Naysayers are principle threat to Medicare — Dosanjh
Harper should have dispelled myths and lies, and acknowledged national pride in health care system.
by Hon. Ujjal Dosanjh, Official Opposition Health Critic, in a Speech to the Economic Club of Canada (December 14, 2010).
Stephen Harper's Record
For five years, since Stephen Harper came to office, health care has been cut from the federal agenda. The Conservatives have done nothing to defend public health care or guarantee its future.
For five years, Canadian health care has been discussed more in the United States than in Canada. Right-wing Republicans have used it as a punching bag, a rhetorical piñata in their attacks on President Obama. They have distorted the truth and told outright lies.
At this point, some Americans probably think that Canadians put the elderly out to pasture on ice floes in the Arctic. But I don't want to give my wife any ideas.
For Stephen Harper, the health care debate was a missed opportunity for leadership.
The Prime Minister should have stood up and made a strong defence of Medicare. We did. He did not.
He should have dispelled the right-wing myths and lies, and shown the pride that so many of us feel in our health care system. We did. He did not.
He should have brought Canadians together around a vision for a healthier future. He did not, and he has not, and he will not — because this is a Prime Minister who believes the federal government should have no role in health care.
Stephen Harper thinks health care is a nuisance, not a priority.
This is a Prime Minister whose only adult job outside politics was at the National Citizens Coalition, a right-wing lobbying group that was founded explicitly to oppose public health care.
This is a Prime Minister who said, and I quote, "It's past time the feds scrapped the Canada Health Act." That was in 1997.
In 2005, just before he took power, Stephen Harper said he thought two-tier health care "would be a good idea."
Since taking office, the Conservatives have refused to take any responsibility for health care. They deny the federal government's role, and speak openly about transferring tax points to the provinces — which would destroy the Canada Health Act and the unity of our health care system.
In his famous "firewall letter" in 2001, Stephen Harper wrote that, "each province should raise its own revenue for health care — i.e., replace Canada Health and Social Transfer cash with tax points."
Make no mistake: this would be the end of Medicare. The federal government must retain its spending power in order to uphold the Canada Health Act, and to ensure that the provinces do the same.
Without the federal spending power, the Canada Health Act — the charter of Medicare — would be no more. It would be open season for privatization and user fees.
We cannot and will not let that happen.
The Conservatives are also undermining our health care system by scrapping the mandatory long-form census, which tells us which health care services we need to deliver, and where.
The Liberal Party has a bill before Parliament that will save the census. It passed second reading in the House of Commons last week. We will do everything in our power to make sure it becomes law.
Fight for the Future
The radical, right-wing attack on Medicare cannot continue. We must defend the Canada Health Act — with access based on medical need, not your ability to pay.
The principal threats to our health care system are those who say the end is nigh — the naysayers who hope their fantasies will be self-fulfilling. I am not one of them.
Private health companies and right-wing politicians distort the truth so that they can create fear and advance their agenda.
They say that we spend too much on health care. They talk as if an army of senior citizens is laying siege to our health budgets, driving costs out of control.
It is not true.
In the past several decades, the share of national income devoted to total health care expenditure has actually remained relatively stable.
Today, health care does make up a larger share of provincial budgets, but this is due in large part to choices that the provinces have made to cut tax revenues and reduce expenditures in other areas.
Demographic change has increased costs, but it is far from the biggest factor.
Yes, our population is aging, and demographics will change the way we manage our health care system. But our aging population is not the biggest driver of health care costs — pharmaceuticals are.
Drug costs are the fastest-growing area of health care expenditure, rising from just under ten percent of the total in 1985, to more than sixteen percent of all health care costs last year. And most of these costs end up paid-for by Canadian families or private insurers, not the public system.
Here is an alarming figure: one-in-ten Canadians report not filling a prescription because they cannot afford to pay. If Canadian families are going broke to pay for medicine, we are surely losing the spirit of Medicare.
We have to take steps to fill this gap in the continuum of care. We will not get there all at once, but we must begin.
We must get back to the ambition we shared with the provinces in 2004, when the former Liberal government negotiated a ten-year, forty-one billion dollar federal-provincial health care agreement. I was the Health Minister at the time.
Part of the 2004 health accord was the National Pharmaceuticals Strategy. This was a definitive step towards a national Pharmacare program.
When the Conservatives took power, all progress stopped. We hear from provincial capitals that governments have abandoned the pharmaceuticals strategy because the federal Conservative government has no interest. That is unacceptable.
We need to get back to that ambition. In the long term, we need to bring pharmaceuticals and the entire continuum of care — including home care and chronic care — into the Canada Health Act.
It will not happen overnight, but we must begin now.
We must defend our health care and strengthen our system. Not by privatizing all or part of it, not by bartering away the principles that have guided us for half a century, but by rising to the challenges our families face, together.
Medicare is a competitive advantage in a competitive world — a key driver of innovation and economic activity.
Medicare also levels the playing field for our businesses, enabling them to attract skilled workers and offer them a standard of living comparable to their larger competitors.
It allows our workers the freedom to move between jobs and regions, unlike other nations where millions of people are reluctant to move for fear of losing their coverage.
Where health care is concerned, Liberals look to the past with pride, and the future with confidence. Our system, while not perfect, is among the best in the world. We should celebrate what we have achieved together.
Yes, we have to fight for the future. But our fight is neither with impersonal forces of demographic change, nor with the public health care system itself.
Our fight is with those who seek to create fear in the minds of Canadians, so they can destroy public health care — the ideologues and incrementalists who want to tear up the Canada Health Act and replace it with something less universal, less equal, more private, and less Canadian.
These people sit in right-wing think-tanks, on the Conservative benches in the House of Commons, and in the Prime Minister's Office. The Liberal Party of Canada will fight them every step of the way.
Medicare is more than a series of transactions between doctors, patients, and governments. It is in the bedrock of our common citizenship. Whoever we are, wherever we are, we access health care as one people, as Canadians.
And when you take your child to the emergency room at one o'clock in the morning, you are not asked which province you come from, or what you earn, or what you can afford. Health care workers only care about healing the patient. In our health care system, that is the only bottom line that matters.
The Liberal Family Care Plan
That must not change as our population grows older, and as demographic shifts create different demands on our health care system.
As I have shown, we are well-prepared to meet these challenges, as long as we defend and enhance our public health care system.
Part of our efforts will be a national brain strategy, to help more Canadian families face Alzheimer's and other dementias.
We must also help families care for sick or aging loved ones at home. That is why we need the Liberal Family Care Plan, which Michael Ignatieff announced earlier this year.
Our plan has two parts. First, a new six-month Family Care Employment Insurance Benefit, similar to the EI parental leave benefit.
This will help our economy by keeping Canadians in the workforce, even if they need to take time to care for their relatives.
Second, a new Family Care Tax Benefit, modeled on the Child Tax Benefit, which will help low- and middle-income family caregivers who provide essential care to a family member at home.
The Conservatives have different priorities. Their message to every family caring for sick loved ones — is, as one Harper minister put it, 'use your vacation time.' That is an insult to every family that has ever cared for a loved one at home.
Stephen Harper even said our plan was "reckless."
This is the Prime Minister who spent a billion dollars on a seventy-two-hour G8/G20 photo-op, twenty-one billion dollars on stealth fighter jets without a competitive bid, thirteen billion dollars on US-style mega-prisons, and six billion dollars on tax breaks for the biggest corporations.
If Stephen Harper wants to see what "reckless" looks like, he should look in the mirror.
Canadian families do not need Conservative indifference; they need compassion and support. That is what the Liberal Family Care Plan will provide.
But this goes beyond compassion. Home care and family care is how we reduce the strain on our hospital emergency rooms.
Last week's report from the Auditor-General of Ontario makes it clear: emergency rooms are more crowded and waiting lists are longer because we are not doing enough to support home care and family caregivers.
Our Liberal Family Care Plan is a first step. In the long-term, we need a national commitment to home care, as envisioned in the 2004 health accord.
Stephen Harper discarded home care as soon as he took office. We need to restore our ambition — to support families and sustain our health care system.
Health Before Health Care
But defending our health care system requires more than just caring for those who are already ill. We must also do more to keep people from getting sick in the first place.
Tommy Douglas used to talk about "the second stage of Medicare," which would be designed to "keep people well." After four decades, it is past time we got started.
Our health care is world-class, but our health is deteriorating. This will be the first generation of children that will not live as long as their parents. Childhood obesity rates have tripled in the last three decades. Type-II diabetes is on the rise. These conditions cost our health care system billions of dollars every year.
If we keep people healthy, we can keep costs down, protect our productivity, and prevent avoidable suffering for millions of Canadian families.
We need comprehensive and specific approaches to women's health, men's health, children's health, minority health, and Aboriginal health. We need to promote active living and healthy eating.
In April of this year, Michael Ignatieff announced Canada's first-ever National Food Policy, which will help Canadians make better-informed eating decisions, and ensure that all children have access to healthy foods. We will also introduce progressive health labelling and tough new measures to curb trans-fats and salt.
The Federal Role
Together, we can make Canada the healthiest society on the planet by 2017, when we celebrate the 150th birthday of our country — but only if the federal government leads the way.
We must not sit on the sidelines. We must not pass the buck. Together, we must lead again, and defend the future of health care. And with a new Liberal government, we will.
We will be an active partner for the provinces. We will encourage innovation and share best practices. And we will ensure that every Canadian gets world-class care when they get sick, no matter what their pre-existing conditions are, or whether they have the ability to pay, or where in the country they live.
These are central commitments of the Canada Health Act, but they have not been fully realized in the rural regions of our country.
Millions of our fellow citizens have to drive hours to see a family doctor, if they can find one at all. Mental health, specialty care, and seniors' care are often all out of reach.
A new Liberal government will improve rural health care.
We will forgive up to $20,000 in federal student loans for doctors, nurses and nurse practitioners who choose to practice in a designated underserved rural community.
We will apply an equitable share of funds towards regional health needs in Quebec, which is not part of the Canada Student Loans program.
And we will achieve full high-speed internet access and expanded cell-phone coverage, to bring 21st-century health innovation to rural and remote areas.
We will also make sure that all Canadians benefit from electronic health records, through the Canada Health Infoway. We will review the effectiveness of the current program, and give front-line health care providers a greater role in implementation.
All of this will require federal leadership and partnership between governments, which is what Canadians expect. We want our governments to fight for Medicare, not over Medicare. We expect the social contract that Medicare represents to be honoured, not abandoned.
The federal government has the jurisdiction, the role, and the responsibility to defend the national interest and our shared objectives: to ensure that Medicare survives and thrives, to ensure the principles of Medicare are respected by enforcing the Canada Health Act, and to share in the cost of the system by providing funding to the provinces and territories.
But the federal government is not an ATM, and the federal role in health care is more than just being a banker to the provinces.
We must ensure that our provincial partners live up to their side of the agreements that govern our health care system.
We must expect the provinces to comply fully with the Canada Health Act, and we must enforce the Act ourselves.
And we must see to it that there is transparency and accountability, so that Canadians can have full confidence that our health care system is working.
Under the Conservative government, there has been no transparency and no accountability. No one has any idea what progress has been made on the 2004 health accord — not the National Pharmaceuticals Strategy, not catastrophic drug coverage, not the expansion of home care, nothing.
We must do better, because Canadians deserve better. Canadians deserve federal leadership to defend our health care system, and we will have it under a new Liberal government.
A Clear Choice
The current government is neglecting its role in health care. The Conservatives seem eager to deny that the federal role even exists.
This is alarming, now more than ever, because the decisions made by the federal government in the next four years will determine the future of our health care system.
The 2004 health accord expires in 2014. The next federal government will be responsible for shaping what comes after. The work must begin right now. We cannot afford to delay.
In the next election, Canadians will have a clear choice: whom do you trust?
Do you trust the Conservative Party, whose leader spent most of his career campaigning to destroy the Canada Health Act and privatize our health care system?
Do you trust a Conservative government that wants to spend twenty-one billion dollars on stealth fighter jets with no competitive bid, and six billion dollars on tax breaks for big corporations, instead of helping middle-class families care for sick or aging loved ones?
Or do you trust the party that created Medicare and brought in the Canada Health Act, the party that has defended public health care in government and in opposition, and the only progressive, compassionate, responsible alternative to the Harper Conservatives?
Because that is the Liberal Party of Canada.
That is the choice our country faces. It is a choice whose outcome will determine the future of our health care system.
I believe that, when the moment of decision arrives, Canadians will choose to stand with our values, with our common citizenship, and with our best traditions. Together, we will choose a public future for our health care system.
Ujjal Dosanjh emigrated to Canada from India in 1968. He graduated from law school in 1976 and in 1977, he helped create the Farm Workers' Legal Information Service. Dosanjh spent 10 years in BC's provincial legislature with the NDP and served as Premier of British Columbia for over a year before turning to federal politics in 2004 and serving as Minister of Health for two years. He currently serves as the Official Opposition Critic for Health.
Posted: December 20, 2010
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