- Member of Parliament
- Member of the National Security and Intelligence Committee of Parliamentarians
- NDP
- Vancouver Kingsway
- British Columbia
- Voting Attendance: 59%
- Expenses Last Quarter: $153,893.57
- Government Page
- Feb/16/23 5:05:18 p.m.
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Madam Speaker, as we near the end of this debate, a couple of things have been made clear to me.
One of them is that I have not once heard the Liberals stand up in this House and say they agree with the New Democrats that additional federal public dollars must go to public health care. They claim to support public health care. They claim to support the Canada Health Act. However, they will not say those words.
The result is that the extra $46 billion that will be delivered to the provinces will be allowed to be diverted to private, for-profit care. The problem is that this care is more expensive, it is more inequitable and it will lead to a drain on the public system. That is the crux of the policy discussion we are having here today. It is not that it does or does not violate the Canada Health Act. It is that it is bad public policy that would result in longer wait lines for Canadians in the public system and additional pressures on already burnt out working groups in the health care sector of this country.
Has my hon. colleague heard anything from the Liberals today that would tell her they understand the gravity of the situation? What needs to be done to protect public health care?
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- Feb/16/23 3:24:05 p.m.
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Madam Speaker, this motion calls on the government to close loopholes in the Canada Health Act. One of the most egregious of these is that while the Canada Health Act prohibits extra billing, which means doctors are banned from charging patients more than the medicare rate for insured services, private clinics get around that by advertising and offering surgery to patients from a different province whom they then charge tens of thousands of dollars. This loophole needs to be closed.
Does my hon. colleague think that her government should agree with the NDP that the Canada Health Act must be amended so that provinces can no longer permit the odious practice of allowing the charging of patients for covered insurance services simply by allowing their citizens to cross a provincial border to get that surgery?
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- Feb/16/23 12:34:01 p.m.
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Madam Speaker, I note that the Bloc Québécois voted against dental care and now it seems it will vote against the NDP motion to ensure we have a strong, publicly funded system. I do not think that is what Quebeckers want.
However, my question is not really about the Canada Health Act today; it is about policy. It is about whether we are going to allow public dollars to be diverted to private-for-profit care when we know that it is more expensive and that it is going to drain workers from our public health care system. That conforms to the Canada Health Act. The question is whether the government is going to attach conditions to its health care transfers to the provinces to prevent it.
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- Feb/16/23 12:02:52 p.m.
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Madam Speaker, I say this with the greatest of respect, but there is a profound error in my colleague's comment, when he asserts over and over again that health care is a provincial responsibility in jurisdiction only. That is just incorrect. The Supreme Court of Canada said, “'Health' is not a matter which is subject to specific constitutional assignment but instead is an amorphous topic which can be addressed by valid federal or provincial legislation...”.
We know there are conditions attached because the Canada Health Act establishes them. When Quebec or any other province gets money, they agree to take that money on the basis of respecting five conditions of the Canada Health Act.
Is the Bloc Québécois in favour of two-tier private access to care? He says he is going to vote against our motion. Does that mean the Bloc Québécois is in favour of two-tier private care in our country, because that is what this motion is about today?
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- Feb/16/23 11:15:23 a.m.
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Madam Speaker, my hon. colleague was relying on quotes, so I am going to share some quotes with him.
Bernie Robinson, from the Ontario Nurses Association, said, “I fail to understand where the government thinks it's going to get the human resources to staff these private clinics other than by draining our already-taxed public system.”
J.P. Hornick, from the Ontario Public Service Employees Union, said, “To improve access to care, public hospitals require staff and funding, both of which will be even further depleted with increased reliance on private clinics.”
Finally, Dr. Bob Bell, former deputy minister of health in Ontario, said, “I totally agree with their desire to do more surgery by moving it out of the hospital into the community. But moving it to a for-profit model is simply dumb.”
This is not about upholding the Canada Health Act. Why is the federal government not stepping in to make sure that the additional funds are not diverted by the provinces to private clinics, even if they are publicly paid for?
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- Feb/16/23 11:07:59 a.m.
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Madam Speaker, my hon. colleague and I sat through a study of the human resources crisis in health care. He knows, as well as I do, there is a screaming conclusion: Human resources are finite. The same pool of doctors, nurses and other health professionals currently working in the publicly funded system would be pulled from that system to work in the privately funded system.
He knows that a parallel private system reduces the incentive to work in the public system, as health care workers may be paid more in the private system despite caring for less complex patients. That is the process known as cream skimming. The reduced capacity in the publicly funded system leads to worsening wait times for those who cannot access the private care.
Could the member explain why he does not agree with New Democrats that additional federal funds should be conditioned on going to the public system? He knows that if that money is diverted to the private system it would simply extend wait times and deepen the crisis in the public system.
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- Feb/16/23 10:34:47 a.m.
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Madam Speaker, I respect my hon. colleague's position. Actually, health care has been ruled by the Supreme Court of Canada to be a shared jurisdiction in this country. We cannot even find the words “health care” in our Constitution. The provinces have jurisdiction over the establishment and maintenance of hospitals and also regulation of the professions. The federal government has its spending power; the criminal law power; and peace, order and good government. We will not fix health care in this country.
By the way, I do not think Canadians care about jurisdiction. What they care about is that, when they get sick and they need care, they can go to their public system and get timely access to world-class care. That is going to take all levels of government working together to deliver it.
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- Feb/16/23 10:32:17 a.m.
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Madam Speaker, we absolutely need to open up the Canada Health Act, but we need to do it for the purpose that the NDP is talking about today. This is to close the loopholes that are allowing private, for-profit care to creep into our system. Right now, we have a shortage of doctors in our hospitals. We have a shortage of nurses in this country. Staff are burnt out at every hospital. How can it possibly be a positive development to allow private clinics to drain people from that system and then allow access based on private access to care?
We have to add profit and administrative costs to the system. By the way, the United States pays 31¢ out of every dollar to administration. In Canada, we pay under 2%. Administrative costs are much higher in the private system. If we drain those workers, what is going to happen to the wait times in the public system? Obviously, they will get longer.
We need to close the loopholes to make it clear that all publicly insured services in this country are delivered in the public health care system. Let us build up our public system. Canadians deserve to have timely access to world-class care. They are not getting it now. New Democrats will continue to make proposals so they can get that.
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- Feb/16/23 10:30:48 a.m.
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Madam Speaker, I do not disagree that provinces and territories should be sharing information and best practices, but the debate today is about national leadership. It is about the member's government and what it is going to do to help ensure that we not only protect but also strengthen and expand our public health care system.
When the Prime Minister of the member's government is applauding a privatization plan by a Conservative premier in this country, that is not the kind of national leadership we need. We want the government to say plainly to Canadians that every additional dollar of health care funding in this country will go to strengthening our public health care system and not be diverted to private, for-profit care. That would make our public system worse. It would increase costs, extend wait times and make care for Canadians worse.
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- Feb/16/23 10:19:21 a.m.
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moved:
That, given that, (i) during the 2021 federal election campaign, the prime minister was harshly critical of the Conservative Party of Canada proposal to encourage “innovation” in the health care sector by expanding for-profit provision of publicly funded services, (ii) the prime minister has now dramatically changed his position and has lauded as ‘’innovation” Ontario Premier Doug Ford’s proposed expansion of for-profit clinics, (iii) for-profit clinics would poach workers from the public system and lead to longer wait times, (iv) there are multiple public reports of two-tier health care in Canada, where people are charged for faster access to care, such as family doctors or surgery, the House call on the government to: (a) express disappointment that the prime minister has promoted Ontario’s for-profit health plans as “innovation”; (b) ensure that recently announced health care funding is not used for the expansion of for-profit health care, but instead used to rebuild and innovate within the public system by hiring more staff and reducing wait times; and (c) enforce the Canada Health Act and immediately move to close loopholes that allow for the growth of two-tier health care in Canada.
He said: Mr. Speaker, Canada's health care system is based on the principle of access to care based on need rather than ability to pay. A well-designed, well-funded single-payer system can provide fair, effective and high-quality care to make this a reality.
Our public health care system is certainly facing some challenges, but the solution lies in strengthening our public health care system, not weakening it.
If we introduce private funding, then need will come second to ability to pay. That would result in less accessibility, longer wait times and higher costs in the public system. It would also lead to increased administrative costs, in other words, more money for insurance companies and less money for health care.
Introducing private payment prioritizes care based on ability to pay, not need. It leads to worse access and wait times, as well as higher costs in the public system. It also leads to higher administrative costs, which means less money for patient care.
There is not only little evidence that private, for-profit investor-owned corporations can provide better quality care or reduce costs. In fact, there are many examples that show precisely the opposite. Those seeking to improve the quality, equality, access, efficiency and equity of health care services in Canada can do so by focusing on strengthening our public system rather than dismantling it.
Proponents of privatization claim that increasing private pay and/or private for-profit delivery will reduce wait times, either overall or for those in the publicly funded system specifically; reduce costs to the public system; and lead to better health outcomes. There is perhaps no more serious and dangerous myth in Canadian politics today than that statement. I want to review the situation today and some of the factors that show this is not the case.
Everyone deserves health care when they need it, no matter the size of their wallet. No one should need to wait in pain because there are not enough health care workers or because the wealthiest jump the queue.
However, under successive Liberal and Conservative governments, today people are waiting in pain for hours, days or weeks, and sometimes months or years. Folks are losing their quality of life while they wait for surgery. In addition, health care workers are run off their feet, burned out and exhausted in every corner of this country.
The Prime Minister could make things better for patients by hiring and rebuilding the public health system. Otherwise, he can contribute to making the crisis even worse by helping to fund for-profit schemes that will poach staff from the public system.
We are not surprised the Conservative Party loves for-profit care. It will make billions for corporations and rich CEOs. This is right out of the Conservative playbook: starve a public service and use that as an excuse to hand it off to the private sector.
A condition of federal health care funding should be investing to fix public universal Canadian health care, not funnelling funds and staff into for-profit facilities. New Democrats want health care to move towards more public delivery, not farther away from it.
If new bilateral health agreements do not result in thousands of new health care workers in our public system, it will fail. Ottawa urgently needs to partner with the provinces and territories to help provinces train and hire more health care workers, respect current health care workers and pay them better, and recognize the international training of thousands of health care workers who are already in Canada and ready to work.
During the 2021 election, the former Conservative leader said that “he would support provinces in introducing privately led health care ‘innovations’”. At that time, our current Prime Minister told Canadians this was evidence that a Conservative government would threaten Canada's public health care system, saying that the Conservative leader “believes in a for-profit, private health care system and he will not tell people what exactly he wants to do with that.”
My, how things change once one is in office. The Prime Minister recently reversed his position by calling Ontario premier Doug Ford's private for-profit clinic scheme an example of “innovation”.
Let us just quickly review the privatization plans by Conservative premiers across the country. Doug Ford has said that he wants to divert funding from his province's hospitals towards for-profit surgical clinics.
His plan includes an expansion of private cataract surgeries, MRI and CT scans, minimally invasive gynecological surgeries, and knee and hip replacements. Ontario's plans to contract out to private for-profit clinics for cataract surgeries is expected to cost the government 25% more per surgery. Moving only hip and knee replacements to for-profit clinics will benefit owners, with an estimated windfall of half a billion dollars annually. The owners of Herzig Eye Institute, one of the top private surgery clinics that lobbied the Ford government to expand private cataract surgeries, have donated thousands of dollars to the Ontario Conservatives.
In a recent throne speech, Manitoba premier Heather Stefanson announced her government's intention to seek out private partnerships to deliver health care.
Saskatchewan is moving forward with plans to reduce its backlog of surgeries by privatizing certain procedures.
In January, Alberta announced that it is contracting Canadian Surgery Solutions to perform more than 3,000 orthopaedic surgeries covered by the provincial medicare plan.
Why are they doing this, and how are they getting away with it?
There are several loopholes here, but I want to itemize one of them. There is a serious loophole in the Canada Health Act. As we speak, private clinics across Canada are advertising to prospective patients that within weeks they can get surgeries that typically take six months or more under provincial health plans. All the patient has to do is pay them $20,000 to $30,000, depending on the clinic.
CIHI estimates that the average cost per joint replacement operation in public hospitals in Canada is $12,223, which means that the private clinics are charging patients roughly double what the surgery costs the provincial medicare system.
To those who claim that private surgery is cheaper, one can tell right away that when one adds profit and extra administrative costs, diverting money to the private system will cost our public system more.
Doug Ford says, “Oh, that is okay. We are still paying for it with public dollars”. Why would Canadians ever tolerate paying twice as much for surgery in a private system than they would in the public system?
The Canada Health Act prohibits extra billing. This means that doctors are banned from charging patients more than the medicare rate for an insured service. However, private clinics are getting around that by operating only on patients from other provinces.
Imagine the loophole in this country where, if one is in Manitoba, one can sell a private surgery to someone from Ontario but not somebody in Manitoba.
This violates the fundamental principle of the Canada Health Act. It is a gaping loophole in our system. We are calling on the government to close that loophole right now if it truly cares about public health care as it says.
It is not only those kinds of surgeries, though. Maple, a Loblaws-funded virtual care business based in Toronto, is charging patients $69 per doctor's visit or $30 per month for 30 visits per year if one wants to go bulk. In-person service would be covered by Ontario's public insurance plan.
Ontario has insured virtual visits under OHIP, but Maple has found a way around the province's rules by connecting patients with a nurse practitioner or physician outside of the province. This is another gaping loophole.
That is not to mention the odious practice that has been going on in this country for years, where people appear at private clinics only to be upsold. They come for cataract surgery but are told that if they want a better lens, they have to pay more. That kind of introduction of private pay and access to health care is a fundamental violation of the medicare system that Canadians hold so dear in this country.
Let us talk about the evidence against privatization. A recent study led by Dr. Shoo Lee, a professor emeritus at the University of Toronto and former pediatrician-in-chief at Mount Sinai Hospital, looked at international experiences to determine what impact private financing would have on Canada's health system. That study found that private financing, both private for-profit insurance and private out-of-pocket financing, negatively affects the universality, equity, accessibility and quality of care.
It is not just that study. A recent study of England's National Health Service found that as outsourcing to the private for-profit sector increased from 2013 to 2020, so did the rates of death from treatable conditions.
I look forward to hearing any questions. Let us stand up for public health care in this country and make sure that every dollar of public funding goes to public health care in Canada.
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- Feb/14/23 2:47:17 p.m.
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Mr. Speaker, for-profit clinics across Canada are selling preferential access to surgery for those with the money to pay for it. They are exploiting a loophole in the Canada Health Act that is costing Canadians up to $28,000 per procedure. Even former Liberal health minister Jane Philpott says this contravenes the principles of medicare. New Democrats believe Canadians should have access to care based on need, not wealth.
Why are Liberals letting for-profit clinics pray on the desperation of patients and allowing two-tier access to care in Canada?
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- Feb/7/23 2:28:53 p.m.
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Mr. Speaker, at today's health summit, Canadians need the Prime Minister to champion public health care and stand against private, for-profit delivery. Privatization is not innovation. It drains workers from our public system, costs more and allows queue jumping for the rich. It will make the crisis worse. Real innovation is better support for health professionals, shorter wait times in our hospitals and access to care based on need.
Will the Prime Minister assure Canadians that additional public dollars will go to public health care?
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Mr. Speaker, a very common theme throughout my hon. colleague's speech was concern for seniors, particularly low-income seniors and seniors living in poverty. It is now widely regarded in Canadian society that one of the best ways to deal with poverty is with strong, universal programs, including our public health care system, which means everybody gets access to quality health care regardless of the size of their wallet.
I was quite disturbed to hear the hon. member, on February 7 in the emergency debate on COVID-19, endorse the concept of “opportunities for private delivery” in health care in this country. Does he not agree with me that the last thing anybody in this country needs, including poor seniors, is private health care, which would make health care dependent on the size of their wallet?
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