Bill 60 is one huge step towards decimating a program that defines us as Canadians and Ontarians: medicare, a program that makes sure that care is based on your needs, not on your ability to pay. What we are doing right now will be almost impossible to undo. Once the private, for-profit, investor-owned corporations have set up shop in Ontario, they will not leave. It doesn’t matter what the needs will be. If the backlog—they will continue to be there. We are seeing, by the actions of this government, the beginning of the end of medicare. I’m really troubled by that.

When we talk about medicare, what we have here in Canada, in Ontario, is a single-payer, publicly funded health care system. The one payer is the government of Ontario, which pays for medically necessary care that we get in our hospitals with doctors, with physicians. This is what medicare is all about. Medicare is about, if you go to the hospital, it doesn’t cost you anything; if you go to see a physician, it doesn’t cost you anything. That’s all. Everything else—long-term care, home care—not part. Medicare is about hospitals and physicians.

Bill 60, the bill we’re debating this afternoon, is about to change all of this because it will change who delivers that care. Right now, surgeries are mainly done—99% of surgeries are done in our hospitals, where you don’t pay for care. They’re about to change this.

People often get a bit confused as to what’s public and private and all this. There are four types of providers in Ontario. The first one is the publicly owned facilities. If you think of a community health centre, an Aboriginal health access centre, a nurse practitioner-led clinic—those are publicly owned facilities. They deliver the care in a publicly owned facility.

The second one is what we call the privately owned, not-for-profit community. Those are all 152 hospitals in Ontario. There are four private hospitals that predate medicare. The rest of them are all not-for-profit facilities, and they are most of the hospitals that all of us know.

The third type is a physician-owned small business. This is what most doctors’ offices look like. They pay rent. They hire a secretary and maybe a nurse to work with them. They will look after 1,000 or 2,000 patients. They are a privately owned small business. The physician is the owner of the business, and the physician provides the care to the patient. And you will remember, Speaker, that because it is a physician’s service, it is free for us to use.

The fourth kind of delivery is what we call private, for-profit, investor-owned corporations. Once you bring in investor-owned corporations, you change everything, because—they don’t have any patients’ roster to them or anything—they are there for one reason: They are there to make money.

To build a surgical suite in Ontario is not cheap, have no doubt. It’s not something you and I could do—I don’t know about you, but it’s not something I could do. It takes millions of dollars to build a surgical suite.

I can tell you right now, there are private, for-profit, investor-owned corporations that are biting at the bit to come and invest those millions of dollars in surgical suites in Ontario. Why? Because they can guarantee their investors double-digit returns on their investment. We’re not talking about 11%, 12% returns; we are talking about returns in the 20% range and the 30% range every single year. They are willing to put up those millions of dollars ahead because they will make back those millions—and those hundreds of millions—really, really quickly. How do they do that? They do that by upselling. They do that by using the power differences in the relationship—when you go see somebody who’s about to do surgery, the surgeon has all the power and you have none. You are a person who is sick, you are a person in need of care, and you depend on the surgeon, on the physician, to make you better. I don’t wish harm upon anyone, but we all know that people do get sick, people do need care, people do need surgery at some point—and when you do, you are more or less at the mercy of the person who provides that care. Big, private, for-profit, investor-owned corporations know this power dynamic. They know full well that you depend on that person for your health, that you depend on that person for your life, and that you are willing to pay. And they will make you pay, have no doubt. They have you pay, first, by gaining access.

I can share the story of Mr. Dutton. Paul Dutton is a Toronto writer and musician. He needed surgery done. He saw a gastroenterologist who told him that it would take quite a bit of time to get his colonoscopy done in a hospital, and he could have it done faster in one of the private clinics that exists in Ontario right now, but he could only gain access to the colonoscopy if he had an appointment with the dietitian at the colonoscopy clinic. The appointment with the dietitian costs $495. The gastroenterologist acknowledged that he did not need any nutritional consultation, but in order to gain access to the colonoscopy within a few days—this is what this private clinic did. You did not get a colonoscopy unless you spoke to a dietitian, and the dietitian costs 495 bucks. He made a complaint to the Ontario college of physicians and surgeons, and he made a complaint to the complaint line that exists at the Ministry of Health, but nothing happened. Nothing happened because it was not the physician who charged him $495 to see a nutritionist, that dietitian he didn’t need to see; it was the business that charged him $495 to see a dietitian in order to gain access.

So this is happening right here, right now. The opportunity to make money is there. You have surgeons telling you that you need to have that test done, that your health is at risk, that there may be cancer and you need to get at it really quick if you want your chances of survival to increase, but it’s going to cost 495 bucks to gain access. What are you going to do? What are any of us going to do? We’re going to pay the 495 bucks because we don’t want to die of cancer. This is how it works. They prey on the vulnerability of people who are sick to make money, and the resources, the creativity they have to find ways to charge you is just out of this world. We already know that. It’s happening right here, right now in Ontario.

And what is this government doing? This government is opening the door wide open, inviting all of the US-based multinational corporations to come to Ontario and set up shop—

Interjection: Open for business.

I’ll direct my question to the member from Richmond Hill, who started off the government comments, then. First of all, when they’re trying to make us feel bad about not having read the bill, this was available today for the first time after being tabled yesterday and we’re already in debate. So I’m happy to do my homework, but maybe give us some time.

However, the comment about patient complaints and not understanding what we don’t understand? Well, here’s what I don’t understand: I don’t understand what you are not getting about physician versus private clinics. The Auditor General did a report, the Value-for-Money Audit: Outpatient Surgeries, and was concerned that there will be no provincial oversight of the private, for-profit surgical clinics. Right now, if a patient calls this Patient Ombudsman and makes a complaint, which is what you were talking about, the physicians are under the CPSO. But a private clinic, when you shift all of that—there will be, inevitably, more concerns and more questions, but it’s no longer under the CPSO, and you don’t have an oversight mechanism in this.

Please explain what I don’t understand.