke–Lakeshore said earlier, we all have parents who are aging as well. We’re concerned about them. We all have compassion for all of the people we’re talking about. Part of this is to make our health care system work better, and that’s the impetus behind bringing the bill forward.

I know you have compassion, as you’ve stated, for these patients who are in hospitals, but could—

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