In surveys of my constituents last summer, an overwhelming number said they oppose a two-tier health care system. Such a system would allow those who can afford it to obtain faster and better service through private, for-profit providers. Meanwhile those who can't afford it would have to seek care in a public system offering an inferior level of service.
Such a system, though existing in some countries of the world, offends the basic principle that Canadians hold so dear: equal access for all. The response from my constituents is overwhelming - most want to defend and strengthen our publicly funded and operated universal health care system.
With billions of dollars in potential profits, it is not surprising that some with a vested interest would like to see a for-profit parallel system. This pressure was evident throughout the debate across Alberta earlier this year over Bill 11, which allows regional health authorities to contract out some surgical procedures to private hospitals and clinics.
Privatization Unpopular
Advocates of privatization know it is not popular, and so they pay lip service to public health care while working to bring in a private system through the back door. Their real agenda is often hidden. t should be apparent that if private hospitals selling profitable enhanced services operate beside a public system, doctors, nurses and other resources will move to the private system, where they can make more money, leaving the public system short-changed. This has occurred in Britain and elsewhere.
At times, various provincial governments have attempted to skirt or violate these principles, whether for ideological reasons, or simply to reduce costs. Usually the mere threat that the federal government would withhold funding has led provinces to back down from such attempts.
Bill 11
Such was probably the case with Alberta's Bill 11. After considerable federal and public pressure, the Klein government sought to ensure that this bill could not be challenged under the Canada Health Act. Without the threat of withholding federal funds, however, the resulting bill might have been quite different. t is far preferable that the federal and provincial governments work together in a cooperative spirit to address health care problems. That is why I was very pleased by the cooperation that resulted in the recent agreement that will provide $21.5 billion in new federal money for health care over the next five years. At the same time, the provinces have agreed to a process that will allow monitoring of the system's effectiveness and compliance with the Canada Health Act.
Proponents of a privatized, two-tier system often argue for measures that would weaken the federal government's ability to enforce the Act. Already much of the federal government's one-third contribution to health care is through the transfer of tax points. It would be a serious mistake to move further in this direction. While provincial governments directly administer the day-to-day details of the health care system, the federal government has a role to defend and uphold this great Canadian achievement. Reducing the federal role, and moving to a privatized two-tier system would be a serious mistake and a national tragedy.
Federal Health funding
The federal government has been a strong defender of the health care system, but in many debates on the issue that points seems to get lost. Sometimes a myth is repeated so many times that it becomes accepted as fact. Repeat it often enough and people believe it, whether or not it's true. One such myth that has almost become accepted as gospel truth is that the federal government has been financially undermining health care. Earlier this year Alberta Health Minister Gary Mar was quoted in the Calgary Sun: "When they (the federal government) first socialized Medicare, it was a 50-50 cost-sharing agreement (with the provinces). Today it's 87-13. Somebody who only chips in 13 cents funding in the tank of gas doesn't have the right to determine where the car goes." There's just one problem with Mar's argument. It's not correct.
Unfortunately the 13-cent figure has become one of those myths repeated so often that it has become accepted as fact. In Ontario, the Harris government ran high-priced television advertising to tell Ontarians, the federal government is only paying 11 cents. When the Klein and Harris governments make this argument, they are using a selective interpretation of the figures. The 13 per cent figure only represents the federal cash contribution under the Canada Health and Social Transfer (CHST). It ignores various other federal contribution such as though tax point transfer (17 per cent) and other direct funding (5 per cent) in Alberta. When these other forms of contribution are taken into account, the federal contribution is 35 per cent compared with 65 per cent by the province. As the Prime Minister put it in a letter to Ontario Premier Mike Harris complaining about his province's misleading advertising: "These claims require a willful neglect of the unanimous request by the provinces in 1977 that part of the federal contribution to established programs be through transferred tax points. These tax points are worth $14.9 billion nationally this year and rising. They are an integral part of the Canada Health and Social Transfer." In other words, it was the provinces that requested that the federal government contribute through tax points instead of a direct cash contribution, and now some of these provinces are conveniently ignoring this fact.
Nor is it true that the federal government has been slashing funding. In total dollar terms, the federal government's CHST contribution to Alberta is $2.97 billion in the current 2000-01 fiscal year - its highest contribution ever. This compares with $2.51 billion in the 1994-95 budget year when this government first came to office. Recent budgets have increased the federal contribution to the CHST to all provinces- by $11.5 billion over five years in the 1999 budget, and a further $2.5 billion announced in the 2000 budget. These figures exclude federal contributions to health research, health and wellness promotion, the AIDS strategy and a slew of other programs aimed at preventative measures - addressing health care problems before they reach the hospital system. Canadians are deeply concerned about the future of our health care system and it is an issue that has become a focus in many political debates. The important thing is to ensure that at the end of the day, we remain committed to securing a strong publicly funded health care system that meets the needs of all Canadians.