1995 Legislative Session: 4th Session, 35th Parliament
HANSARD
The following electronic version is for informational purposes only.
The printed version remains the official version.
(Hansard)
MONDAY, JULY 10, 1995
Afternoon Sitting (Part 1)
Volume 21, Number 25
The House met at 2:07 p.m.
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Prayers.
L. Reid: It is my pleasure today to welcome to this chamber a dear friend of mine, Dianne Milsom, visiting from Richmond, her son Blaise Kennedy, and another friend, Eleanor Denton. I would ask the House to please make them welcome.
Hon. M. Harcourt: I'm honoured to be able to welcome to the Legislature the longstanding member for Vancouver East from, I think, 1979 to 1993, who taught a number of Vancouverites how to work with citizens to stop things like freeways and urban renewal schemes and to have communities become more actively involved in their neighbourhood issues. I was hoping the member for Saanich North and the Islands would welcome one of his new constituents, who is now living on the Gulf Islands: Margaret Mitchell.
G. Farrell-Collins: I would ask the House to help me make welcome -- I don't see her in the gallery; I knew she was trying desperately to get over here today -- Ms. Birgit Lund, who is working with the injured workers' groups in British Columbia and has been for some time. She was trying to be here today with a petition from the weekend. If she is up in the gallery and I can't see her, I'd like to welcome her. Anyway, I know she'll be here sometime today, so I'd ask the other members to help me in welcoming her.
Hon. P. Ramsey: One of the difficulties about being a member of this assembly if you live a long way away is that too often members of your family don't get a chance to see what you do day to day or to understand exactly why you want to do this with your life. I'm pleased to inform the chamber that this week my wife, Hazel, has been able to join me in Victoria for the week and is here in the House to observe our proceedings today. Would the House please join me in making her most welcome.
G. Wilson: Supplementary to the introduction from the member for Fort Langley-Aldergrove, Birgit Lund, with her son Stephen Lund, as well as Daniel Pinske, who is the chairman of the British Columbia Injured Workers' Society, are with us today in the gallery. I've had an opportunity to meet with them this morning. They are here actively lobbying for changes to the Workers Compensation Act. Would the House please make them welcome.
L. Fox: It is with real pleasure today that I introduce a family from Vanderhoof -- as I mentioned last week, the geographical centre of British Columbia: Russell Plett, Ruth Plett, their daughter, Angela, and their son, Nicholas. They are here to make sure that their member is representing their interests. Would the House please make them welcome.
Hon. E. Cull: In the public gallery today is my executive assistant, otherwise known as the other Lynda Reid. She's travelling here with her uncle Howard Kelley from Calgary. Would the House please make them welcome.
D. Jarvis: I'd like to introduce two friends of mine from the Prince George-Omineca area, Tim and Lisa Shute. They are in the confines of the Legislature today and are down here on holidays. Would members please make them welcome.
Hon. P. Ramsey: I have the pleasure to table today the 1994-95 annual report of the British Columbia Health Research Foundation. In doing so, I'd like to particularly thank the member for Burnaby North, who has served as chair of the board of directors of the foundation.
RECALL AND INITIATIVE AMENDMENT ACT
G. Campbell presented a bill intituled Recall and Initiative Amendment Act.
G. Campbell: We all know that one of the most critical issues that faces all of us in public institutions today is the re-establishment of trust and public accountability between elected officials and those who elect them. The current recall and referenda legislation fails on both counts. Therefore I have introduced a bill that will bring true accountability to the Legislature and give us an opportunity to give our constituents the real sense of control that they deserve to have over their elected representatives.
There is nothing more critical than to re-establish the trust of our citizens in the public institutions that are there to serve them and to meet their needs, and I believe that this bill goes a long way towards doing that.
Bill M215 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.
EDUCATION AS AN ESSENTIAL SERVICES ACT
L. Stephens presented a bill intituled Education as an Essential Services Act.
L. Stephens: This bill will allow the chairs of the school boards or the Minister of Education to establish levels of essential services not only for health, safety, welfare and education but also as they apply to economic threat. This bill will broaden the scope of the level of essential services and provide for the best levels possible that serve the public interest. This bill also will allow for a cooling-off period not exceeding 40 days.
Since 1991, students across the province have lost almost two million days of education due to labour action. Estimates indicate that over two-thirds of B.C. students have been affected. Our children's education is too important. We need our teachers in the classrooms teaching. This bill recognizes that our children come first. That is why education must be an essential service.
Bill M216 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.
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V. Anderson presented a bill intituled Donation of Food Act.
V. Anderson: As former chairman of the Vancouver Food Bank, I'm very much aware of the hunger that has existed for many people in our province over many years and that has increased considerably in the last few years. Food banks across this province are desperately in need of food, while grocery stores and restaurants throw out large quantities of food. This bill will make it possible for these persons to donate surplus food without fear of being sued. It is a very practical solution to a very big problem. It's endorsed by the food distribution network. They will look forward to this bill, which is similar to one passed in Ontario and by unanimous vote in Saskatchewan.
Bill M217 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.
[2:15]
WORKERS' COMPENSATION BOARD GOVERNANCE
G. Campbell: For some time now, the Liberal opposition has been pointing out that the WCB is in a mess. We know that the costs of the WCB have skyrocketed and that services to injured workers have plummeted. We know that the minister -- although he's denied this time and time again -- finally recognized it this year with the appointment of a commission, which he proceeded to basically ignore. The results of all this inaction from the Minister of Skills, Training and Labour has really been a revolving door in the executive suite of the WCB. The fact of the matter is, hon. minister, that injured workers are not being serviced by the WCB. I therefore have a question to the Minister of Skills, Training and Labour: when will the minister actually act to restore the confidence of injured workers in the WCB, to make sure that they have service and to make sure that injured workers come first in terms of the WCB agenda?
Interjections.
The Speaker: Order, please.
Hon. D. Miller: Unfortunately, I didn't bring the transcripts of a public meeting held Saturday night, wherein the Liberal Labour critic actually congratulated me, hon. Speaker -- I'll bring that back to the House later -- for commissioning a report dealing with the problems associated with governance at the Workers' Compensation Board. However, let me say at this opportunity that I was advised on Sunday that Mr. Dale Parker, president and CEO of the Workers' Compensation Board, has submitted a letter to the chair, Mr. Lee Doney, wherein he offers his resignation as president and CEO. I want to say that I regret this very much. I have a great deal of confidence in Mr. Parker's ability to carry out his work. I am currently considering a range of options, and I intend to report to this House later today on actions this government intends to take to ensure that the Workers' Compensation Board is there to serve the interests of working men and women in this province.
The Speaker: Supplemental.
G. Campbell: I'm glad the minister has finally realized what his responsibilities are, hon. Speaker. One of the problems we have had is that last year the minister was in the midst of full-fledged denial of the problems at WCB.
Interjections.
The Speaker: Order, please. The Chair will allow a reasonable time for a member to make a preamble, and I would appreciate it if members would not interject.
G. Campbell: Hon. Speaker, Mr. Parker has offered his resignation. My question to the Minister of Skills, Training and Labour is: will he act today to fire the existing WCB board and ask Mr. Parker to stay on until a new board is appointed that will put the WCB back in order so that injured workers are cared for first? Instead of worrying about NDP politics at the WCB, when will this minister start to worry about injured workers?
Hon. D. Miller: I might recommend that the Leader of the Opposition follow his own advice with respect to playing politics. I've indicated that I will be reporting back to this House later today on actions this government will take. The Workers' Compensation Board is supposed to be there to serve the interests of working people and employers in this province. The failure of the board to deal with those issues is of grave concern to me, and we will take action.
G. Farrell-Collins: The report by Patrick O'Callaghan and Judi Korbin came in on April 18. I have asked the minister repeatedly since then when he will take some of their recommendations to replace at least 50 percent of the Workers' Compensation Board. I suggest that the entire board should be fired and that Mr. Parker should be the one to stay on. Will the minister tell us right now, not later today, whether he will he fire the entire board and decline the letter of recommendation from Mr. Parker?
Hon. D. Miller: I've already expressed my admiration for Mr. Parker. Since he has been in the job, to quote from his letter, "administrative costs at the board are flatlined." Mr. Parker expects that the deficit will be cut in half next year. He is doing a commendable job, and I will advise this House later today on actions this government will take.
The Speaker: Supplemental, hon. member.
G. Farrell-Collins: The Minister of Labour has two responsibilities with the Workers' Compensation Board: (1) to appoint the board; and (2) to give them a mandate. We've been waiting three and a half years for two Labour ministers to finally come to that. Can the minister tell us why it took the resignation of yet another senior executive at the Workers'
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Compensation Board before he finally acted? Is he really going to act today? Is he really going to fire the board and ask Mr. Parker to stay on?
Hon. D. Miller: All I can say is stay tuned and watch out -- you'll see.
B.C. TRADE CORPORATION PAYMENTS TO BOB WILLIAMS
J. Weisgerber: My question is to the Premier. The Premier said that Bob Williams was paid more than $167,000 by the B.C. Trade Corporation over the last two years for his failed efforts to sell British Columbia's registry system to the Russians. The fact is Bob Williams has been collecting $750 a day, sometimes for as many as 20 days in a month, over the last two years. Can the Premier also confirm that Bob Williams, in addition to that amount, was collecting a monthly pension of $3,993.08, which the Superannuation Commission say has been paid since March 8, 1991?
Hon. M. Harcourt: I answered this question in estimates, and the Leader of the Third Party answered his own question.
J. Weisgerber: A supplementary. Bob Williams made five trips to Russia, sometimes taking as many as ten bureaucrats, in this failed mission. He spent over half a million dollars of taxpayers' money in this failed mission, and he couldn't even get the mayor of St. Petersburg to return his faxes or acknowledge the so-called draft deals which he put together. Can the Premier tell us whether Mr. Williams is currently employed by the government of British Columbia? Will he confirm that in addition to getting $750 a day, Bob Williams was in fact collecting his pension during that period of time?
Hon. M. Harcourt: I answered that question in my estimates. I said that Mr. Williams is no longer working with the provincial government. Second, to get lessons from the Leader of the Third Party, who was a Socred minister in a government that gave $320 million in bad-debt business loans that the taxpayers of British Columbia had to write off in 1992.... It's a heck of a lot of cheek for him to try to talk about saving taxpayers' money.
STATEMENT RE GORDON HANSON BY FORMER ABORIGINAL AFFAIRS MINISTER
M. de Jong: On September 10, 1992, the then Minister of Aboriginal Affairs issued a statement dealing with conflict allegations involving ex-NDP MLA Gordon Hanson. The minister's statement was purported to be based upon a report prepared by Sunny Mathieson of the comptroller general's office. On July 4, at an FOI hearing last week, Ms. Mathieson was asked about the minister's statement of September 10, 1992, and gave this answer under oath: "I don't agree with the statement in the press release. I think that was misleading." In light of the statements made by Ms. Mathieson under oath, can the now Minister of Forests tell us: who is telling the truth -- the senior comptroller from the Ministry of Finance, or himself?
Interjections.
The Speaker: Does the hon. member have another question?
Interjections.
The Speaker: Your question, hon. member.
M. de Jong: There can be no more serious allegations than that a minister of the Crown has misled British Columbians. That is the very allegation that a senior official within the comptroller general's office has made under oath against the present Minister of Forests. The question I have is: has the Minister of Forests notified the Attorney General about the allegation, and will he be stepping aside pending an investigation into his conduct in the Hanson matter?
The Speaker: Before recognizing the hon. minister, I would point out, hon. member, that while I did not call you to order, any implication of an impropriety or improper motive on the part of an hon. minister or a member is unparliamentary, of course, and I'm sure the member would withdraw any implications.
Hon. A. Petter: I'd be happy to take the question on notice for the current Minister of Aboriginal Affairs.
The Speaker: The question is taken on notice.
BOB WILLIAMS, B.C. TRADE CORPORATION AND VANCITY CREDIT UNION
R. Neufeld: My question is also to the Premier. In a letter dated January 12, 1995, on B.C. Trade Development stationery, Bob Williams wrote to the executive director for Canada at the Asian Development Bank in the Philippines. This was a follow-up to a meeting that Bob Williams had with an individual in Vancouver. He said: "The co-financing opportunities you referred to are matters that I will discuss further with my colleagues at Vancouver City Savings Credit Union and its wholly owned trust company, Citizens Trust." Can the Premier tell us why on earth he paid Bob Williams $750 a day to drum up business for VanCity through B.C. Trade?
Hon. M. Harcourt: Hon. Speaker, I would appreciate receiving a copy of that letter from the member, and I'll get him an answer to his question. I haven't seen that letter before.
The Speaker: The member has a supplemental question?
R. Neufeld: It is a new question, also to the Premier. In his efforts to peddle the B.C. Assessment Authority's tax assessment technology, it appears as if Bob Williams abused his position at B.C. Trade to help his pals at VanCity. Does the Premier agree that it was highly inappropriate for Bob Williams, of all people, to be using B.C. Trade to further the interests of his buddies at VanCity, as suggested by the letter?
Hon. M. Harcourt: I'm not sure what the letter suggests, because I haven't read it. I will read it. To attack the second-largest credit union in the world, which serves British Columbians very well, and to imply that there is wrongdoing there is unfortunate. I have said as well that the whole question of selling British Columbia's world-leading Torrens land registry system, a computerized assessment process.... The joint venture that we entered into with the surveying industry to sell that to the rest of the world -- yes -- got down to the last
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two in Saint Petersburg. But there are many other areas in the world that are very interested in B.C.'s world-leading technology in this area.
STATEMENT RE GORDON HANSON BY FORMER ABORIGINAL AFFAIRS MINISTER
W. Hurd: My question is for the Minister of Finance. On July 4, 1995, a senior comptroller from her ministry testified under oath that the Minister of Forests has made a very serious misleading public statement. Can I ask the Minister of Finance whether she has reviewed the charges made under oath by Sunny Mathieson during her testimony before the freedom-of-information and protection-of-privacy commissioner, and can she tell the House what specific actions she has taken as a result of that testimony?
Hon. E. Cull: I believe that this question has already been taken on notice.
The Speaker: The question is taken on notice, hon member. Do you have a different question?
W. Hurd: The answer we received from the minister is alarmingly like the one we got from her with respect to the Parks memo. A senior official in her ministry has testified against one of her cabinet colleagues, and she is apparently doing nothing. Can the minister tell us how she accounts for this bad judgment, and what will she tell the people of B.C. today about the truth being told by ministers in her own cabinet?
HOMEOWNER GRANT ELIGIBILITY OF NON-NATIVES LIVING ON NATIVE LAND
G. Wilson: My question is to the Minister of Finance. There is a very serious and urgent situation that exists for non-native people living on aboriginal land with respect to taxation. These people are no longer eligible for the homeowner grant. These people are also being faced with top-up grant dollars, which means large tax increases to them. Neither are they given the privilege of deferment of taxes. Will the minister tell us what efforts she is making to make sure that the B.C. Assessment Authority, as a contracting agent for self-taxing bands, puts in place a taxation system that is fair to all British Columbians and does not discriminate against non-aboriginal people who are in lease situations?
[2:30]
Hon. E. Cull: I do have a considerable amount of sympathy for people who find themselves in that situation. As the member is probably aware, the provincial homeowner's grant is provided by the province to offset property taxes that are collected for school purposes. Bands that are collecting taxes under the Indian Self Government Enabling Act are operating under federal legislation, not provincial. The taxes they collect do not come to the province for school purposes; so there lies the difficulty in terms of giving them a homeowner grant. However, section 14 of the Indian Self Government Enabling Act does provide for us to do so if the band itself puts in place a homeowner grant-like program. There are a number of bands that have started to do that. We are reviewing them, and I have asked my staff to deal with it expeditiously so that those people who will be able to qualify for a grant are able to do so as soon as possible.
The Speaker: The bell terminates question period, hon. members.
R. Neufeld tabled a letter from Bob Williams to the executive director for Canada, Asian Development Bank.
G. Wilson: I ask leave to present a petition.
Leave granted.
G. Wilson: I have here a petition submitted by people who are concerned about the actions of employees and officers of the Workers' Compensation Board of British Columbia. These are people who are demanding a complete revision of the current Workers Compensation Act in British Columbia, and they represent a large group of people throughout the province whose experiences show patterns of abuses that the current Workers' Compensation Board and its employees are thrusting upon claimants and their families.
J. van Dongen: I ask leave to present a petition.
Leave granted.
J. van Dongen: I rise to present a petition today that has been signed by 300 people. It is a petition that has been taken up by the family and friends of Sherri Bell, who was killed recently in a car accident. That accident involved a drunk driver. The petition seeks heavier sentences against drunk drivers.
D. Mitchell: I rise under standing order 35 to move adjournment of the House to discuss a matter of urgent public importance: namely, the crisis in the British Columbia salmon fishery. Advance notice has been given of a request for an emergency debate on this subject under practice recommendation No. 8.
British Columbians are extremely frustrated and deeply dismayed over the threat to one of our important industries and an international symbol of our province. The overfishing of our salmon resource raises the spectre of the decline, and even the extinction, of our salmon resource. The current unwillingness of the Alaskan fishers to live up to the terms of the Pacific Salmon Treaty has now greatly intensified this apprehension. Yesterday in Prince Rupert harbour, we saw a strong manifestation of this fear when an American ferry was blockaded by hundreds of B.C. fishing boats.
Federal Fisheries minister Brian Tobin is travelling to British Columbia this week to consult on this issue. It is imperative that our assembly debates this matter today in order to express the will of our province's elected representatives on this crucial and timely matter. We must let our American neighbours know that we will never tolerate overfishing of our precious salmon resource; we must also let our federal government know today that unilateral conservation will not and cannot work.
Now that the government's spending estimates have been approved by this House, there is no other opportunity
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for us to immediately deal with this issue. This is a very serious matter that can only be addressed by immediate debate in this assembly. There is an urgent need for our House to express itself on this matter now, as it is a definite matter of urgent public importance. Hon. Speaker, I'd be glad to table this statement with you now.
The Speaker: The hon. Attorney General, responding to the matter.
Hon. C. Gabelmann: First of all, let me thank the member for giving notice under practice recommendation No. 8.
Secondly, let me say on behalf of the government that everybody in this government -- and, I believe, everybody in this Legislature and in this province -- views with dismay the activities and actions being taken by Alaska. It's detrimental to our fishing stocks and, if allowed to continue, in the long run would contribute to the potential elimination of the chinook fishery on this coast. We must do everything in our power to ensure that their actions not be allowed to continue.
Thirdly, let me say that we feel so strongly about this issue that the minister responsible tabled a motion last year in this House, which this House passed unanimously. We are already on record with our unanimous view about the threat to the fishing industry. That minister has communicated the view of this House from last year's motion to the governments of Alaska, Washington and Ottawa, and in fact is meeting again this week with the federal minister on Wednesday. Hon. members can be sure that the views of this House will be communicated strongly and effectively on behalf of all British Columbians.
G. Farrell-Collins: I also want to thank the member for West Vancouver-Garibaldi for notification of this motion coming forward. I can't agree more that this is an issue which grows more and more urgent and more and more timely day by day. I realize that a motion was put forward by the minister last year, which we all supported unanimously. I think, however, it is incumbent upon this House to restate in no uncertain terms -- in a very strong, united and adamant way -- our position and our opposition to the continued overfishing. Conservation has to be something that's borne by all the people who draw and rely upon that resource. I think it's critical that this House support the federal government and the fishers in British Columbia in demanding that conservation be borne by all parties. It includes the people from Alaska. I think this House could do nothing better than offer our support yet again to those people who are seeing their livelihood jeopardized.
J. Weisgerber: Certainly we share the concerns of the member for West Vancouver-Garibaldi and other members of the House. It seems to me that this issue -- again, with Alaska -- demonstrates the need for British Columbia to take jurisdiction over the west coast fishery. We are a province stymied and denied the ability to deal with the state of Alaska, which has made the decisions. The United States government has not made decisions regarding fishing in Alaska. It has been the state of Alaska and the Governor of Alaska. As British Columbians, we should be in a position to protect our interest directly. In that vein, it would be particularly urgent for us, as a Legislature, to be debating that issue. So Mr. Speaker, the issue and the concerns are real. It's unfortunate that we, as a Legislature, haven't demanded jurisdiction over the west coast fishery so that we could directly involve ourselves in the measures necessary to protect our fishery.
The Speaker: The member for Powell River-Sunshine Coast seeks the floor.
G. Wilson: I seek leave to speak to the motion, hon. Speaker.
The Speaker: Proceed, hon. member.
G. Wilson: Thank you, hon. Speaker. I'm in such a habit of being denied the opportunity, I guess that I just automatically assume that I fall into that category.
There are four matters before us with respect to this motion. Firstly, the fact that this is an urgent situation with respect to the well-being of the salmon industry is not in dispute, and I think all of us can agree on that. Secondly, I think the fact that we had a debate last year only underscores the urgency for debate today. Notwithstanding that debate and the position taken by the province, a year later the crisis is before us yet again for some of the same reasons.
Thirdly, the issue with the motion is one of urgency of debate. I think what's important is the urgency of debate on this issue, not whether the situation is urgent in itself, because the federal minister will be in this province on Wednesday. There can be nothing more timely or more necessary now than this Legislative Assembly serving notice to the federal Minister of Fisheries and Oceans that we are not content to allow this situation to continue to occur year after year. The fact that we had that debate last year and that we now must have a debate this year speaks to the urgency.
Lastly, given the timing of this particular motion, it is important to have this debate today so that we can send a very strong signal that will be one more weapon in the arsenal of the federal minister as that minister sits down and tries to negotiate with our American neighbours with respect to the position we have. So I strongly support this motion and hope the Speaker will rule in favour of the debate.
The Speaker: The Speaker will bring back a decision at a later time.
C. Serwa: I beg leave of the House to suspend the rules for the purpose of passing an urgent resolution condemning the government of France for resuming nuclear weapons testing in the South Pacific Ocean. [Applause.]
The Speaker: Whoever said this job was easy?
I am sure that the hon. member for Okanagan West is very familiar with the rules. While the matter he raises may be of importance, it is not within the procedures in the House to recognize.
Hon. C. Gabelmann: I would urge the member to file his motion so that it could appear in the record, and see how events proceed.
G. Farrell-Collins: Point of order. With all due respect, I admire the nimbleness of that request, but I believe that the member has asked leave, and it is my understanding that leave should be requested, unless I'm completely wrong.
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The Speaker: Hon. members, he can request leave, but it is not customary to allow such a request unless we are in that order of business, and we are not at that point at which the member could put the request forward.
Before we go on to the next business, to assist the House in conducting its business, I would like to report back on a matter raised last week. I believe it is sufficiently important to give you my ruling as soon as possible. This has to do with two matters raised last Friday by the hon. member for West Vancouver-Garibaldi dealing with points of order for consideration by the Chair.
First, the member asked for a ruling that the proceedings in the House relating to Bill 55, Miscellaneous Statutes Amendment Act (No. 3), 1995, are invalid by reason of section 2 of the Members' Conflict of Interest Act, and second, that the Chair ought to exercise its discretion in order that section 21 of Bill 55 be severed and considered as if it were a bill separate and apart from the remaining sections of the bill.
Section 2 of the Members' Conflict of Interest Act, cited by the hon. member, provides that members of the assembly cannot exercise official powers or perform official duties when their private interests are involved. Therefore the hon. member suggests that all members were in a position of conflict when voting on section 21 of Bill 55, which affects certain pension entitlements of members, which in turn are in members' private interests.
In this respect, the Chair notes that section 1, the interpretation section of the Members' Conflict of Interest Act, provides that "private interest" does not include the interest arising from the remuneration and benefits of a Member of the Legislative Assembly. This, however, is an issue to be determined by the conflict-of-interest commissioner, to whose attention the hon. member has conveyed his concern by letter, dated July 7, 1995. In any event, as previously ruled in a Speaker's decision in this House -- Journals, April 11, 1916, page 88 -- the Speaker cannot be called upon to express a legal opinion on statutory interpretation.
[2:45]
On the second point raised by the hon. member, asking the Chair to divide section 21 of Bill 55 from the rest of that bill, it appears to the Chair that while the Speaker may, on the application of a member, divide a motion containing two distinct and separate propositions -- May, sixteenth edition, page 412 -- I have considerable doubt whether the practice in respect of motions has extended itself into a practice in respect of bills. In similar circumstances, Speaker Jerome -- House of Commons, Ottawa, Journals, May 11, 1977, at page 5522 -- stated in referring to a previous decision:
"His decision is crystal clear, and there can be no doubt that a motion containing two or more substantive provisions is quite distinct from a procedural motion or a motion which is generally described as having only the effect of dealing with the progress of a bill. The practice in respect of substantive motions has never been extended to those motions which relate to the progress of a bill. The use of the omnibus amending bill is well enshrined in our practice. Nor can I find any authority which would support an order of the Chair at this second reading stage that the bill be divided."
I have examined with care the authority cited by the hon. member in his presentation, and, with great respect, they deal in the main with instructions to a committee and do not support the proposition urged upon the Chair by the hon. member. In any event, even if there did exist any foundation for the Chair to intervene, the hon. member's application to the Chair for an order of severance ought to have been made before completion of proceedings on second reading of the bill.
Objections similar to that of the hon. member for West Vancouver-Garibaldi have frequently been made in this House, as well as in other jurisdictions, to so-called omnibus bills containing within them numerous distinct principles relating to different statutes, but such objections have been consistently rejected, essentially on the grounds that in committee stage the sections of the miscellaneous statutes amendment bills have, by practice, been treated as if each section in itself constitutes a separate bill.
It is the House and not the Speaker that must determine the content and form of omnibus bills if the longstanding practice of the House relating thereto ought to be altered or abandoned.
I therefore rule that the hon. member's points of order must be rejected on the basis of the precedents to which I have referred.
Hon. C. Gabelmann: I call second reading of Bill 54, An Act to Protect Medicare.
AN ACT TO PROTECT MEDICARE
(second reading)
Hon. P. Ramsey: It is with a great deal of pleasure that I rise today to open second reading debate on Bill 54, An Act to Protect Medicare. This legislation, which bans extra-billing of patients in British Columbia, is part of an ongoing commitment to protect medicare for all British Columbians and their children. This legislation shows British Columbians that they can depend on this government to make sure that health care is available to all of us on the basis of need, not on the size of someone's wallet.
From the moment we were elected in 1991 we have worked to make sure that our province's health system lives up to the high expectation that British Columbians have of it, and that the health system continues to meet their needs. This hasn't always been easy, especially when we were faced with record numbers of Canadians and immigrants coming to British Columbia. It wasn't easy when we were faced with a massive budget deficit to overcome. But we have achieved considerable progress in protecting and improving medicare -- more success than any other province in Canada -- and we have balanced the budget.
Health care has been the number one spending priority in every budget of this government. Funding increases for health have been consistently higher than for any other program funded by our government. We have made medicare our top priority while some other provinces and, most regrettably, the federal government, have been cutting not increasing their funding for health care. We've gotten medicare priorities right in British Columbia. We've put new health dollars into reducing surgery waiting lists, into expanding cancer treatment for people and into other measures that are priorities for all British Columbians. We've put new emphasis on preventive care, whether it's preventing heart disease, new immunization programs for our children or improvement of environmental
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standards. We have also looked for new ways to get more out of the health dollar. We've challenged our health system to cut waste and abuse and find new efficiencies in the delivery of health care services. If medicare is Canada's success -- and I believe it is one of the hallmarks of our identity as Canadians -- then British Columbia has been leading the way with one of the best health care systems in the world.
But not everyone shares this commitment to medicare; not everyone has a similar vision of what the future holds for our health system. There are those who believe that medicare should be changed, those who believe that families should pay extra if someone gets sick, those who believe that only catastrophic illness or injury should be covered by medicare, and those who believe that governments should cut medicare funding and protect corporate tax breaks and subsidies. At times, some opposition members and their parties have advanced part of that vision for a changed medicare. It's a vision that puts narrow, ideological and commercial interests ahead of patients and their families and our public health care system that we all depend on. It's a vision of medicare where patients can be extra-billed and where the quality of care that you receive will depend on the size of your bank account.
That is not my vision of medicare. It's not the vision of this government. It's not the vision of most British Columbians. Our vision is of a medicare system that provides security for all British Columbia families. It's a system with one overriding rule: it must be there when British Columbians need it.
The medicare protection act is a first step to make sure medicare continues to meet this challenge. Its purpose is to defend against threats to change medicare. The legislation will, for the first time in any Canadian province, entrench in provincial law the five founding principles of Canadian medicare: universality, comprehensiveness, accessibility, portability and public administration.
The medicare protection act reaffirms these guiding principles and makes them real by banning extra-billing of patients for medicare services regardless of where in the province those services are provided. It means that British Columbians cannot be charged by providers of medicare services.
Medicare covers some 3,000 separate health services, ranging from simple blood tests to complex neurological surgery. As a result of this legislation, there will be no more tray fees, no more facility fees, no suture fees -- no extra charges at all for medicare services. Thousands of British Columbians who are currently being charged for medicare services will no longer have to pay as of September 30 of this year.
There is also a provision in this bill that provides government with the ability, should it be required, to address extra-billing of patients by physicians who might someday be working outside of medicare. At this time there are no physicians working outside of medicare in our province. This legislation will make sure that access to medicare services is based on medical need, not financial means. In doing so, it takes another step forward in protecting medicare for our future.
In accomplishing this important task, we recognize that it should not be done on the backs of the physicians. We recognize that many physicians have paid for medical supplies used in providing medicare services in their offices. Others have chosen instead to charge patients. Neither situation is appropriate. The cost of these supplies is real; the need for those medicare services is legitimate. So medicare will now cover these costs, and patients will no longer be charged.
This initiative has been developed cooperatively with the British Columbia Medical Association. It ensures fairness; it makes sure that medicare is both realistic and fair to both patients and physicians. I'm confident that An Act to Protect Medicare will have the strong support of a large majority of British Columbians.
At the same time, I know and members of this House know that there are some wealthy and powerful interests out there who would take a different position. They're saying that we're limiting "freedom of choice" for patients. They're saying that we are dictating to health professionals and taking away their rights. If those arguments sound familiar, that's because they were put forward by opponents of medicare some 35 years ago. History proved them wrong then, and it will do so again in today's case. Extra billing for medicare services doesn't lead to better health care, and it certainly doesn't help medicare. With this legislation, we're protecting medicare from those who want to change it.
This legislation cannot and does not stand alone; it's part of an ongoing strategy to protect medicare and our health system. This act is one of three major steps that our government is currently taking to protect medicare for all British Columbians. The others include working hard to eliminate waste and abuse throughout the system and pressuring the federal Liberal government to cut corporate tax breaks, not funding for medicare. By reducing waste in the system, we are making medicare as efficient and as effective as it possibly can be.
We're making sure that we get the most out of every health care dollar. It's being accomplished by a variety of initiatives; whether it's the PharmaNet computer system, which will reduce waste and abuse of prescription drugs while at the same time doing a better job of protecting patients; whether it's that major public education program, sponsored jointly by the Medical Services Commission and the province's doctors, called Taking Care of Health Care -- education for both the public and physicians about the best and most sensible use of health services; or whether it's about the regionalization process -- New Directions -- which will replace that confusing and inefficient array of more than 700 health care decision-making bodies across the province with a more sensible system of 100 regional health boards and community health councils and with a more effective and cost-effective way of delivering health services. In total, these and many other measures being pursued throughout the system are reducing waste and abuse and helping to make medicare sustainable for the long haul.
[3:00]
By pressuring the federal Liberal government to stop hurting medicare, we are also working toward the same goal. Last week I travelled to Ottawa to meet with other provincial ministers of health and with our federal counterpart. Our goal was to convince the federal government that they are wrong about their priorities in making cuts to medicare. We demanded that the federal government return to its historical role of supporting medicare -- supporting it both in the principles enshrined in the Canada Health Act and through shared funding at an adequate level for medicare services. We urged that action on them, rather than the continuation of
[ Page 16752 ]
their backing away from health funding, as they have been doing while continuing to provide tax breaks to corporations -- $6.6 billion in cuts across Canada to medicare, to universities, colleges and our social safety net. That is the federal Liberal plan in the next two years, and that plan can only hurt young people, patients and their families.
British Columbians are clear on this point: they want all governments to get their fiscal act together, and they want all governments to do it without gutting medicare. That is our approach here in British Columbia, and we're trying to convince the federal Liberal government that it's the right way to go. The federal government does have alternatives, and last week's meeting of federal and provincial ministers of health proved it. The federal government is softening its position on health cuts. We are pushing them in the right direction. They have now agreed to at least maintain a stable and ongoing level of cash contributions in support of medicare. My job now is to make sure that these federal contributions aren't just stable but also adequate.
We will continue to press the federal government to change its priorities and, instead of medicare, address the high level of corporate tax breaks still contained in federal legislation. In combination, pressuring the federal government, reducing waste and abuse and banning extra billing represent an aggressive campaign to protect medicare for ourselves and our children.
The act we are debating today, I believe, is important legislation. It is important to the future of medicare in our province. It is important to the well-being and security of all British Columbians. With it we are taking another major step forward in the protection of medicare. We are the first Canadian province to entrench the principles of medicare in our legislation, and by banning extra billing we are protecting medicare from the current and future threat of expanded charges. In short, we are acting decisively to protect medicare for all British Columbians.
We know that this is a first step; there is still more to do in the future. The creation of medicare, though, was no fluke. It was a conscious act motivated by actual needs and made a reality by a strong commitment, difficult decisions, tremendous courage at times and hard work. The long-term survival of medicare requires no less diligence today and in the future. The medicare protection act meets this challenge and continues that proud tradition, and while it has some opponents, I know that the vast majority of British Columbia's families are counting on us to make sure that medicare will be there when they need it. That's why I know most British Columbians and most people who work in our public health system support and welcome this legislation. I encourage members of this Legislature to do the same. I move second reading of Bill 54, An Act to Protect Medicare.
L. Reid: What is really required is an act to protect medicare from the NDP. June 29 saw electionism of the highest order -- election opportunism and full-flight legislative panic. What you see today in Bill 54, An Act to Protect Medicare, is a lesson that the Ontario NDP and the Manitoba NDP tried to teach this government. Both those administrations attempted to make this an election issue, and both failed miserably. This is about election opportunism, and only about that.
Regionalization has been the biggest threat to medicare in the history of this province. Wait-lists have not been well managed by this minister or by this government. This is the same minister who has risen to his feet on more than one occasion to announce and celebrate one-time-only funding in this province. I ask hon. members of this chamber: how many times can you announce one-time-only funding?
This government is not succeeding admirably in their contention that they are handling the wait-lists in the province. Look at the wait-lists. Look at them clearly and look at the facts, not the spinning that goes on on behalf of this minister and this government. I will quote from a table that looks at the actual wait and then the reasonable wait. It equates the difference and compares every single province in this land, from British Columbia to the east coast. We have orthopedic surgery....
The minister is calling out about orthopedic surgery. This minister should call out about orthopedic surgery. It's his constituents who must travel to Alberta to receive appropriate treatment. This minister had best heed the facts and move away from the spinning of what he believes to be appropriate, because his opinion is not valid. The facts speak for themselves. There is a tremendous difference between how British Columbia treats patients on wait-lists and how other provinces treat patients. This minister cannot rise to his feet and suggest that he is the defender of medicare. It is simply not valid or true.
I will quote on orthopedic surgery, and let's use Prince George as an example, because that is the example in the minds of the majority of British Columbians when they pick up the newspaper and realize that in the Health minister's own riding, individuals cannot get their bones set. They must travel to Alberta for simple orthopedic surgery. It's untenable that this could happen in the minister's own riding, when this is the very same individual who leaps to his feet and suggests that he is the defender of medicare.
The actual orthopedic surgery wait-list in British Columbia is 15.7 weeks, and what is considered reasonable is 7.9 weeks. So less than half is considered reasonable. It's the same for radiation oncology. What is actual in British Columbia is six weeks. I have spoken in this chamber about treatment that is required by individuals suffering from cancer. It's a huge issue for every single British Columbian. What is actual is six weeks in British Columbia, and what is considered reasonable is two weeks. That's a tremendous difference, and it's a lifetime if you happen to be the patient waiting for surgery or some treatment.
My hon. colleague from North Vancouver-Seymour talked about heart surgery. Each of these waiting lists -- and I may, during the course of this debate this afternoon, enter each one into the record -- suggests that British Columbia is not doing the job that this minister would suggest he and his ministry is doing for the patients in British Columbia.
That is the concern, because British Columbia Liberals stand up for medicare, and we would actually deliver. Talk is cheap. The hypocrisy is rampant in this House, but you have to deliver on what this government says they stand for. They have had the audacity to introduce an act to protect medicare, when I can assure you that they have done more to dismantle the system than any other government in the history of this province. That is alarming in the extreme.
Frankly, I think this minister should be absolutely ashamed of himself. The only danger to health care in this land is
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debt -- provincial and federal debt, absolutely. That is what hampers the ability of governments to deliver. Frankly, hon. Speaker, I would suggest to you very strongly today that this government's lack of priority is what is hampering health care delivery in British Columbia. They can find the dollars for all kinds of pet projects for NDP insiders. They have absolutely no difficulty giving soft landings to new individuals in health care. Chris Chilton is only one example. What Liberals could do with $125,000 that is allowing somebody to spin more hypocrisy from the government benches! It's completely inappropriate.
Perhaps a little analogy is in order. We have this Health minister lighting the grass on fire and then running in and somehow suggesting that Bill 54, An Act to Protect Medicare, is the fire extinguisher. It's absolutely not. It is this government's inability to set clear and precise priorities which is the dilemma around health care delivery.
I can tell you that in the cabinet document we referred to some weeks back in this chamber -- "New Directions for a Healthy British Columbia" -- this is what their own people had to say about where this government was in terms of advancing health care: "...still a lot of confusion around responsibilities, parameters of regional health boards...big implementation vulnerability...maintaining good relationships with the BCMA is critical to reaching cost savings." This is the government's own document. "Meeting reduction terms contained in the health accord is a huge issue" -- and we know that extremely well. "Within service delivery there is a general public sense of deteriorating services."
You have to go a long way to alienate the average British Columbia patient for there to be a general sense of deteriorating services. That means that not only the patient has been negatively impacted by this system, but also members of their families and their care providers. An enormous number of people are now so disenchanted that there is a public sense of deteriorating services.
What do we see for that? We see this minister rise to his feet and introduce Bill 54, An Act to Protect Medicare on June 29. So obviously it wasn't an issue for this minister until the twenty-ninth day of June, when he was searching around for an election issue. I can tell you that this is not the way to proceed. It causes me great concern that this minister would truly believe that this is plausible and that this will sell.
I can tell you, based on their own government document, that "maintaining good relationships with the BCMA is critical to reaching cost savings." Then we see this document.... Hon. Speaker, I will suggest to you in very strong terms that to destabilize the medical community at a time when there is conflict about health care is politically stupid. To legislate for nine individuals is politically stupid. The true test of legislation is: is this bill required? Is this necessary? Does this make sense as part of a legislative package?
We're not clear, because we've never seen a theme in this legislative package of any great merit. We're also not clear about why this minister and this government would take a sledgehammer to put out a problem of this size.
An Hon. Member: It's to kill a fly.
L. Reid: My hon. colleague talks about a sledgehammer to kill a fly. We are talking about nine physicians in the province who are extra-billing the system.
Hon. Speaker, I can tell you that this government should have allowed the negotiations with the British Columbia Medical Association to conclude. They should have been taken at their word, and they should have allowed the process to proceed. We as taxpayers should have been able to take this minister and this government at their word.
When you enter into a negotiation, hopefully you do it in good faith and with some kind of goodwill. Not this minister. The negotiations are underway, and he legislates. Why? Is that something that he could stand up and be proud of? Either you believe in negotiation and commit to being at the table, or you believe in the heavy-handedness of legislation when it is not required. I would submit to you today, hon. Speaker, that this legislation is not required.
This document says that maintaining good relationships with the BCMA is critical to realizing cost savings in the system. That's the point I made earlier: the only way for us to get a handle on health care and establish it as a priority is to get a handle on the debt load in this province and in this country. We see legislation that is not about that; it's about seeing this minister and this government grandstand as the defenders of medicare. It simply does not make sense.
I would submit that it is yet another example of this government not taking their own advice. The advice was sound. We as taxpayers probably payed a great deal of money for that advice. We tend to pay more than anyone else when this government contracts someone to perform a service.
[3:15]
In terms of the legislation, there's not a lot here. It doesn't say a great deal. What it allows is for individuals at the cabinet table to have tremendous power around regulations and to create huge numbers of regulations that we may or may not believe are pertinent to the issue. I can tell this Speaker and this minister that we will never have the opportunity to participate in that debate, because it will be another closed-door opportunity for this minister to hammer health care. What he doesn't appreciate is that when he hammers health care, it's the patient who suffers every single time. There are no winners in this system.
D. Jarvis: How about my cousin who died last week waiting for a heart?
L. Reid: My colleague from North Vancouver-Seymour.... A member of his family...
D. Jarvis: Three months.
L. Reid: ...was on the wait-list for more than three months before this province saw any necessity to move ahead and provide heart surgery for that individual. That individual has now passed on. This government and this ministry did not see any urgency in standing up for the patient. I can assure this House that the British Columbia Liberals will always stand up for medicare, because we will focus on the patient; there's no doubt about that.
These individuals chose to legislate, because they simply do not have the skill set to negotiate. We expect better from buffoons; we truly expect better. When they bring in a piece of
[ Page 16754 ]
legislation, we expect that it is required and that it is significant. This one meets neither of those criteria. Bill 54 does not deliver on a promise. It's empty, and it's not particularly well-thought-out.
I can cite a statement from this Health minister from Saturday, June 25, 1994. He's talking about physicians opting out of the plan. "B.C. Doctors Agree to Stop Extra-Billing" is the title of the article. So we already have their agreement; they've already decided that they will do that. This minister said: "I'm very pleased we don't have to do legislation; I'm very pleased we don't have to legislate."
Again, my contention is that negotiations are ongoing today with the British Columbia Medical Association and were up to and including June 29, when this bill was introduced. A whole year later, they were continuing to negotiate and making, in our view, significant strides and inroads about bringing individuals back into the system. We were down to nine physicians -- nine. Then we see a heavy-handed piece of legislation that suggests that those negotiations weren't valid, that it wasn't important to honour that negotiation.
Yet again I will cite their own cabinet document that talks about not.... "Maintaining good relationships with the BCMA is critical to reaching cost savings. Not alienating that group is critical." That is cabinet advice, paid for by the taxpayer yet again and then not followed.
It makes no sense that we continue to buy into this minister and this government, who tell us they are there for medicare when their actions simply do not support that contention. That's very alarming. I can tell you that when there is, as this document suggests, a general public sense of deteriorating service, we know we have just about hit the bottom of the barrel with this New Democratic government. For the spillover to be that immense means that more and more taxpayers and patients in this province have been hit by this government's extremely bad management around health care. I very strongly make the case that it is indeed very bad management.
We see this minister grandstanding around the federal announcement that he alone is somehow going to defend medicare. Well, the Hon. Diane Marleau, the federal Minister of Health -- and I quote -- "has assured the provinces that she wants to maintain cash transfers they now receive for health care." It seems to me that this minister continues to grandstand. He created an opportunity to frighten British Columbians -- that somehow they were going to lose through the federal minister. She has not allowed this minister to get away with it. She's reined him in and said to him and all the ministers in this country: "We will stand up for medicare." That message must be heard. It is the only leverage this minister has to cover up for the fact that he has not delivered on previous promises. She continues, making sure that the federal government keeps transferring cash, and ensures that Ottawa has leverage over provinces and can enforce the Canada Health Act. That's a very important statement.
And we believe in it. We have said that there should be portability among provinces and that citizens in this country travelling from province to province should have access to an extremely high calibre of health care. We have said that; we certainly stand by that. The comprehensiveness, the universality and the fact that it's publicly administered are all issues for British Columbia Liberals. We will continue to be there for those issues.
The federal Minister of Health, Diane Marleau, says there will be stable, ongoing cash in the system. The federal cash will not disappear. So again, this minister has no right to continue to frighten British Columbians and grandstand around the fact that he would like to be perceived as the defender of medicare. It is simply not true. This minister in his remarks talked about Ottawa attempting to dictate standards while failing to give the provinces financial means. Well, it kind of begs the bigger question: if we indeed are rising to a federal standard for health care, what is this minister suggesting? That the provincial standard would somehow be less? That we would somehow accept less care and a different quality or calibre of care? I think not. That would be a shocking way to treat patients in this province. We have to ensure that this minister not just talks the talk but delivers. Each of these items is actionable and so as a collective, as a province and as taxpayers, we must stand together and demand from this minister that he deliver.
We have talked a number of times about this government and their inability to deliver on promises. There is a litany of promises this government has made. I can take you all the way back to the 48-point platform during the 1991 election: "No more friends and insiders." Have they delivered on that? No. There is a whole raft of promises this government has broken. So now when they stand before us and promise to defend medicare, it's hardly a wonder that the majority of British Columbians simply do not accept that contention.
If this is about a sacred trust -- and I will submit to you today that health care in the province is a sacred trust -- it's vitally important to stand up and clarify the relationships around it, and to understand the relationships we have province to province and the relationships patients have in this province with their care providers. It is vitally important, but I would submit to you that it is not well understood by members of this government. It is simply not understood.
I have some issues around the bill. I think the title is infinitely supportable. Who could disagree with the wording: An Act to Protect Medicare? The public is looking for action. They are looking to see whether this government follows through. So to return to an earlier point, I would suggest that this legislation is not required. I do not believe this legislation is vital to the future of this province. I would much rather see us spend the dollars on patients today rather than another legislative process to mask the fact that this minister and this government simply do not possess the skills to negotiate. That's what this is about. My hon. colleague talked about taking a sledgehammer to a fly. That's absolutely true. There's no question that this legislation is overkill, absolute overkill.
In his remarks, this minister talked about how British Columbians can depend on this government. No, they can't. If you have anyone in your family on a wait-list, you know that you cannot depend on this government. This minister suggested that his government's priority is waiting lists. If you have somebody in your family or a friend waiting for service, you know that's not a priority, because they're waiting three and four times longer than citizens in any other province. So you know that's not true.
This minister talks about getting more out of the health care dollar. Frankly, we know that's not true. This minister has chosen to pay individuals, whom we've not paid in the past, to create more health care bureaucracy -- alarming new levels of administration in health care. I submit that none of that is
[ Page 16755 ]
about the patient. What we are spending on new levels of administration is simply taking dollars away from the patient. There is no doubt about that. Frankly, this minister and this government have not delivered.
This minister talks about needing to make some changes. Well, I can assure you that these changes will not be made on the backs of patients in the province. It is absolutely not appropriate. No matter how you package or mask it, the people who will suffer, and who have suffered under this administration, are the patients in the province. This minister talks about no one else paying a tray fee when they go in and, as an example, have a suture put in at a doctor's office. Does this same minister intend to take out every single cash register in every hospital? I would ask him to respond to that in his closing remarks, because there are services today that individuals in British Columbia pay for. Perhaps the minister can highlight which ones we'll continue to pay for and which ones not. From my understanding, he has no intention of changing the status quo, so we would like to hear a bit more about that.
This minister talks about the federal government backing away from health funding. He is hypocritical in the extreme. This government and this minister are the very same individuals who assured hospital administrators in the province that they would fund the health labour relations accord appropriately: "You buy in, and we will fund it." I can't find a hospital administrator today who believes that this government and this minister can be taken at their word. They don't believe that this minister delivered, and they don't believe that this government and the previous minister delivered. They promised sufficient funding, and they haven't provided it. Yet this minister will stand up and suggest that the federal government promised sufficient funding and that they haven't delivered. They have in fact delivered, and they will continue to deliver. You, Mr. Minister, have not delivered, and your government has not delivered. You've been absolutely hypocritical on that question, and it's time you took some decisive action and delivered.
[3:30]
Don't come back and talk to us about your priorities. They are evident everywhere you look in this province. They're evident when we ship patients from Prince George to Edmonton, and when we keep people on the wait-list three, four or five times longer than anywhere else in Canada. That is not a significant sense of priority around health care. Patients are paying yet again, and they will continue to pay every time the health labour relations accord allows elective surgeries to be cancelled and emergency departments in this province to be closed or allows this minister and this government not to deliver on funding that they have promised hospitals in British Columbia.
I can tell you that this is a very current and timely discussion. Hospitals -- and I can provide this minister with a list -- are finding budget shortfalls today of millions of dollars, and those dollars are not forthcoming from this minister. Those dollars will not do things for patients in this province, because they're going to find another priority that this minister has yet to dream up. I have serious, serious concerns about that.
Interjection.
L. Reid: We don't see legitimacy around this problem, hon. member for Okanagan West. Frankly, I would submit that this member will also stand up and agree with a number of the comments I have made today. Each and every one of us in our constituency office has to bear the brunt of this government's bad management in health care when people are put down on a wait-list or when they have an elective surgery cancelled for the third, fourth or fifth time.
Interjection.
L. Reid: I can provide the hon. member for Prince George-Mount Robson with a list. I can provide this member with the individuals who have indeed had to wait months and months or have gone on vacation two, three or four times. They have taken vacation time to see if they could secure surgery from a hospital in this province, and they have been bumped. Talk about hassle -- for their child care providers, for their spouses and for their jobs. This delivery system today does not allow people to plan. It has no sense of priority and doesn't allow them to plan. It makes good sense to deliver on a product. This government has not delivered on a product.
In terms of Bill 54, An Act to Protect Medicare, it seems to me that every single person who reads that title will truly believe that there's some substance to it, and that it actually does something. This is symbolic electioneering, a last desperate attempt by this government to put an election platform in place, because every other attempt has failed dismally. It saddens me that this minister is again prepared to use the patient to that extent, because this is not about serving the patient well. It's rather pathetic that we would not see this government deliver something tangible to patients in the province, because that is what patients in British Columbia are looking for. I can assure this House and this minister that a British Columbia Liberal administration will deliver on the promise to the patient. They will be well served by the health care system, because they are the health care priority for British Columbia Liberals.
D. Mitchell: I seek leave to make an introduction.
Leave granted.
D. Mitchell: Visiting in the galleries today are some friends of mine, and in particular, a very good friend from Whistler, Laurie Vance. We don't often have visitors from that far away. Would members of the House please make them welcome.
L. Fox: I'm pleased to rise and speak on Bill 54, An Act to Protect Medicare. The title of this act in itself speaks volumes. It shows that this government is prepared to politicize the issues of health care even more than they've done in the past. More importantly, we have before us a piece of legislation that wouldn't have seemed necessary in early '91. It wouldn't have been deemed to be necessary by the people of British Columbia, but over the last three and a half years the way that this government has bumbled the transition to New Directions....
The problems that have shown up in health care delivery throughout the province are nowhere more prevalent than they are in Prince George and PGRH. If we had had a more well-thought-out and well-planned transition to New Directions, the government wouldn't have deemed it necessary to bring in a bill called An Act to Protect Medicare. The people
[ Page 16756 ]
wouldn't have lost confidence in this government and wouldn't have been concerned about the future of medicare in British Columbia. But indeed they have, and I can only envision what the latest poll showed this government in order to bring in this title. I'm sure that poll is overwhelming in terms of the high percentage who suggest that our medicare system is in a mess. It does not have any clear objectives; it does not have any clear mandate; and there's no definitive plan in terms of where we're going or how we're going to get there.
There are three major initiatives in this bill, according to the minister's opening speech -- the first being that it enshrines the five principles of the Canada Health Act into this legislation. Secondly, it bans extra billing, and I'll go into that in some detail. Thirdly, it pays for certain medical supplies used by physicians in the province. There are a number of other initiatives contained within the bill, but the minister didn't seem to feel they were important enough to mention in his opening statement. I would suggest that that suggests they're fairly limited in terms of what they do.
[G. Brewin in the chair.]
Let's just look, first of all, at what this bill does with respect to enshrining the five principles of health care. One of the major flaws in that is that it's in the preamble, which means absolutely nothing. It's a political statement.
Interjection.
L. Fox: It's a symbolic gesture that kind of lives up to the request of the Seaton royal commission. But the real chore -- what we should have seen before, if this government is going to live up to the Seaton royal commission -- was to put that specifically in a section and provide a definition section, where we could discuss and define what we mean by accessibility and universality. That's what the people in the province of British Columbia are wondering about and would like to hear answers to. Until we define what we mean by those five principles, we're not going to be able to design a project or a new delivery process, because we don't know what the objectives are. And we don't know how to evaluate it, because we haven't identified what it is we are trying to create. That is one of the major flaws in our New Directions system today.
Somebody mentioned that it's in the Canada Health Act; that is precisely my point. We are obligated under law to follow the Canada Health Act. So why is it necessary to put it in the preamble of this bill if it isn't for political reasons? Pure and simple, that's all it is. If we look at this bill and diagnose it from a medical perspective, we see that there has been no real surgery done in terms of improving our health care. All we have is a bit of cosmetic surgery done to try to improve the image of the minister. That has been the major initiative contained within this legislation.
Over the course of the last three years I have spoken consistently in Health estimates, as well as during debate on other bills that came forward from the Health ministry, about the need to bring in legislation banning extra billing. Many residents in my community and in the community of Prince George have had to come up with dollars they didn't have in order to achieve health care, because of the doctor they went to, while other residents didn't have to pay the fee in order to see their respective doctors. That is not fair, and shouldn't have been condoned.
But while we're saying that, we first have to remember what brought this on. What initiative caused those doctors to opt out of the system and therefore extra-bill their patients? I remember very vividly, not long after the last election -- in fact, days after the last election -- when this government broke a contract with the doctors that set the stage for where they were going in medicare. They broke that contract and caused huge dissent between the the government and the medical profession. They fought tooth and nail, and what happened at the end? They signed a contract that was far more expensive than the one they broke, which had been negotiated by the previous administration. They gave away the farm in order to finally have those signs taken down from the doctors' offices: "These individuals are dangerous to your health care." We all remember those signs. Every time I went to the doctor, I saw my two counterparts from Prince George up on the wall in the doctor's office: "These individuals are dangerous to your health care."
That is why we see this bill that has come before this Legislature: An Act to Protect Medicare. It is because this government and this minister have created the image that medicare is in trouble. They've created the myth, and now they are going to somehow try, through this very thin document, to say: "It's okay, British Columbians, we now have an act to protect medicare." That act is as thin as.... In fact, you can almost see through it, it's so transparent in terms of what this government intends to do with this act.
We've already seen it in the local Times Colonist and in surely every newspaper in the province of British Columbia: "Extra Billings Banned." My goodness, all this money spent to ban less than 20 doctors in the province! Not only that, contained in this ad is: we're going to ban extra billing, we're reducing waiting lists, we're cutting waste and abuse in the health care system. All out of this document? That's a lot more than I read into this document. We certainly haven't seen any evidence from any initiatives from this government that waiting lists have been reduced or waste and abuse in the health care system cut. In fact, we have seen the opposite.
In my riding it's the norm for our seniors to have to wait for up to a year to have a knee or a hip replaced. And during that time they're in excruciating pain and on heavy drugs in order to control that pain. Before this government took over, we used to think six months was a long waiting list, but now it's over a year.
On Sunday last week, a 77-year-old Alzheimer's patient in Prince George fell down and broke his hip. There was an orthopedic surgeon available to do that operation in Prince George on Monday morning, but there was no operating room available. In the afternoon, when there was an operating room available, there was no surgeon available. That is the kind of service we're getting at what used to be one of the best regional hospitals in the province, and now we can't get a routine break fixed in that regional hospital. I have story after story. That individual had to go to Richmond. He was an Alzheimer's patient and the family didn't even know where he had been sent, and it took a day to find out.
[3:45]
I could tell story after story, and if the minister would like, I will relate some of them. Many of these people come from the Minister of Health's own riding. They phone the Minister of Health's office and ask for help. Families are in despair: their family member is in severe pain; they are con-
[ Page 16757 ]
cerned because they can see no readily acceptable horizon where their family member is going to get treatment. They phone the minister's office, and then they very quickly phone mine. The message they get out of the minister's office is that he can't interfere with the system. So then they call my office and look for help. That is too bad, but it's a clear picture of what the problems are in health care.
In the coming election there will be a need for British Columbians to know, clearly and concisely, what every party is going to offer the province in terms of its policy. We've heard the Liberal policy, and I'll give the member credit for that. She clearly articulated that not only now but consistently, they do not believe that the New Directions process is going to work, and they are going to scrap it.
We haven't heard from the government at this point. But if we're going to meet the challenges of tomorrow, we can't go back to yesterday. There's no question about that. We have to look at designing New Directions in a way that's going to work. It's very unfortunate that this government chose not to bring forward the Provincial Health Council as the very first step in the New Directions strategy. It's very unfortunate, and I understand the Liberal opposition opposed that. But the government can't use that as an excuse. The Liberal opposition, as have we, has opposed many things which the government has chosen to go forward with, but they chose to do it because they believed it was in their best interests. I suspect that is the reason this government did not choose to go to the Provincial Health Council, because the Provincial Health Council as envisioned by Justice Seaton would have indeed depoliticized the system. It would have made the system report to the Legislative Assembly, not to the minister, and it would have really put an opportunity forward for the people of British Columbia to have some choices in the health care system -- not the system we see today, where the municipal health councils and regional health boards are indeed obliged to comply with the top-down instruction from the ministry. That has been one of the major problems.
Let's go back a bit and talk about the five principles of health care. How can we design a system in British Columbia under New Directions unless we understand what comprehensiveness means in the 1990s and to the year 2000? How can we design a system unless we understand what universality means? How can we design a system unless we understand what accessibility means? I believe that it would have been good use of this legislative time to have a good debate around what those principles mean in terms of the 1990s to 2000.
What do they mean when you're living in rural British Columbia and you can't get a broken leg set in a regional hospital, or you have to be taken out of Prince George Regional Hospital in an ambulance down to Quesnel or Vanderhoof to have a C-section done because there's nobody available in Prince George to do it? A community hospital has those kinds of services, to deliver a baby, yet PGRH at many times hasn't. When you, as an expectant mother, have to be flown to Edmonton to give birth to twins because your regional hospital has been down-rated and cannot deliver that particular surgery or service, that shows that we don't have universality or accessibility.
This bill does absolutely nothing to protect medicare, other than the statement on it. It does a whole lot towards giving the minister an opportunity to pay thousands of dollars, which we could use in services within our health care system, to buy ads in community newspapers, on TV and on the radio around the province. There are many health facilities that would love the opportunity to have the use of those dollars. That's what this bill is all about, and the speech that the minister gave at the opening of second reading was exactly that. It was purely political. It's unfortunate that this government chooses to continue to play politics with the health care system, and to put our seniors and the ill at risk because they have the wrong priorities.
Let me speak just a moment about a couple of statements the minister made in his opening speech. I'll paraphrase them, because I'm not sure that they're exact quotes, and I have not had the privilege to review the Hansard. "Since 1991, the health care system has lived up to the high expectations of British Columbians." Nothing could be further from the truth. I haven't heard anybody tell me, as I travel around British Columbia, that the health care system is living up to their expectations. In fact, just the opposite is true. In saying that, I want to be clear. Everybody I talk to, whether they're in PGRH, the Kamloops hospital or the Vancouver Hospital, does nothing but show great appreciation for the health care workers within those facilities for the dedication they show in the treatment of their patients and for the efforts they go through, even though they are limited in resources.
Another paraphrasing of what the minister suggested is that health care has been this government's top priority. Well, given the mess we have in health care, if health care has been their top priority, I would hate to look at the state of the rest of the province. I would hate to look, but perhaps we might get the opportunity if this government ever calls an election. I can envision what the rest of the delivery of services in the province might be if health care has indeed been their top priority.
He went on to say that they had gotten that priority right. I will leave that to British Columbians, because I think they speak volumes about what this government got right and what it's done wrong. This bill -- An Act to Protect Medicare -- is going to do very little to comfort British Columbians when they get an opportunity to examine it. It is nothing more than a transparent piece of paper that allows the minister to go out, front and centre, on his soapbox and say: "We brought in Bill 54, An Act to Protect Medicare. It's great legislation." However, it wouldn't have been needed in 1991. Only since October 1991 have we made such a mess of medicare in British Columbia that we've now found the need to bring in this act of supremacy. With that, I'll take my place.
C. Serwa: I'm pleased to stand and speak to Bill 54, which is a new name for an old act, the new name being An Act to Protect Medicare. It has been with some pleasure that I have listened to members on this side of the House speak with respect to the philosophy and principles of this bill, and I think everyone has seemed to see with a great deal of clarity that this is simply another political bill that the government in its dying days of one of its final sessions -- perhaps the last session -- is bringing forward. It's sort of a good-news bill. I don't know whether Karl Struble, who has probably advised the government on this, wants the minister to parade around the province wrapped in a Canadian flag, a British Columbia flag or an American flag. I guess that's a decision we'll have to wait for Karl to make, and we will eventually see the results of that.
[ Page 16758 ]
This is really an interesting bill, not because of its content but because of what it tries to do. It's fundamentally trying to create an illusion. The real truth is that the stated objective of this particular bill is diametrically opposed to the eventual effect that this bill will have on medicare. I hope that the Minister of Health is listening very clearly, because this isn't a bill or an act, the way it's described, to protect medicare. It's an act designed to destroy medicare.
As I go through my speech, the minister and the government of the day will see this more clearly -- especially the member from the Terrace area. We'll see more clearly how this bill is actually going to destroy medicare, which was brought into the province by that visionary Social Credit leader, W.A.C. Bennett. It was the second government in Canada, I might say very proudly, to bring in medicare. I'm mindful of that Social Credit legacy that we've enjoyed in British Columbia, but there are other legacies. I look at the expediency of a name change, and the idea of the name change is to purchase ownership of the medicare system in British Columbia by the current minister and the current government in the province. That's all it is.
I'm not entirely happy with the results of the name change. I'm mindful of the name change of one fund the previous Social Credit government left in the current government's hands, and it was the privatization fund. When the new government came in, they wanted to ascribe a new name to that privatization fund. So it was renamed the B.C. Endowment Fund -- happy day! All sorts of pronouncements were made on the wise expenditure of the money. The government has never really brought in any significant source of revenue from any wise decisions, but they have been very mindful in their knowledge of how to spend the money. So they changed the name of the act to the B.C. Endowment Fund.
But most of that has simply disappeared. Where has it disappeared to? Primarily into the Minister of Finance's general revenue category to endeavour to balance the budget. That's what happens when you change names. I suspect that one of the legacies of this particular act, if it goes through, is to destroy medicare in the province, as we know it.
We have to look at certain facets that challenge medicare not only in British Columbia but in Canada. We all are aware that the only constant in our world is change and that we have to make adjustments to that change. When I say "we", I don't mean simply government. I mean society as a whole, and individuals in that society have to acknowledge that changes have to be made.
What is the major challenge in our future that is endangering medicare as we know it? The minister didn't allude to it. Do you know what it is, hon. Speaker? It's the baby-boomers. The baby-boomers -- this tremendous population bulge -- are now approaching their fifties. It's a twofold challenge: seniors are the greatest consumers of medical and health care services, and that's a reality. In the last few months or the last few years of their life, they probably consume more than 50 percent in the total consumption of medicare costs in that age bracket, so that's a tremendous burden. The other side of that particular coin is that we have a smaller population of younger people working and paying taxes to support an increasingly heavy demand on the medicare system. The minister can't change that; the government can't change it; it's a reality that confronts all of us, regardless of who is government. So we have to be mindful of that. We can't write in an act that we're going to preserve medicare as we know it for future generations, because that is a patent untruth.
[4:00]
We know that the current government, for example, has reduced some services that were formerly covered under medicare. We know that the government has taken steps in Pharmacare to reduce the scope of the ability to prescribe certain prescriptions in a class of drugs. Those are realities. The taxpayer can only afford so much, and we all have to understand that. That really means we have to make adjustments.
One of the problems, perhaps, with modern society is the belief that as Canadians, somehow we're entitled to a variety of rights and freedoms and benefits that other citizens elsewhere in the world are not entitled to, because we have this Charter of Rights and Freedoms. So we think we're perhaps entitled to all these medical and health care services, never once recognizing that we're the consumers of those services. Being on the demand side, we can do a great deal, normally, to lighten the load on the taxpayer and lighten the load on government. I think that's the direction we should be heading. We shouldn't try to do it with a simple facade, and the minister surely knows and recognizes that.
What has happened in other jurisdictions that really pioneered medicare? Well, let's look at Great Britain and New Zealand. What have they done there? They've recognized what is happening in the population; they're confronted with the same reality. Fundamentally, there is a two-tier system utilized in those states. That's done for a simple and expedient reason: to lighten the burden on the taxpayer. Those who are able to pay for services are able to obtain those services outside the medicare program.
It reduces the waiting period for those less able to afford it, because the supply of facilities -- be they private hospitals, etc. -- will recognize and provide the services for the demand. So the medicare program can provide a good standard without long waiting periods for the individuals who are unable to resort to their own financial base for medical care. They have a good standard of medical health care in those two nations. So that system does work.
Whether we want to acknowledge or deny it, the reality is that either this current government will have to have the intestinal fortitude.... In all probability, they will be long gone. But the next government is going to be faced with an even more acute problem. They're going to have to recognize that some compensation, accommodation and change is necessary to preserve medicare. You simply can't write a few squiggly lines on paper and think you're going to achieve something for perpetuity and get credit for that, because it just doesn't work that way. If it's not affordable, then we can't continue it.
This government knows that no imposition by a former government is necessarily a responsibility of the current government. They repealed legislation. Perhaps the repealing of some of the legislation that they did in their first year is part of the fiscal problem that deteriorated the provision of the service of medicare in British Columbia. There were a number of acts that they repealed. They provided remuneration to public
[ Page 16759 ]
sector employees much higher than -- triple, actually -- the inflationary growth in British Columbia. So they dug themselves into a hole in a very early period.
There is a great deal of hypocrisy is this particular bill. You know, the one thing I can't abide is principles that can be so readily bent. When I look at the current government.... I want to talk briefly about Pharmacare. There's a double standard in this government with respect to Pharmacare. All of a sudden, it's against the public interest to have a two-tier standard in medicare, but it's quite all right to have a two-tier standard in Pharmacare. So the people who can afford the quality prescriptions of the current, state-of-the-art drugs can pay a little more and get them. But the ordinary folk, who may need the quality, state-of-the-art drugs, are going to get the lowest-cost item in its class. It might have been patented ten, 15 or 20 years ago; nevertheless, that's going to satisfy this.
Here we have a government that is bending a principle. If that's not sheer, thin hypocrisy, then I don't really know what hypocrisy is. So I have a great deal of trouble with the sincerity of the minister when he presents this bill -- other than that Karl Struble has recommended that they do something like this. At this time in the life of a government you see all sorts of silly bills come forward, and this really is one of those silly bills.
At the present time, a number of hospitals in British Columbia actually earn extra income from facilitating operations for non-resident patients in British Columbia. They earn that extra income because they have excess capacity. So there's an opportunity where people from other jurisdictions, perhaps across the line from the United States, will come into British Columbia for an operation. The hospitals make money on this and are able to provide better, expanded services to residents in British Columbia.
Well, if non-residents can get that type of treatment, what the deuce is wrong with us residents in British Columbia who are able to afford a specialized level of health care? What's wrong with that? It's opposite to the stated socialist principles of the current government, but I'll tell you that it doesn't make any difference to the patients. They're concerned about the length of the waiting list and the quality of the services. There are options and accommodations that have to be taken into account with the changing demands on health care in British Columbia and in Canada.
In section 3, section 1.1, they're referring the minister's statements.... It concludes with: "...not an individual's ability to pay." That's really interesting, because if the individual isn't able to pay, then how is the taxpayer going to be able to support the type of load that the current government is imposing on the medical health care system? Obviously health care has to be cognizant of the taxpayers' ability to pay. The minister doesn't seem to be making any headway or expressing any particular concern about the taxpayers' ability to pay; he's only talking about an individual's ability to pay. And that's not right, hon. Speaker.
Society has a finite ability to pay for goods and services delivered by government, and society is saying, collectively, that they have had enough of wanton waste by governments, excess expenditures and high taxation. They're saying it by mitigating the tax returns. The government passed a bill dealing with car sales that changed the nature of the way the auto business was transacted. They found that with their higher rates they were getting less and less in taxes, and they had to repeal their own legislation to get things back on an even keel. That's one of the ways that the public speaks out about this when they feel that their ability to pay is really challenged.
I note that the minister continues to want to vent the anger of residents of the province against the federal government, as if they're the culprits in this. Are they the culprits? I suspect not. Okay, the minister nods his head.
British Columbia should be responsible for collecting all of the taxes, be they destined provincially or federally. Then British Columbia could, for the first time in history, start to call its own tune for the direction that those tax dollars go. I notice no fault placed on Quebec, and Quebec does that. Quebec writes the cheque and sends it to Ottawa. I note with considerable interest that Ottawa pays a great deal more attention to Quebec than it does to any other province in Canada, and I submit that that is primarily because Quebec writes the cheque and sends it to Ottawa; Ottawa doesn't write the cheque and send it to Quebec. It puts the province in a much stronger bargaining position.
What is wrong with transfer payments? Well, I'll tell you what's wrong, hon. Speaker. British Columbia has historically contributed far more to the federal government -- which is spread across Canada to support health care and post-secondary education -- than virtually any other province in Canada. The only positive contributors have been British Columbia, Alberta and Ontario. After the advent of the NDP government in Ontario, Ontario slowed down in its ability to pay heavy taxes to the federal government, so British Columbia and Alberta have been supporting, to a large extent, the costs of health care and post-secondary education right across Canada. I don't think that's right. I don't hear anything from the hon. minister about looking at the feds and changing the formula with respect to money flowing to British Columbia.
I'm not as current as I should be on the age and population figures right across Canada, but the average Canadian, age 65 and over.... Throughout Canada their percentage of the population, on average, is 9 percent. That could have been slightly increased; it could be closer to 10 percent. In British Columbia, seniors in the population are over 12 percent. Some communities, like Peachland just south of Kelowna, have a population of approximately 50 percent seniors. Kelowna, not dissimilar to Victoria, probably has 30-35 percent seniors. This imposes a very heavy load on our medical health care system in British Columbia.
A large number of seniors were not resident and working their productive lives in this province; they emigrated from other provinces. There was a mass exodus from Ontario and the prairie provinces -- virtually from every province across Canada, because British Columbia is recognized as Canada's evergreen province. It's the nicest place in all of Canada in which to live, and we provide an excellent standard of service.
But these people have worked and accrued a dividend from investing and working in the province, and that should be a health care dividend that should be moved with those individuals. I don't hear the minister or the government talking about the validity of that. I don't hear the minister saying: "Let's introduce another element in the formula so that the provinces can for the first time take into consideration the number of people who are in the senior category over and above the national average and have a compensation package for that." I don't hear the government talking about that or negotiating that type of situation. I believe there are all sorts of
[ Page 16760 ]
options and alternatives to preserve the medical health care system. It's not going to be done by the simple expediency of words printed on a piece of paper, guaranteeing once and forever for all of the generations that will follow. That's not going to work. The government has to work harder, and it has to be smarter. It has to be proactive, not reactive, in striving to represent the interests of British Columbians.
[4:15]
I spoke about Pharmacare earlier, but what about other cost-effective opportunities in the medical health care system? I don't hear the minister talking about that. He's talking primarily about doctors. I do know that there are non-surgical services in British Columbia -- chiropractors, for instance. The current government has done everything it can to reduce payments to chiropractors. They have not kept up with what has happened with the medical doctors in the province, and consequently they are reducing the ability of British Columbians to utilize non-medical services. And that's not different than other services, whether they're naturopaths, physiotherapists or acupuncturists. There are a variety of services that British Columbians want that go back to traditional health care that are probably far more cost-effective, and I don't see that the government is encouraging that.
The current government has created its own problems. The sweetheart deal with the Hospital Employees' Union, for example, has cost Kelowna General Hospital something like 14 percent over the life of that contract. That 14 percent didn't provide goods and services or medical health care to the residents in the region that Kelowna General Hospital serves; it simply went to guarantee wages and working conditions of the Hospital Employees' Union. And that's a significant cost when you're looking at the large expenditure of the Ministry of Health's budget.
When we also look at the government, it had harshly criticized the previous government's settlement with medical doctors with respect to a fixed sum that was going to be directed toward doctor's pensions. Rather than that fixed sum, the current government negotiated a deal which was far more expensive for the taxpayers of the province and far richer to the medical doctors in the province, and they are seemingly quite happy and satisfied with that. Again, medical health care dollars have sort of gone awry. They don't provide goods and services or treatments, reduce waiting lines or provide more facilities for British Columbians; they simply look after friends and insiders. They fought a good fight with the medical doctors, but they were defeated soundly and are still smarting from that defeat.
The minister hasn't carried the day on the concept of prevention, either. The Ministry of Health has catered to the medical health industry and has not talked long and loud about prevention. As a consumer of medical health services, I'm well aware that a number of habits -- be they diet, exercise or a healthy lifestyle -- have a great deal to do with the cost of medical health care services in British Columbia. I'm also aware that tobacco and alcohol probably still impact our medical health care system, and at one time.... The current records are probably quite right: 45 percent to 50 percent of our acute care beds are occupied by individuals who do not simply use those two commodities; they abuse them. I don't hear any great effort on the part of the Ministry of Health to endeavour to educate or to reduce, although the government in their wisdom -- and they were quite correct -- did not go along with the rest of Canada and reduce taxes on tobacco. I'm thankful for that, because in doing what they have done, the federal government has guaranteed the shortening of tens of thousands of lives through cancer and heart attacks with the increased amount of smoking that has occurred with the lowering of taxes. I guess that if I'm going to say something good about this current government, I'll ask them to stand tall on that particular aspect.
I have gone through a number of areas. The final thing I will say is that it results in the Minister of Finance's and the current government's commitment to put the people of the province further and further behind in debt. In the short period of time -- four short years -- that they have been government, they have doubled the direct debt of the province. They have also added over $10 billion to the indirect debt of the province, and that figure may be minimal, because under B.C. 21 and the largesse of the current government trying to buy an election, that figure is perhaps low. The interest costs alone are taking the lifeblood out of this province. When we're talking about medicare and a $6 billion budget, we're reducing our ability to provide goods and services for people, regardless of the statement on a piece of paper, simply by wilfully encouraging increasing debt in British Columbia.
When the current government took over the reins of power and authority in British Columbia, the debt repayment on direct debt amounted to 3.8 cents out of every revenue dollar. It's now close to 10 cents of every revenue dollar. The federal government is confronted with the reality of paying 34 cents out of every revenue dollar simply to satisfy interest on debt. If we're going to increase the debt, we're going to have to increase the debt repayment, and what is it going to come out of?
It's going to have to come out of medical health care. That's the big one. Up until now it has basically been a sacred cow, but it cannot be sustained. The important thing about medicare is that it has to be sustainable, it has to be affordable and it has to impose a sense of discipline on the consumers of medical health care services. That's the answer. In the end, the answer is the appreciation of responsibility on the part of the consumer of those services, because if we don't do that, no amount of funding is going to be adequate. I don't care whether it's a Social Credit government, a Liberal government or the current New Democratic government; there is no government that is going to be able to sustain the concept of health care if it becomes absolutely unaffordable to the taxpayer, and that's where the jeopardy and the challenge come in.
The philosophy and principles of this bill are virtually non-existent. It's simply a political piece of paper that has no ability to do any of the things stated. The sooner government picks up its own personal responsibility for striving to tell the people of British Columbia what they must do to make medicare effective.... Each one of us -- me, everyone in this Legislature and everyone in this province -- has to accept personal responsibility for controlling the costs of medicare.
Hon. C. Gabelmann: I move adjournment of this debate until later today.
Motion approved.
WORKERS COMPENSATION AMENDMENT ACT, 1995
Hon. D. Miller presented a message from His Honour the Lieutenant-Governor: a bill intituled Workers Compensation Amendment Act, 1995.
[ Page 16761 ]
Hon. D. Miller: Bill 56, Workers Compensation Amendment Act, 1995, is being introduced to allow for the replacement of the board of governors of the Workers' Compensation Board by a panel of one or more administrators appointed by the Lieutenant-Governor-in-Council. The appointments would be for a period of up to one year, which may be extended. I don't think I need to canvass, with most members, the history of the introduction of new legislation, and of the attempt to have a board of governors that was comprised of representatives of the principal users and people responsible for the Workers' Compensation Board system -- the labour community and the employer community -- and two public-interest governors. It was clear to me when I took over this portfolio that there were difficulties with that governance structure. I have worked with all the communities -- in fact, beyond the appointed governors -- and with the organizations that supplied me with names of representatives to appoint.
We have made very strong efforts to try to encourage the board of governors to take responsibility for what is arguably one of the more important institutions in British Columbia. It's an organization with over $4 billion that is primarily there to serve the needs of working people in this province -- and, I should say, to serve the needs of employers in this province. It is far too important to be left to the vagaries of a board of governors that up to now has shown they are incapable, in instances where it really counts, to take that responsibility that is rightfully theirs in terms of that system. Given the letter I received on the weekend from Dale Parker, the new president and CEO whom I have already expressed confidence in, I think that it's timely for this government to take action to put in place an administration and governance that will make this WCB system work for the people of British Columbia.
I move the bill be read a first time now.
Bill 56 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.
Hon. C. Gabelmann: I call resumed second reading debate on Bill 54.
AN ACT TO PROTECT MEDICARE
(second reading continued)
L. Boone: It's too bad we had a little intervention there, because it's always a pleasure to follow the king of the Coquihalla, especially when he's talking to me about fiscal responsibility. This gentleman stood in the House and defended the Coquihalla, and I find it rather surprising that he is taking us on about fiscal responsibility.
It's a pleasure to stand here today and talk about something that is very important for all of us: health care in British Columbia. I don't think there is anybody in this province who thinks that anything is more important than health care, and it's under attack. It's under attack from some who have a different vision of health care than what I'm sure we in this chamber -- not the previous speaker, but the majority of us, I think -- envision for British Columbians. The health care system that I envision and that my family envisions -- those whom I support -- is not a health care system that says that because you have more money, you get better care. It doesn't say that because you have deeper pockets, you get to the top of the list sooner than somebody else. It says that we are all equal, and we are all entitled to the same health care in this province, regardless of money.
Next door to us is Alberta. We see a different type of system there. It's one where they're privatizing ambulance services. Right now, as we speak, the doors are open for private clinics. People can come up and open for-profit clinics, so they can make the big dollars there.
As the Health critic during the former government's regime -- the Socred years -- I spent a lot of time talking to health care providers, and it became very clear to me that the system had to change. There were pressures on the system such that we couldn't endure the existing system. We have an aging population, as a former speaker mentioned. We have changing technology. We have people living longer. Under circumstances where they previously would have died, they are alive now, and we have to maintain them and keep them alive and healthy. All of those pressures mean that the burden on the system was such that we saw budgets just increasing year after year. There were tremendous increases in the health care budgets. It's clear that that budget would have dropped and the whole system would have collapsed if those types of increases were sustained. It wasn't a sustainable system. We needed to change the way we delivered those services.
[4:30]
I often think about Elsie Gerdes, who was the nursing supervisor at the Prince George health unit. When I was on the board of health, she used to get out the pie and show the little sliver that went to preventive care and the massive slices that went not to health care but to extended care, hospital services and treating illnesses. That's what we have. It's not a health care system but a system that treats illnesses. We needed to change that around. We are trying to make people healthier so that they are at home, our costs are reduced and we're not necessarily treating illnesses all the time. We still have to sustain the treatment of illness, because it's impossible to eliminate that altogether.
We brought about Closer to Home. That came about not as a socialist plot, as the former speaker indicated, but as a result of a Socred...
An Hon. Member: Royal commission.
L. Boone: ...royal commission; thank you. My mind went blank there. A Socred royal commission brought this about. We took that, looked at it and said: "Yes, this is what we need to do; we need to change those things around." Jurisdictions across this country are recognizing that we need to change the way we deliver those services. It is being done so that we can preserve medicare as we know it for all British Columbians.
Closer to Home has come about. Has it been perfect? Of course not. The minister can tell you that it hasn't been perfect. Change is never easy. The changes that are coming about are, in some cases, coming about slower than we'd like and, in some cases, faster than we'd like. But I can tell you, hon. Speaker, that they are changes that are absolutely essential if we are going to maintain the system we have.
There have always been wait-lists around in this province, and unfortunately there always will be. I listened to my colleague for Prince George-Omineca talking about wait-
[ Page 16762 ]
lists in Prince George. I can tell him that when he was a Socred...in his government before us, there were also wait-lists in Prince George. I was on the phone trying to find out where people were on these wait-lists and what could be done to assist them. But you know, hon. Speaker, I never once tried to get somebody queue-jumped; I never once said that because I phoned somebody, they should get to the head of the list. It was our job to try and find out if they were receiving the proper treatment, to find out if they were being treated properly and fairly and to make sure that the services were there.
We must change the way we deliver those services. I want to talk a little bit about it. The previous speaker talked about story after story. We always hear this stuff about orthopedic surgery and how everybody has to go to Vancouver. There was a period of time in Prince George, not too long ago -- and before we were in government; it was during the Social Credit regime -- when all weekend orthopedic surgery patients had to be shipped to Vancouver, because our orthopedic surgeons did not work on weekends; they just didn't work on weekends. Did that make the front pages? No, it did not make the front pages; I think that it may have had something to do with the political leanings of the various papers involved. But now these things have become very prominent, and what have you. It's not right, it's not good, but it's a reality. As long as we live where we live, surgeons are going to choose to live elsewhere or move elsewhere. That is unfortunate, but we provide the services we can; we cannot force orthopedic surgeons to come to Prince George.
I, too, have a little story here about orthopedic surgery, which I'd like to relate. Orthopedic surgeons left Prince George, and recently they were advertising in our paper: "Come and see me down in wherever, and we can get you surgery right now if you're on a wait-list." We did a little research, and you know how much it would cost you to go down and get this surgery from those orthopedic surgeons who left Prince George to go south -- down where they can get for-profit surgery, the type that is advocated by some of the opposition members here? It would be $23,000 up front -- in advance -- and that does not cover the cost of the surgeon or the anaesthetist.
That is the type of health care system being advocated by those who want a two-tier system. That is the type of system that some around here are advocating, and that is a type of system that this bill says no to. This bill says no, you will not be able to purchase that type of service just because you have a lot of money. I can tell you that as soon as that were allowed here -- if we had the two-tier system such as the former speaker talked about -- it wouldn't be long before the system in existence for those of us who don't have that $23,000 would soon become poorer and poorer, and it would not be a system that anybody would want to use.
I'm pleased to see this bill. I'm particularly pleased because last year, when the minister was negotiating with the BCMA to end extra billing, just about everybody in the province complied. Most of the physicians in this province said: "Okay, we'll end." Unfortunately, there were some who didn't. Now, some speakers here have said that this bill doesn't do anything. Well, I can tell you that people who have been in my office, who have had to pay $500 up front for plastic surgery because the two -- and only two -- plastic surgeons in my area chose not to go back into the system and chose instead to extra-bill, will say that this bill is good, it is long overdue, and they welcome it.
They welcome it because they do not want to pay that extra billing, because extra billing is not a part of medicare in British Columbia. It never has been. It was not acceptable ten years ago, it is not acceptable now, and it's not going to be acceptable next year or any other year in the future. This bill says that. It says it clearly. It's a bill that I think is long overdue and one that I really support.
I commend my colleague for taking that measure, partially because it helps us out in our office, and we won't have all those people coming in to see us anymore, but mostly because it really does protect medicare. And it makes a clear distinction as to what our priorities are with regard to this government.
D. Mitchell: I'd like to say a few words about Bill 54, which is entitled An Act to Protect Medicare. Of course, one of the changes is that it's renaming the old act, the Medical and Health Care Services Act. I suppose we have to ask why the government would be bringing in this bill at this late time in the session. I think that there are good political reasons why the government wishes to do this; I'm not so certain about the practical reasons. But when I look at the preamble, which talks about the principles of medicare -- a program that I think all Canadians have supported over the last two generations -- I can certainly support the principles that are enshrined in the preamble to the new act. The name is An Act to Protect Medicare; I would call it the Save Medicare Act. Although I'm not sure it's going to save medicare, I think that would have been a better, more appropriate name, given the political context in which the government brings this bill forward.
The question is, I suppose: who is going to save medicare? How are we going to save medicare, and how are we going to afford to save medicare? Those are some of the crucial questions that I think need to be asked.
One of the things that I take objection to is the way the bill has been brought forward, and the way the hon. minister, in whose name the bill stands, has been promoting this bill even before its passage through this Legislature. I refer, of course, to the full-page advertisements in the newspapers that many of us will have noticed over the course of the last weekend. "Extra Billing Banned" said the headline in the newspaper ads. But, of course, the bill isn't passed into law yet. I question whether or not the minister and the government should be so presumptuous as to assume that they can preach about extra billing being banned when the bill has not passed through the House yet, when we have not had a chance to speak to it on behalf of our constituents, and whether or not the minister is actually infringing upon the privileges of all members individually, and the House collectively, by putting ads in the newspapers that make it seem as if the bill has actually already passed into law. It has not, and I think there's an important principle here: that we have an opportunity to speak to this bill, to add the concerns or support of our constituents, before the government presumes that this bill is actually an act of the Legislature. So I think the minister is getting a little bit ahead of himself by putting full-page ads in the newspapers, saying "Extra Billing Banned."
Of course, one of the objectives of the bill is to ban extra billing for health care services in British Columbia. I take
[ Page 16763 ]
objection to some comments made by the member for Prince George-Mount Robson, because I don't think she's interpreting the bill exactly correctly. While the bill does outlaw extra billing for medical services in British Columbia, it doesn't prevent private health care from taking root in British Columbia. It doesn't prevent private clinics from emerging in British Columbia, where perhaps only the wealthy could afford to pay for services and avoid lineups and surgery waiting lists. Private clinics could still be established, but patients could only be billed for services if the clinics were completely outside the public system. This would mean that the province and the taxpayers of British Columbia would pay no portion of that fee. Those kinds of private clinics could still be established in British Columbia, as I read it under this bill, but they would not be supported by taxpayers. I think that's an important distinction, and I think it's important to put on the record that the member for Prince George-Mount Robson was wrong on this.
The interesting thing is that the bill does hold a sledgehammer over even the prospect of such private clinics coming into the province. The bill says that the government could regulate those private clinics should they flourish in British Columbia, should private clinics, which make available their services only to those who can pay for those services, actually take root in the province. Currently we have no doctors in the province who are completely out of the public system. But if such clinics should flourish, the government could come in, under this bill, and impose regulations to establish payment schedules for such private services. I think that's an important feature of this bill, and it's one that deserves some discussion. I'm sure when we get to committee stage of the bill, we'll be discussing that.
The government says it's opposed to a two-tier health care system, such as exists in some American states -- in most parts of the United States, in fact. But I question, and I think many people question, whether or not we really already do have a two-tier system in British Columbia -- and in Canada, perhaps a multi-tier system. I question that, and I question it in the context of the possibility of private clinics taking root.
I would like to support this bill; I would like to support the principles in the bill as well. I'm concerned about the politics that inspired the bill. I know that the government is wanting to lampoon Liberal opposition members for their tie to the federal Liberal Party, which they obviously have and try to deny. We know that there are politics involved in that, and say: "Oh well, I guess that's life in this Legislature. We can understand that that's part of what's going on here." Having said that, we all want to protect medicare as well.
I think we have to understand a little bit of the historical context, though, because I think that's more important than the political context. Medicare is a program that started up in the postwar era two generations ago at a time when our country was very different than it is today. It was based upon the concept of universality, upon the concept that all Canadians deserve equal access to high-quality health care services. Those are principles that I think we still want to see enshrined in our social security system in Canada. But because the demographics of Canadian society have changed, we have a real challenge on our hands -- that is, how to continue the system which our grandparents enjoyed and at the same time deal with some of the challenges of an aging population. That's not easy, because of the costs involved.
Let's take a look at some simple demographics. If we go back to the centennial year of Canada, 1967, at that time there were six Canadians under the age of 20 for every senior citizen 65 and over. Today the ratio is about two to one: two Canadians under the age of 20 to every senior citizen. In the early years of the next century, the ratio is going to be about one to one: one Canadian under the age of 20 for each Canadian who is a senior citizen.
That has tremendous implications for the cost of our health care system. Today we're spending a third of the provincial budget -- that's over $20 billion now -- on health care. I can tell you that approximately half of that health care expenditure is spent on seniors. In the early years of the next century, that's going to increase to more than two-thirds. More than two-thirds of the cost is going to be spent on seniors because of the demographics, because of the fact that in Canada we have the most rapidly aging population of all western industrialized countries.
Of course, we have an even higher proportion in British Columbia, because so many Canadians correctly want to come and retire here. We have some regional disparities within the province, as well. For instance, in the constituency I try to represent, West Vancouver, we have a high proportion of senior citizens. That's the case as well right here in Victoria, and there are higher percentages of seniors in White Rock and in the Okanagan Valley. Health care costs will inevitably be higher as a result of that, not only today but increasingly in the future.
[4:45]
How are we going to deal with those kinds of challenges? How are we going to deal with the costs of an aging population and the delivery of universal, high-quality health services? We know those services are valued by all taxpayers in the province. I know that because of constituency polls in my own riding. These are not simply surveys; these are actually scientific polls. I do them once a year in my riding, and consistently every year my constituents tell me that the public service they most value is health care. They also say that they want to ensure that a high-quality health care system continues. They also say that they have confidence in today's health care system and in the integrity of it. They also say that when it comes to the issue of user fees, which is related to the issue of extra billing....
Hon. P. Ramsey: It's the same thing.
D. Mitchell: When it comes to the issue of user fees, a majority of my constituents have said that they might be willing to consider them if they are required to maintain the integrity of the system. That's all I'll put on the record.
This legislation, Bill 54, is outlawing all extra billing. That means user fees are out when it comes to a visit to your doctor and a visit to a clinic and for probably just about all services, except perhaps for emergency services. Even though we don't have user fees or extra billing for a visit to the emergency ward of a hospital and even though the Canada Health Act prohibits it, there's an interesting case going on right now in our neighbouring province of Alberta on whether that is constitutional and whether it is possible without penalty.
I suppose the minister might say that all user fees are out once this bill becomes a law, except hypothetically the province might have the ability through policy to impose a
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user fee for emergency services in a hospital if it was willing to suffer the reduction in transfer payments from the federal government on a dollar-for-dollar basis. That's what I understand from the debate that's going on in Alberta, and that might be a hypothetical situation. But essentially, user fees are out, and this government has said it doesn't support user fees. That may be a good or bad thing, but we know one thing for sure. With this legislation in place and with the philosophy of this government, probably all user fees are out even for emergency medical services.
That doesn't solve the issue of how we're going to pay for medicare and for the highest-quality health care system in the world, which we enjoy today and want to sustain. One of the questions that we can ask is: who is going to save medicare? This government says that it's going to save medicare by bringing in Bill 54. I'm not so certain of that.
The official opposition, the Liberal opposition, says that we should trust them to save health care. If we take a look at some of the statements coming out of the Liberal opposition, we should question that. I listened carefully today in the House to the member for Richmond East, the health care critic for the Liberal opposition. While she tried to speak passionately, I noticed in her comments that she actually paraphrased and directly quoted, without attribution, some of the comments made by a former Social Credit health care minister by the name of Jim Nielsen, who runs a private health clinic today in British Columbia. She actually used a comment that he used on the weekend and that was quoted in the media. She used it verbatim. She didn't quote him by name, but she used the comment. So I wonder: is the Liberal health care critic talking about a Liberal position, or is she talking about a different kind of position? Can we even trust...?
The Liberal health care critic might become -- heaven forbid that that party ever form the government! -- the Health minister. Can we trust that, or do we believe other statements that we hear in other parts of the province? Another nominated candidate for that party in Kamloops, a former head of the British Columbia Medical Association, Dr. Gur Singh, might become Health minister in a possible -- heaven forbid! -- Liberal government in the future. I raise that, because a rumour is out there in the community that Dr. Gur Singh, who is now the nominated candidate for the Liberal Party and a former head of the B.C. Medical Association, is going to be the Health minister should the Liberals ever form government.
The reason I raise that as a concern is that Dr. Gur Singh once wrote a paper called "A Case for User Fees." It wasn't very long ago; it was a couple of years ago. I'm not going to quote at length from this paper, but clearly he is a proponent of user fees. Hon. Speaker, I'll just give you a quote that starts off this paper. It says: "The problem is that a reasoned debate is being held up by a tunnel vision mind-set against user fees." That's a quote from an academic, but that's how Dr. Gur Singh starts his paper. He quotes a number of people in this paper. It's quite interesting. Most of them are extreme right-wing thinkers, like David Frum, writing for the Financial Post, and Diane Francis and others. It's hardly Liberal philosophy -- at least, it's not the way I understand Liberal philosophy to be. But it is this Liberal candidate who once wrote this, and he talks about user fees; he makes the case for user fees.
I just question who is going to save medicare. The government says that it wants to save medicare. I applaud them for their instinct, at least. I'm not sure that this bill is going to do it; we may need a second opinion on that. The Liberal opposition says that they're going to save medicare, but if you look at the positions taken, they're not really Liberal positions, and they're not very consistent. We don't know who would ever have the chance to be in charge of that portfolio if that party -- heaven forbid! -- should ever be given the chance. I don't wish that on my fellow British Columbians.
But we have a bill here. The bill should be called the Save Medicare Act, because different parties want to save medicare. The Reform Party talked about their vision, as well. They were opposed to many aspects of this legislation.
I would actually like to try to support this bill. I do have concerns, though, hon. Speaker. I've got to warn you that I do have concerns about the political context in which this bill was introduced, whether or not it's really going to save medicare and whether it's really going to prevent the development of a two-tier or a multi-tier system. I know one thing for sure: it's going to ban extra billing. How is that going to pay for the extra costs associated with an aging population?
How is that going to pay for the decentralized form of health care that the government is committed to with their Closer to Home strategy? We don't really know what the costs of that are yet; we're only now starting to head into that system. There is some resistance in some parts of the province. I fear that some of the resistance is political in nature. Having said that, the Closer to Home approach, which many people support in principle, may end up being more expensive than the current system. If there are going to be extra costs with the Closer to Home strategy and with an aging population, how is banning extra billing going to save the system?
The larger concern I have, and what I'd like to say in conclusion, is that this debate cannot take place in isolation. The debate over who will save medicare and how we are best going to protect medicare cannot take place without also referencing the other elements in our social security system that also need to be reviewed. Our federal government says that it wants to review that, but it hasn't made much progress toward that just yet. Until we can talk about the larger context of how Canada has changed since the postwar era, how our population is aging and how there are extra costs associated with health care and other social services, I don't think we can really talk about protecting medicare simply by passing Bill 54.
I truly wish the hon. Minister of Health hadn't put ads in the newspapers suggesting that we had passed this bill before we had. Who will save medicare? I'm not sure, but I think the taxpayers of this province may in fact demand a second opinion on this subject.
A. Hagen: I want to speak briefly to this bill. As all the members have noted in the debate this afternoon, this is a big issue, and we could spend a session looking at many aspects of our health care system. We have in fact done that through estimates and through major amendments to the New Directions legislation and the Health Authorities Act. We have spent a lot of time on health issues in this Legislature, so I want to confine my comments today very much to the bill before us.
I want to note that the bill's title is An Act to Protect Medicare. "Save" is a big word, and I think it is a political word. We are really looking at the various elements we have to have in place to protect medicare, and that's why I welcome this legislation.
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It speaks to the principles of medicare, and I think it's very important for us in the province at this time to acknowledge those principles again. They are clearly under attack by the federal Liberals. The musings of the Prime Minister and the weak knees of the Health minister are cause for alarm about those principles, which have been in place and endorsed by people of all parties over many years. So I welcome the affirmation in this legislation.
I welcome it, too, because people in this House use a lot of sophistry and ducking instead of saying what they believe in. The Liberal critic was all over the place today when we know what the Liberals have been saying. They are talking about moving away from these principles. They are talking about something they call out-sourcing, which is to say that we're going to move away from a universal system, from a publicly managed system and from a system that is affordable and accessible to all. They are very clear about it, except that they don't talk about it in clear language. We need to know that they're very clear about this, and have no illusions about what those people on the other side of the House are talking about when they fail to define their agenda. Let us acknowledge that what this bill does is give all of us an opportunity to affirm the principles of our health care system.
Now let's look at the main substance of the bill, which is to ban extra billing in the services that are provided to people by the doctors of the province in their offices, in their clinics and in hospitals. Right now, we have all kinds of ways in which extra billing is creeping into our system. We all have stories to tell, stories that affect the ordinary working person, the ordinary family and the seniors in British Columbia. I have a story that happened just recently. A young working woman who earns a modest rate -- the minimum wage, in fact -- had to deal with the potential of an extra-billing system. For her to have access to the specialists who had the expertise she needed, she was going to face a $60 initial fee in addition to what medicare was going to pay that doctor, because he had opted out. If she needed any surgery, there would be a $200-500 bill for that surgery, and a fee for any post-operative visits. I figured out that for her to have access to medical care from a specialist, she was going to pay one-twelfth of her salary to access that service. That's something we're not prepared to tolerate in our province.
This bill makes very clear that extra billing is banned. It's banned for good reason. It's banned for reasons that are supported by conservative health economists all over the place: extra billing adds to the cost of health care, it diminishes the quality and quantity of service available to the citizens of the province, and it very often leads to an expansion of service rather than to the efficient management of service. I will agree with every person in this Legislature who talks about the challenges we face with medicare. But I will give this Health minister credit for looking at the ways in which we can look at those challenges in order to make it possible for us to continue to provide the quality and quantity of services that we need in a way that we can afford.
It's interesting that we continue to spend the same proportion of our budget on our health care that we were spending 20 years ago. That doesn't mean that we aren't facing challenges; it doesn't mean that we don't have to deal with an elderly population and some of those pressures. All of those things are real. But we are managing the system within those principles, and with a universal system which is available to all but a few with the extra billing that is currently here. We are now saying that those principles are entrenched and that extra billing does not lead to better efficiency, cost-effectiveness or delivery of service. So we are making sure that that does not continue. We are avoiding the slippery slope of profit in the sense of just-for-profit in our system. Let's remember that in the United States, where 30 million people are without health care, many people have to pay an inordinate amount of money. Even if they are insured for health care services, they pay a premium of almost 50 percent for the limited health care they have.
This bill is not about politics, but about reaffirming our principles, setting the base for the challenges we face, and getting on with the business of modifying and developing our medicare services for a multicultural population, a population that's getting older, an urban population and populations where we're still dealing with too much poverty. All of these are challenges that every government will face. But if we face them with these principles intact and with certain protections in place, we will be going a long way toward saving medicare.
[5:00]
This is a bill that deserves the support of everyone in this House, and I hope we will see that in the standing vote at the end of this principle debate on second reading.
[The Speaker in the chair.]
R. Chisholm: I rise today to support this bill in principle. When I look at the preamble, I can definitely support that. But I have some of the same problems you have heard in other speeches, such as the timing of the bill -- that becomes rather obvious. People are debating about "save" or "protect." I don't think we have to debate a word. We have to start talking about the realities of the real world, and some of the realities of the real world were brought up by the member for West Vancouver-Garibaldi, such as that one-third of our budget is spent on medicare. If you look at the three top-line ministries -- Education, Social Services and Health -- you're looking at over $15 billion of our budget. We have a $19 billion budget, yet there are still 16 ministries to be administered. So we really have to take a good, long, hard look at what we're doing here. I can support this bill, but I'd like to know how the minister is going to pay for medicare.
There are some realities, like transfer payments from the federal government. We know that they are going to cut the transfer payments. Does the minister know how much they're going to cut them by? When they cut, how is he going to react? How are we going to take care of these reductions? I haven't seen or heard anything about that, but I've seen where we're going to ban extra billing. I can support that, too. But realistically, tell me how we're going to pay the bill, especially with the federal government taking money back and trying to get control over their debt. I don't see the minister's plan to react to that. As I said, there are a couple of questions there that I'd like to hear the minister answer when he responds to this. Just how much reduction are they expecting? What is our plan to administer that reduction? How are we going to handle it? These bills are all well and good; they're all very nice. But they don't tell me how they're going to pay the bill, especially when we're spending $15 billion of a $19 billion budget and there's no more money in the coffers.
There's another point that was brought up: advertising before the bill was made into law. When you do this as a
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government, you've prejudiced the law to start with. Then we have to start talking about timing. I mean, we're coming up to election time. All of a sudden, bills like this appear in the last, dying days of the session. If the government thinks it is appropriate for us to be debating this in the last week and a half of the session -- if this is what is most important -- that's fine. But don't belittle it by going out and advertising at the same time, knowing full well that you're going to be calling an election in the very near future.
Private clinics were mentioned. Just how is the minister going to address that? I'd like to see him respond to that one, too, because, after all, they are not covered by the bill. Extra billing is covered, but not private clinics. What is the minister going to do if private clinics start to multiply? Is he going to regulate? Just what are some of these answers?
We are in a society, after all, that is growing older. There are more of us growing older all the time. As we grow older, the costs increase. With us spending over a third of our budget now, with our age bracket, what is it going to be in ten years' time? Then how are we going to administer the other portions of government, such as education, social welfare and the other ministries?
If the minister can respond to some of these questions when he sums up at the end of this reading, I'd be most appreciative, because I asked him these same questions in estimates. At that point in time he didn't answer the questions, either. As a matter of fact, he used it to slap the Liberals around. I don't blame him; I would have done exactly the same thing if I'd been in his position.
But the point is that it doesn't answer the questions of how he's going to handle medicare and how he's going to pay the bills. Once and for all, I'd like to hear what his plan is, because if he's going to ban extra billing -- which I agree with -- how's he going to pay the bills, especially with the federal government downloading and with the transfer of payments being cut?
G. Wilson: In rising to speak to Bill 54, it's important for us to put into context what the government is attempting to accomplish and then perhaps discuss whether, from our perspective, this bill is going to be able to make the grade. Bill 54, entitled An Act to Protect Medicare, in effect, is an attempt to make illegal the opportunity for extra billing. There are a few other minor amendments that this act brings in with respect to the Medical and Health Care Services Act. But in effect, that's what it is, in a nutshell: it's to say that we're going to stop this notion that there can be a two-tier system.
In principle, I support that. I have never believed we should move toward a two-tier system. I don't believe we should put in place a means test to try and regulate whether, because of somebody's income, they should be able to access medical services that those whose income may not be quite as rich cannot. Therefore, in principle, we have to say we want a comprehensive, universal, portable medical system that can be accessed by all British Columbians when they need it.
We've seen on television, heard on the radio and read in the newspapers ads that are currently being run that we must not abuse this system. I wholeheartedly agree with that. If we are going to have an affordable system, we have to make sure that we do not abuse it with complaints that are not real or that are less than necessary with respect to the services we require. I don't believe that most British Columbians do that or that they would accept very comfortably those who are excessive abusers of the system. I also don't believe that we should be trying to draft legislation in this precinct to look after a very small minority who may be abusing the system.
What we have to do, and what this bill perhaps doesn't do, is to look at the other side of the equation. By and large, the delivery of health care services in British Columbia is a necessary provision for those people who require medical care. The question is: why do they require medical care. What brought them to this state of ill health? Is their requirement for medical care something that is associated with workplace accidents? Is it associated with poor nutrition or substance abuse? Is it something that has been brought about because of an environmental consideration -- i.e., contamination within our atmosphere because of excessive burning or pollution? Is it something caused by virtue of a lifestyle, or an attempt in our lifestyle to advance certain kinds of activities that would be quite hazardous or dangerous and so create injury? Sports injuries is one example.
We have to start to address the individual responsibility for staying healthy. I believe it is perhaps a right to have access to comprehensive, portable health care. But with every right there is a responsibility. It is therefore incumbent upon every British Columbian individually to seek to become as healthy as they can be and stay as healthy as they can be within our society.
I find it interesting that as we look at this debate and listen to the discussion that's going on, there is a great deal of discussion around the questions of cost. How much does it cost? Where is the government going to pick up the additional revenue that's required if we don't go to this extra-billing process? I don't believe there is a need for extra billing, because I don't believe there is a need for larger amounts of dollars coming in than are already there. Indeed, this government has increased spending on health care over the last number of years. What we have to do is to allocate more wisely the moneys that are already going into the system. That's what we have to do. As citizens, where we can participate in trying to make our health care system more affordable is making sure that we take on ourselves and our children a certain amount of responsibility to keep healthy.
I believe, and the Alliance Party believes, that there should be within our system five fundamental guarantees. These five fundamental guarantees include shelter, adequate nutrition, health care, education and access to justice. Those are the five guarantees that every citizen in this province should have. In exchange for those five guarantees, there have to be equivalent responsibilities, because one of the problems we have in our society is that we are increasingly looking to government and demanding that it supply ever-increasing service while denying it the funds to be able to provide that. We're saying we want more and more service from government. We are condemning politicians of every stripe when those politicians provide the service and then turn around and say to us that the cost of the service now has an equivalent increase in property tax, income tax, sales tax or, if some political parties have their way, the cost of medical services.
We cannot have our cake and eat it, and it's just as simple as that. If we want additional services or if we want to expand services, there are only two ways we can go. We can increase the cost and therefore increase the supply of money, which is an increase directly to the taxpayer; or, as taxpayers, we can
[ Page 16767 ]
reduce the demand. By reducing the demand, we look to employers to make sure that we have a safe working environment. We look to each individual to make sure that we have a healthy and adequate diet. We look to our education system to educate people on ways in which we can start to get away from chronic ailments, disease and problems.
I don't think it is in the least bit ironic and I think it was most timely that this debate was interrupted or briefly adjourned for the Minister of Skills, Training and Labour to introduce an amendment to the Workers Compensation Act. It's timely to the extent that one of the larger drains on our medical system is workplace-related injury. One of the problems we have is the need to provide ongoing medical care for people who develop long-term disabilities as a result of the kind of workplaces we have. It's interesting, when you listen to the cases.... Believe me, I'm sure there is not an elected Member of the Legislative Assembly who does not have a whole file and raft of cases of people who require assistance through the health care system as a result of workplace-related health care questions. When you look at those cases, you can see that often they are the most difficult, most challenging and, frequently, the most expensive to administer and maintain.
So we have to collectively work to reduce demand. I haven't heard anything in the debate to date with respect to how that is going to protect our medicare system. We have talked about making smoking more difficult for young people, because we know how extremely difficult it is, and this government has taken some steps to try to do that. All of us stood in congratulations for it.
We're seeing now that governments are becoming much more concerned with air quality, because we recognize that a lot of the diseases we find -- in fact, the problems of the lung -- are related to air quality questions. We're recognizing that our industrial use and simple disposal of hazardous waste into our water systems and ocean dumping sites, the dumping of hazardous waste into landfill, and other contaminants that would get into our water systems, that all those kinds of things have lasting effects with respect to health care. Similarly, we're recognizing that those people who, for reasons quite beyond their own control, are in the lower income brackets, who are struggling to get out of an entangled web of welfare support -- and the young people, particularly and especially the children -- and who do not have adequate nutrition and adequate access to educational facilities and services to upgrade themselves and get out of that treadmill, often fall victim to substance abuse. Through substance abuse, whether it's alcohol, drugs or other forms of related substances which may be used, they create a health hazard for themselves which ultimately is borne by the rest of us.
[5:15]
This is where this debate has to happen. We have to come back to asking ourselves.... If government has an obligation to those five primary guarantees -- and we in the Alliance Party believe government has that obligation -- we have to recognize that there is a certain responsibility, then, that rests with the citizens of this province to make those five guarantees affordable.
I've heard members of this Legislature say the timing of the introduction of this bill is more driven by politics than anything else. Well, this is going to be an issue in the next provincial election -- and rightly so, because the people of British Columbia have a right to know where each of their elected members, and the parties they purport to be members of, stand on these issues.
We know where the government stands, because they've just introduced a piece of legislation that tells us clearly where it stands. We've heard a very clear and articulate position from the Reform Party that tells us where they stand. We know clearly where they are on that position. We can agree or disagree with them; I disagree with some of the concepts that Reform puts forward. I've just indicated where the Alliance Party stands with respect to the provision of five guarantees, a commitment to a universal, portable, affordable and accessible health care system, and that we do not believe in a two-tier system or user fees.
But we don't know where the official opposition stands. This is extremely critical. I'll tell you that when I was in Kamloops recently, it was interesting that -- I've mentioned this to the member for Richmond East, so my comments will come as no surprise -- a reporter asked me -- because there's still some confusion out there as to whether I'm a member of the Liberal Party.... In fact, some people still believe I'm the leader of that party, believe it or not.
D. Mitchell: The real Liberal Party.
G. Wilson: The question....
J. Tyabji: It's true. They get his last name mixed up.
G. Wilson: I guess that's the problem of sharing the same first name -- I don't know.
But the question from the reporter was simple: who speaks for the Liberal Party with respect to health care? My comment was that it was the competent and Liberal voice of the member for Richmond East. At which point, the reporter said: "Well, when challenged on comments made by the candidate nominated in Kamloops, the leader of the Liberal Party said that the member for Richmond East does not speak for the Liberal Party on matters of health care; the leader does."
That's interesting because the nominated Liberal candidate in Kamloops, Dr. Gur Singh, says: "With the country's present economy and deficit, one cannot with any conscience continue to urge the government to continue the level of funding they have to provide for health care whether at the federal or provincial level." That's an interesting perspective. He goes on to say: "The evidence seems overwhelming that the use of user fees led to a decrease in utilization at times to the economic detriment of the physicians." As we go through this whole document, there is a very clear, well-presented and very thoughtful argument with respect to user fees -- I certainly don't take anything away from the academic work that's involved in this. I'll continue to quote from this document, which is entitled "A Case For User Fees" by Dr. Gur Singh. It was printed in April 1994. It goes on to talk about those countries that have user fees, and it says in fact that a lot of these countries enjoy a better health status than Canada.
I would like very much to see that information, because this is from somebody who was previously the president of the B.C. Medical Association and is now a nominated candidate whose point of view is consistent with that of his leader and who speaks for the Liberal Party. He goes on to say that this has been the most convincing argument -- talking about
[ Page 16768 ]
the argument with respect to the benefit of introduction to user fees. He quotes Diane Francis of the Financial Post, who is astounded that people do not believe that fees for use of the medicare system will lead to better accountability, both by the public as well as the provider. Then she goes on to essentially support Michael Walker of the Fraser Institute in the belief that in a free system the only deterrent to the use of medical services is the opportunity cost. Dr. Singh underscores this interesting quote: "If the lawyer is losing $500 for the hour he has to take to see the doctor, he is not likely to rush to see a doctor, as opposed to somebody who has no opportunity cost by taking that hour out of their day. And this may partly explain why there is such a high use of the system by the lower socioeconomic groups."
That is an amazing position. If that is, indeed, the Liberal Party position with respect to health care, it does not take into account the fact that people on the lower end of the socioeconomic group have problems with adequate nutrition and, potentially, with substance abuse, and they have problems associated with a whole host of other reasons that may in fact create demand upon our health care system.
So, hon. Speaker, I think it is important that this debate take place. I do believe it is very important that we understand which of those two actually speaks for the Liberal Party. Is it the Liberal voice of the member for Richmond East? Or is it the leader and his sidekick from Kamloops, Dr. Gur Singh?
D. Mitchell: It's a two-tier party.
G. Wilson: That's probably the most appropriate comment. There are those who have secured their nominations and those who haven't yet, and therefore we've got some of these problems.
This is an extremely important debate. No matter what side of this debate you come down on, in the final analysis, the public wants to know that decisions will be made, in a less than partisan manner. When you're sick and you need health care, it doesn't matter what your political stripe or what party you voted for in the last election; you want to make sure that you or members of your family who need health care have the adequate service that is required. Similarly, it's not partisan to the extent that we as Canadians have to stand firm and united in protecting our health care system from coast to coast. I say that in light of the continentalization of our economy, in light of the move to harmonization of our social systems as a result of the FTA and NAFTA, and in light of the ever-increasing large multinational corporate influence in the decision-making that is taking place around provincial and federal economic policy decisions.
If we are going to make a social contract with all Canadians, we have to know that that social contract should be founded upon the five guarantees that I outlined. If we are going to be able to succeed in the delivery of those five guarantees, we have to underscore that every citizen has a responsibility to make sure that the system works by using it only in a manner that is acceptable and proper and has a responsibility to keep themselves healthy in a manner that will allow our system to be used for those who, for reasons beyond their control, require it.
I believe that our health care system is the envy of all in the world. Notwithstanding the comments of some who say that others have a better system than Canada, I have yet to see it. I have had an opportunity in my short life to travel this world a great deal. I have talked to many people who live in other countries, and the one thing that Canadians fear more than anything when they travel abroad is that they'll get sick and have to be treated in another country. Most of them would pay the money to have a Medivac fly them back here, because they know that this is where they will get the best medical service in the world.
This is an interesting act. Will it protect medicare? I'm not so sure, because acts are subject to amendments of future governments. But I do think it is the first step in what should be a broad and comprehensive debate on this question. It is very, very important that British Columbians -- and Canadians generally -- know that those they elect to office have as one of their primary concerns the protection of our most valuable asset, our health care system.
The Speaker: Hon. member for Kamloops-North Thompson. Sorry, hon. member, Cariboo North.
F. Garden: It goes on all the time, hon. Speaker. I am mistaken for that member on several occasions. The only thing is, I still get my own bills; he doesn't pay them.
It's my privilege to rise in this House to speak in favour of this bill. I just want to commend the Health minister for having the foresight to put this bill before us at this time.
First of all, I'd like to say this. Following the member for Powell River-Sunshine Coast is a really difficult thing to do. He's an articulate individual, and he laid out the policy of the Liberal Party perfectly, so there's no need for me to repeat that. We know where the Liberal Party is going as far as health care in this province is concerned, based on the quotations made by the Liberal Party nominee for the Kamloops area. I won't get into that.
What I do want to do is commend this minister for bringing this legislation forward. It has been said by members of the opposition that this is being brought in during the dying days of the Legislature and that it will be an election issue. Certainly it will be an election issue, and the reason we're coming forward with this legislation now is that the battle is on. You can't pick up a periodical at all across this country where you don't see the attack on the system right now. We are going on the record as protecting medicare and protecting those people who have access to the finest medicare system in the world right here in British Columbia.
I came from a country 37 years ago. I thought it had the best medicare system in the world until I came to Canada. We didn't have a chamber pot to do things in and a window to throw it out, but we did have access to medical care. Poor as we were, we never had to worry about a medicare bill or double-billing. Then we came to this country and found a better system, a far superior system. I brought up a handicapped child in Powell River who had a very serious accident. He was immediately flown down to Vancouver, whisked in to see the finest brain surgeon in the world -- as they had at that time in Vancouver and still do -- and got absolutely the best of attention. My child survived because of that attention.
Nobody at any time said to me: "Where's your medical card? Where's your insurance? Can you or can you not afford that?" It was just done, from the time he was put on the emergency plane to the time that he recovered in that hospital.
[ Page 16769 ]
He is now walking around as a constituent of my colleague from Powell River-Sunshine Coast. Never, at any time, did I think that any of my family would have to be faced with the thought that that might not be available to them as it was available to me. Therefore I commend the Health minister for bringing forward this legislation so that those who can't afford the kind of treatment that gets taken for granted right now will continue to get that, and so that my grandchildren and their grandchildren, as long as this type of government is in power, will be able to access the kinds of services they need at any time, regardless of their status in the financial hierarchy of this province. I'm proud of that system, and it's under attack. Mark my words: it's under attack, from Nova Scotia to Vancouver Island. There are already people moving to Ontario and buying up private insurance schemes, getting ready for that double-billing situation they think is coming. The rhetoric is on, and we need to say that it's not going to happen in B.C. This does it for us; this puts our position squarely in front of the people of B.C. They'll be able to make the choices.
[5:30]
I urge everybody in this Legislature to stand up and support this legislation. It's looking into the future. It's making sure that we don't get into a situation where people who can't afford it will have to get in a lineup. Sure, there are problems. Sure, there are expenses we have to look after. Sure, there is a burgeoning expense out there as far as hospital care and other situations are concerned, but we're taking care of that. New Directions In Health Care, and prevention, will take care of some of these expenses. The present Health minister is reviewing the costs of acute care all over this province, with a view to cutting back on waste. But it is essential that double-billing does not take place within our health care system. With all due respect to the opinions emanating from the Liberal Party and from some members of Reform, this is the way to go for British Columbians.
D. Schreck: I want to make very brief remarks on this bill, because while one can wax eloquent on all aspects of health care under this topic, it's important to keep in mind that the bill really deals with one fundamental problem: controlling extra billing under the physician side of medicare. What the legislation does is implement the technique which has been used very successfully in Quebec for the last 25 years, and bring it to British Columbia, and add two steps to that. It deals with the problem of physicians who may totally opt out of the system, and regulates any future billing patterns on behalf of those totally opted-out physicians, and it also puts in the preamble the five principles of medicare. Those are principles that we should all support: a proven control mechanism that has been tested in Quebec for 25 years, an option for the province to use in the future if we have problems with private clinics, and a confirmation of the principles of medicare.
People say that this is somehow a political bill. What it does is honour our obligations under the Canada Health Act. We now call on the federal government to honour its obligations under the Canada Health Act. It may be political for the opposition, because there is ambiguity on the opposition benches. We don't know whether the opposition Health critic, who has not received a nomination, speaks on behalf of that opposition, or whether Dr. Gur Singh, who has received nomination and who has clearly opposed our Canadian medicare system and advocated extra-billing by physicians, actually puts forward the Liberal position. What we know is that Dr. Gur Singh has the support of the leader and has a nomination, and he has put forward a position that is the antithesis of this legislation, of the Canada Health Act and of the Canadian medicare system.
To that extent, this is a political bill, but I would say that it's more a matter of choices. We can choose medicare or we can choose the Liberal-nominated candidate in Kamloops, who wants to destroy medicare. Politics is about choices, and I know where my choice lies.
J. Tyabji: It's not a big surprise where his choices would lie, actually, but it was an interesting speech nonetheless. Before I start, I want to mention that the member for Cariboo North said that he'd been in Canada for 37 years. That's quite an interesting brogue after 37 years. I'll have to learn the hang of that one.
I want to speak very briefly to this bill, An Act to Protect Medicare, and to the changing of the name of the original act. I guess, if anything, I'd like to put some questions on record for the minister that are questions of philosophy. This government has been in for almost four years, and the threats that are facing medicare are real threats. I think the member for Cariboo North articulated those; the minister has commented on some of those. But the questions are: why has it taken so long to bring something in that will speak to that issue, first of all, and why is it so little in terms of what can be done if we truly want to ensure that medicare is going to be safeguarded in the long term?
The reason I ask those questions is that the threats we talk about when we talk about the continental pressure, private facilities, private insurance and whether we go to a two-tier system or universal health care.... Those questions and concerns were first raised in public debate about ten years ago. That's when we first started to hear that we were going to have some serious threats. They were part of the debate around the free trade agreement, when we talked about harmonization. They were part of the debate around the North American Free Trade Agreement when we talked about what the implications would be for a social contract that took in Mexico, the United States and Canada. Since all of those components to the threats to medicare have been in existence for so long, why is this bill coming in at the eleventh hour, and why does it do so little? Why does it address so narrowly the threats that health care is facing?
If I could say one thing to the minister, it's that we are almost in the middle of July; we're virtually at mid-July. Most people have lives; they have families; and they have better things to do in the middle of July than pay any attention whatsoever to what goes on in politics. If part of this bill, as everyone has been talking about, was supposed to be political strategy, spinning of the bill, dealing with the debate and generating one aspect of that debate -- which is the protection aspect, such as we see in the change of the name -- why would this government do it so badly? With all due respect to their strategists, we've had so much time to bring forward a debate on health care. We've seen this government try.... This is the third session in a row where they've brought in significant legislative or policy changes to health care, and yet we've never had a proper debate in the public arena about what lies ahead.
I get calls every day from people around the province, particularly in my riding, asking, "Where is the government
[ Page 16770 ]
going with this?" I want the minister to know, while he's here and we're in debate on this bill, that people are calling for some of the changes, with respect to access to prescriptions and prices of prescriptions, that he's contemplating in policy and might bring in in legislation. They are phoning me to find out: is it true that the minister might be thinking about that? The only reason they know that he might be thinking about that is because there's an ad campaign going on, slagging him for possibly thinking about that.
Ironically, people want to get in on the debate, but not necessarily in the middle of July. I don't want to get into the debate in the middle of July. I've got better things to do. Let's get on to the fixed sittings of the House that we've been calling for. These debates become too important for any of us to miss, and yet they are happening at all the wrong times and, I think, for the wrong reasons.
If we really wanted to protect medicare.... Two years ago in this chamber this government brought in the regional health council legislation and what they called the implementation by legislation of the Closer to Home initiatives. The member for Prince George-Mount Robson talked about the Closer to Home report that the Social Credit government did and said that this government has gone in and brought in many of those changes.
We have a fundamental philosophical disagreement on whether or not this government is actually speaking to a lot of the changes in that report. That debate should be happening. The debate that occurred two years ago.... I remember the leader of the Alliance, who was then leader of the Liberal Party, speaking specifically to that debate at great length. I learned a lot during those debates about what the impact of the government's changes were going to be. I remember speaking to those in terms of administrative dollars versus dollars for service, the interim measures that would have to be taken to bring in this whole new government structure, and the fact that legions of people were working in the health care sector who wouldn't realize the impact of these decisions until after they were already brought in.
You know, I've had no recourse since then, except to hand out the Hansard from those debates. It's still ongoing. "Yes, I did raise it; yes, we did bring it up; yes, we did make those points. I agree with you; I agree with you." And still there's no arena for that debate to occur in.
Now we're talking about another narrow focus. We've changed the name of it, so now it's An Act to Protect Medicare. We can only congratulate the minister for doing that. Thank you to the minister for taking a stand, a stand on a point of principle and for doing something that should be done.
We can say those things. We can ask: why are we doing it in the middle of July? Why isn't it generating the debate we want? How do we make this an inclusive debate so that people actually understand the threat represented by comments like those that the leader of the Alliance brought up, which are coming through a nominated candidate of the Liberal Party? Do people understand what that represents? Many people do if they're in the sector, but the people who need to understand are the people who'll be most affected. They are the very people referred to as not having an opportunity cost for waiting in a doctor's room, the people who need a proper long-term strategy that goes beyond health care and integrates Social Services, workers' compensation, post-secondary education and Skills, Training and Labour so that we bring them together and include them in the solutions, and so they understand the impacts of this.
How ironic it is to have the member for Vancouver-Langara introduce a private member's bill with respect to food banks and the poor in society at the same time that his party has come out against the new employment standards laws that this government has brought in, against the universal health care that this government is trying to protect and against almost every small-l liberal policy that this government has brought in. The member for Vancouver-Langara, to give him credit, is one lone voice for those who are disenfranchised by his own party.
D. Mitchell: He's a tier-one Liberal.
J. Tyabji: He's a tier-one Liberal. That's right, he's an early-entry Liberal. He's a late-to-be-eliminated Liberal, because he's not very vocal about those things. Maybe they'll leave him in the caucus so that they don't antagonize some of the old-guard Liberals too much.
The Speaker: Hon. member, get back to the bill pretty soon.
J. Tyabji: Thank you, hon. Speaker. Yes, I do digress.
But it's hard, when we talk about so fundamental a service as medicare, to not start talking about the poor in our society -- the very people that medicare was meant to protect -- and that's where I get off onto a tangent about food banks and the poor.
Those are the questions I want to raise in this debate. I can't take exception to this bill. How could anybody who advocates Canadianism and nationalism take exception to a bill that tries to protect universality? Many people might not realize it, but in my days as a Young Liberal for the federal Liberals, I remember hearing John Turner speak about universal health care. What was interesting about that is that he wasn't somebody who would be personally affected. He wasn't someone who was poor and who, if we didn't have universal health care and we moved to a two-tier system....
Interjection.
J. Tyabji: He was a real Liberal.
He himself might have been wealthy, but he spoke very passionately about universal health care. I was impressed, because I thought that here was somebody who could easily buy into the kind of right-wing rhetoric that comes out from time to time, and more frequently -- as the now leader of the provincial Liberal Party does; he frequently buys into that right-wing rhetoric, which is very knee-jerk.... That's where I remember learning about liberalism. Liberalism doesn't mean that you speak for the poor when you're poor, and speak for the rich when you're rich. It means that you look out for the interests of the greater good.
That's what we're supposed to be trying to do. But if we're doing that, I wish we could do that in a way where we could bring the public into the debate, let them understand the threat that's represented by people who don't buy into universal health care, and let them understand what it means to allow angry rhetoric to take over the debates about our
[ Page 16771 ]
social legislation, social policy and social spending. If we don't do that, what we will have is a vacuum around those issues that are most important: the definition of Canadian nationalism and the definition of quality of life that we value in British Columbia. That would be unfortunate, because these are debates that should not be happening in July. They should not be happening on an arbitrary basis, and they should not be happening because we believe that we can put a political spin on it. They should happen at a time when we can bring people in and help them understand what this threat means to their everyday lives, to our children and to our grandchildren.
So I speak in favour of this bill, but against the timing and with a wish for a more productive debate on such an important issue at another time.
W. Hurd: I am pleased to rise in the House today to speak to Bill 54, An Act to Protect Medicare, which has accompanied ads designed to protect the political future -- or at least to attempt to protect the political future -- of the New Democratic Party government.
On this occasion it's important to reflect on the sad history of medicare under this government since it was elected in 1991. The first off the mark was the so-called war on doctors and their fee schedules. As part of that legislative package, the government rescinded the doctors' pension plan by bringing in a bill to suggest that the doctors' pension plan had never existed in legislation. It's the same government that won't go backwards and rescind their own MLAs pensions. Can you believe it? The second off the mark was the health labour relations accord -- that famous labour relations accord which wasn't even signed by the Minister of Health. It was given to us by the Minister of Finance, and we know what kind of attitude he has towards public sector unions in British Columbia. He was working full-out to protect medicare on that occasion by dynamiting into place public sector workers in the health care field at the expense of patients in the province.
During the last three years we also had an extended strike in the long-term care field that went on for months. Every day in the Legislature members of the opposition were up asking the Minister of Health when he was going to do something to encourage people to stay in their own homes and take advantage of intermediate and long-term care provided by non-profit societies. The government was waiting until they all got unionized and signed their first contract. This government is the first government in the history of British Columbia to tie grants in the social services and health care field directly to unionization of those non-profit societies. And they make no pretext about it. They forced the non-profit societies to enter a bargaining unit in the province -- PSEC -- before they could even qualify to receive funds from the government. They have taken this vital area of medicare -- the non-profit societies -- and they're rapidly driving them into the ground. Is that protecting medicare in British Columbia?
[5:45]
Half of my riding is senior citizens, and calls have piled up from people trying to stay in their own homes and getting absolutely no support from this government. They claim that they are moving health care into the communities, but when it comes time to protect seniors in their own homes, they aren't there for medicare. Surely health care isn't just about acute care hospitals; it's about those non-profit societies that provide community-based health care. I'll tell the minister and these members opposite that those non-profit societies are providing less service today under this government than they have ever provided in the last ten years, because the money that they were putting into programs is now going into paying contract settlements with the B.C. Government Employees' Union. That's the reality in British Columbia.
We already have a different fee schedule for some services. They don't fund chiropractors, other than just a basic rate. They don't fund a number of alternative medicine procedures that could save the system money. We already have a different fee schedule....
Interjections.
The Speaker: Order, hon. members. The hon. member for Delta North is fully aware of the rules. I would ask all hon. members to wait until they have an opportunity to take the floor and be recognized before they participate in the debate.
Would the hon. member for Surrey-White Rock please continue.
W. Hurd: Let me continue this sad chronology over the past four years. We've had debates in this House about waiting lists for surgery. We've told the members opposite about people flying to Edmonton and travelling to Bellingham at taxpayers' expense because they couldn't get a place in the surgical waiting line in British Columbia. That's been going on for the last four years.
The other issue is reference-based pricing in the Pharmacare system. I'd like to show the Minister of Health the phone logs in my riding from the last two weeks regarding reference-based pricing for Pharmacare. I'd like to show him the number of people who are concerned about the fact that soon this government may force them to buy a prescription drug that their doctor says is not in their best interests.
An Hon. Member: That is not true.
W. Hurd: The minister suggests that it's not a fact. Well, he should answer some of the phone calls in the province personally and tell them that reference-based pricing....
Interjections.
The Speaker: Order, hon. members. Now, I've tried to be reasonably sensitive to your desire to participate from your seats. But when you are yelling, as some members are doing, when a member has his place on the floor, it is very difficult for the Chair to hear. It is also distracting for the person who is attempting to make a presentation, so let's just be reasonable, and hopefully it won't be necessary for the Chair to intervene. Please proceed.
W. Hurd: I really commend to the members opposite to ask people who live in rural areas of the province whether the level of service they enjoy today is better than it was four years ago. Is it better in Prince Rupert or in Prince George, the minister's own riding? Is it better in Quesnel? Five hundred people showed up at a meeting in the riding of the member for Cariboo North to express their concerns about the loss of services in that hospital. They were there. They weren't there
[ Page 16772 ]
to praise the government, they were there to bury it, and for good reason, because they are concerned that the services of their hospital are not as good as they were four years ago.
Interjections.
W. Hurd: Well, I'm being heckled by the member for Cariboo North. I don't know if he went to that meeting and spoke. I hope he did....
Interjection.
W. Hurd: I hope he did....
The Speaker: Order, please. Hon. members, I don't intend to intervene anymore to ask members to come to order. The hon. member for Cariboo North has been persistent in interjecting, and I would ask the hon. member to try to refrain from doing so when he doesn't have a place. Please, hon. members. The next time I have to call someone, I may have to ask them to leave the chamber if they can't be more temperate. Please proceed, hon. member.
W. Hurd: Thank you, hon. Speaker. Other members in the assembly on this side of the House, in speaking to the debate about the future of medicare, outlined the challenge at hand. In this country, and in this province in particular, the fact is that we have an aging population that will place increasing strains on the system, but nobody has talked today about medical technologies, one of the most significant factors in the increasing costs of health care.
I can remember speaking a few years ago with a medical doctor who expressed to me his total frustration at being put in the role of gatekeeper to the system of health care in our province. He cited the example of a young boy who came into the emergency ward in a local hospital. The boy had fallen off a swing and had hit his head, and the parents were concerned and had taken him to the emergency ward to have his condition analyzed. The doctor, who was the admitting doctor, carefully examined the boy and deduced that there was probably nothing wrong, that it was a bump on the head and he could probably go home. But he also said: "If you want to be on the safe side, we can order a CAT scan and a series of X-rays and be 100 percent certain." That one decision, which is made every day and in every hospital in this province, is a $1,000 exercise at least. Why should it be up to the doctor to decide whether or not that procedure can be justified? Why is it up to the doctor?
Interjection.
W. Hurd: Hon. Speaker, the minister says that it isn't. We see ads in the newspaper suggesting that somehow there's a level of cooperation going on between the provincial government and doctors to control the costs of medicare. The last three years really illustrate how much cooperation we've seen between the province's doctors and this government. I mean, it just defies credibility. The problems are there with this system.
The federal government is between $500 billion and $600 billion in the hole, and 35 cents of every dollar they spend is on debt service costs. Those are facts that can't be disputed. What is the government suggesting? That we protect medicare by increasing debt service costs to 50 cents on the dollar, 60 cents, 70 cents? How in the world do you protect universal medicare by increasing the debt service costs of the federal government? These people have got to be living in a fantasyland. Where have they been for the last ten years?
We have a formidable challenge on our hands in this assembly and in provinces throughout the country: how are we going to maintain an affordable, effective system of medicare without bankrupting the federal treasury? That's the issue. I don't pretend to have all the answers, but I know one thing: it isn't going to happen with Bill 54.
This is an electioneering bill. It's tied into a series of government ads, and as the member for West Vancouver-Garibaldi stated, the ads were running before the bill was introduced in the House. There's nothing in this bill that could possibly protect medicare. Other than aiming another missive at the doctors of the province and bashing the federal government, there are no solutions in this bill -- none whatsoever -- to protect medicare.
It really is unfortunate, because I would have welcomed the opportunity during this debate to hear some concrete solutions -- how these problems are going to be dealt with. How are we going to deal with the soaring costs of medical technologies, where one treatment can cost the system half a million dollars? How are we going to deal with the debt situation federally? It is the responsibility of all of us. It's not just a federal Liberal problem or a Conservative problem or a Reform Party problem; it's a problem we all face in this country -- how to maintain an affordable, effective central government as well as a government in British Columbia and elsewhere. Those are problems we all face, and I see nothing in this bill to address those fundamental problems. We can engage in this kind of rhetoric, and we undoubtedly will. The government will go forth and claim that it introduced a bill to protect medicare. The problems will still be there at the end of the day, they'll still be there after the next election, and there will be precious few solutions available to us.
Last, I want to talk about this grand experiment in health care that we're involved in called New Directions. The minister and the members opposite have stood up in this House for the past four years and told us categorically that this New Directions will save the taxpayers money. Where are the models? Where's the proof? Where's the cost structure of fixed savings from New Directions? We haven't seen a single case study tabled in this House which would demonstrably prove that by putting funds into the hands of a regional or local health board we're going to save X number of dollars in this particular district.
Before we embark upon this grand experiment in our health care system, surely we need some hard data on where we're going. It's not there, and this Minister of Health has got to understand that the people of the province are, understandably, skeptical. When they go to their local hospital, whether in Quesnel or Prince George, and find the services are not there that used to be there, how do you convince them they're better off? I wish them luck. Maybe they can, I don't know; but they're not going to do it with Bill 54. That's not going to convince a person who has to fly from Prince George to Edmonton that they're better off than they were four years ago.
In closing, I think we have a challenge on our hands with respect to provision of medicare in our province. I know that the minister travelled with me to Washington State with a select standing committee. We asked questions in a plant we
[ Page 16773 ]
visited down there about the cost of health care. I think both of us were amazed to learn that the employer was paying $5 an hour on top of the basic rate for a very rudimentary health care plan that didn't provide more than six months' worth of benefits. The employee then had to go out and buy a patchwork quilt of additional plans to cover them. We know that the cost associated with doing that is immense.
This issue isn't about which party recognizes the value of our health care system. We all recognize that, but we have to find a way to deal with the costs. We have to find a way to deal with our debts and deficits in this country, because at 35 cents per dollar -- and rising -- for debt service costs, there's no surer way to sacrifice the programs we all hold dear than to allow that debt to gallop ahead and those debt service costs to continue to eat into program spending at every level.
I take my seat, saying that I have no problem supporting Bill 54, An Act to Protect Medicare, because it doesn't mean anything. It doesn't mean anything, so what difference would it make?
Interjections.
W. Hurd: The members.... They brought in a bill.... Who am I to go against $10 million in government advertising? I don't have a $10 million ad budget to counter the Karl Struble spin on Bill 54. Nevertheless, it's a bill that will undoubtedly pass. The government will head into the election claiming to be the defenders of medicare, and I can assure the Minister of Health that people in his own riding won't buy it.
[6:00]
V. Anderson: One of the realities of the riding I'm in is that whenever we have a clash and need the police or something, we call car 54. And every time I think of this bill, I think of car 54 instead of Bill 54. It's a crisis intervention bill, and probably a needed one; I'm not complaining about that. Within the limits-on-billing section, which is the main part of this bill -- it's a management section to try to manage, and it's one way of managing the health care system....
But I want to speak for a moment as one of those maligned senior citizens. I'm proud to be one of those maligned senior citizens who has been so expensive in the health care system. Fortunately, I happen to be healthy at this moment. However, for all of us, the majority of the money we will spend in the health care system will be when we become senior citizens. Hopefully, we will all live to that age and won't have to use those health care benefits prior to that time.
I've been listening to this discussion for 50 years, and it hasn't changed. When I was in high school, my topic in the debating contest was the benefits of state medicine, as it was called back in those days when it was just being discussed.
An Hon. Member: Those were CCF days.
V. Anderson: Those were CCF days.
An Hon. Member: Good days.
V. Anderson: Those were good days, exactly. Those were good days, which went out when the CCF ceased to be, but those were good days because the CCF was simply a collection of the people of the community, of all backgrounds and realities. They were the people of communities that had lived through and come through a recession and the hard times of the thirties. They knew how to be independent, but they also knew that you had to co-operate with one another. You had to depend on each other to build the barns and do the barn-raising. You had to depend on one another when you fell sick, when you lost communication or when something happened in your family. Out of that movement came the desire that there should be equal protection, equal support and equal health opportunities for all people.
L. Fox: That was back in the time when the Premier and I had hair.
V. Anderson: That's right. But that concern -- that every person in every family should have the opportunity and care they deserved and required -- can be summed up in equality for all people. We put it into fine words now. We've taken equality and we put it now as universality, comprehensiveness, accessibility, portability and public administration, but we are still talking about the same thing. We are talking about how we can have security in our life and medical help when we need it, and how it can be accessible to us. Hon. Speaker, accessibility means that you can get near a phone or a radiophone to call for help when you are in need of it. There is a whole variety of things in accessibility.
All I want to say today is that we are talking about the same thing that we were talking about 50 years ago when the people of Swift Current, Saskatchewan, came together as a community and began to develop what became the medical services program of Saskatchewan under the CCF. It then became the medical program of Canada under the Liberal government. But it didn't matter which government came into being; this is what the people were demanding, and therefore any government that was listening to the people would respond and bring that forth.
The question I hear in the discussion at this point is about who is listening to the people. I hear the Liberals being maligned because we speak with different ideas, we come together with different suggestions, and we try to work out a consensus among us. There seems to be a suggestion that liberalism has something wrong with it when people have different ideas and different opinions and do different research and bring it together to look at a consensus from all parts of the province. But that's why I'm a Liberal. That's what the CCF was in the early days in Saskatchewan when the people came together, each with their own point of view. They interacted, and they built a community. That's what liberalism is in our own day.
I agree with those people who say that this cannot be a partisan issue. It must be an issue of the people of the community. I trust that all of the parties will be listening to the people of the community, and I doubt that the people from all sides of the House who listen to this debate will be very pleased about what they've been hearing. I think they have been hearing partisans trying to say politically: "We have the answer, not them." And the people are saying: "In truth, none of the political parties had the answer; we the people have the answer, and we will reflect it to the party which happens to represent us at this time."
There is some concern about the limits of billing. That has to be dealt with, it has to be responded to, and it's being responded to here. We set forth the principles of the medical care system in Canada which have made it unique around the
[ Page 16774 ]
world, and we need to set them forth and periodically remind ourselves of them. My concern is the charade that is played. I am always interested that when we go through the bills -- which we will in committee stage -- we will finally say, "Do we agree on the title?" as the final reality of what we've done. This title is a charade. We previously had the Medical and Health Care Services Act which talked about the medical health care services that we were going to provide and which were being provided to all the people in the province. We now say we're going to have a medicare protection act; we're no longer going to have a Medical and Health Care Services Act.
We've taken a political slogan for a political purpose to catch attention, and we have taken away from the original meaning of the whole validity of the act and given the suggestion that because we're going to limit billing, this is what medical services and medical care are all about. It's one element, but it's not what medical care and medical services are about. The title is the worst charade of this whole thing, and I think the government needs to put it back. If for nothing else, I'd be tempted to vote against the title, except that that would be taken as voting against the principles.
So I can speak harshly of the charade that's been put forward here. People are looking for services that they can rely on, that reflect their needs and that are balanced financially. They also know how to balance a budget; it's not just we who know how to balance a budget.
An Hon. Member: We don't.
V. Anderson: We don't, I agree: collectively, we don't. Collectively we've got into this mess over the years, so I'm not going to say it's we or they. Collectively, the people in the community know how to balance a budget. They know what are the essential services that they need, and they're demanding that they provide those.
It's not the name that's going to make the difference. Let's be honest with that and not try to pull the wool over their eyes, because it can't be done. They'll see through it very easily. I suggest that the principles of medicare, or medical services which have been there since 50 years, are fundamental and need to be maintained. This only deals with a very minor element within that. It's the whole element that we need to be talking about, not downgrading it by putting on a title which is only a political ploy at this particular time.
The Speaker: The hon. minister closes debate.
Hon. P. Ramsey: It's a pleasure to stand and close debate on Bill 54, An Act to Protect Medicare. I guess I want to say a few things about what we did talk about today and some of the things we didn't talk about.
Much of today's debate from the Liberal opposition benches has sort of been a reprise of the estimates debate, where they really talked all over the map about a whole range of issues other than what's before them. Given the fact that when division is called on this bill, I expect most of them will stand in their places and support it, I guess that's not too surprising. We heard a lot from the Liberal opposition about wait-lists. We heard them quoting those famous medical experts, the Fraser Institute and Jim Nielsen. We heard them saying repeatedly that these are the wonderful numbers -- though they fit nothing that anybody in the province knows anything about.
We heard them saying that no action is being taken and that wait-lists are growing out of control, when they know that that is not the reality. They know that in 1991 there were 900 people on the wait-list for cardiac surgery, and now there are between 300 and 400. They know that we have expanded magnetic resonance imaging services in this province by 3,000 additional procedures in the lower mainland and a new machine that travels from my riding in Prince George to Kamloops and Kelowna. It brings a whole new service to the central interior of the province. They know that what happened in previous governments -- shipping people to Bellingham for cancer services -- is becoming a thing of the past as we invest $90 million in new cancer treatment facilities in Surrey, Kelowna and Victoria and replace aged machines in Vancouver. That's the reality of what this government has done with wait-lists, and the members opposite know it.
I hear the members opposite say repeatedly that wait-lists somehow have to go away entirely. They know that that's not the reality. They know that wait-lists are part of our public health system for elective procedures, and that placement on that list is set by medical practitioners. When the member for Prince George-Omineca suggests that somehow my office in Prince George should interfere with that process and inject a political element into how elective services are delivered, he is speaking against one of the fundamental principles of Canadian medicare, and I reject it entirely.
We have a system where your place in line is set by your medical need. There are wait-lists in virtually every health system in the world. The difference is that in our province and in our country we ask people to wait for an elective service based on their medical need. In the two-tier system south of the border, they are asked to wait based on the size of their wallet -- on whether they have the wherewithal to pay for the service that they desire and require.
We also heard a lot of talk about funding. We heard two different messages out of the two sides of the Liberal mouth. On the one hand, we heard that the biggest threat to medicare is debt. I suppose that includes the $245 million that we're going to spend building new hospitals and health clinics and long term care facilities and cancer clinics in the province this year. I suppose that's part of the debt that threatens medicare. I call it a good investment in health care for British Columbians.
An Hon. Member: They don't want to build them.
Hon. P. Ramsey: My colleague says that they don't want to build them. Hon. Speaker, that's not entirely true: you ought to hear them in estimates when they're talking about the hospital or long term care facility in their own ridings. Then the other side of the mouth goes into action, and debt is not such a bad thing for health care anymore.
On the one hand, we say that spending must be restrained; on the other hand, we hear Liberal members saying that spending 90 million new dollars on hospital budgets this year -- a 3.4 percent increase, the highest increase to the hospital sector of any province in Canada -- is too little; that somehow hospitals are being starved. I think the member is confusing British Columbia with Alberta, where hospital budgets have been slashed 7 percent this year on top of a 7 percent cut next year, and are anticipating another cut in the future. That's the reality of hospital funding in other provinces. That's the reality of health priorities in the Klein
[ Page 16775 ]
government and the federal Liberal government and, I suspect, in all variations of the Reform Party in this House. That's not the reality of this government. This year we have increased funding for Health by another $250 million; it stands at $6.6 billion. One-third of every tax dollar is spent on Health.
We heard a lot of talk which amazed me. On the one hand, members opposite say that we have stresses on the system: an aging population, a growing population; we have new technology; and we have to find more effective and efficient ways of delivering health services. On the other hand, they stand in their place for hour after hour to condemn some of the very measures that will make our system more effective and efficient. They stand to say that asking knowledgable local people to assume health planning authority and decision-making for the communities is wrong; that saving $30 million on administration in the Vancouver region is wrong; that we shouldn't look at coordinating services at a local or regional level; that we shouldn't integrate those services between an institution and a community; and that somehow having 700 different boards and agencies -- human resource departments, financial departments and data processing departments -- is effective and efficient delivery of health care. They are resisting the New Directions initiative to reduce that number to 100 regional health boards and community health councils. This is an initiative that we share with every other province in Canada, for the very simple reason that study after study has shown that stovepipe, top-down, one-solution-fits-all administration of health care is a failure. It's a failure in wise use of tax dollars; it's a failure in integration of health services; and it's a failure in getting the services to people where they need them, when they need them.
[6:15]
We hear the member stand up and attack every initiative we make. In Pharmacare, we can't do the PharmaNet program. We shouldn't do the low-cost alternative program. And today we have the member for Surrey-White Rock standing up and saying: "Reference-based pricing" -- which will save this province $30 million a year and, if other provinces have the guts to follow our lead, would save the provincial governments across this country $1 billion a year -- "is wrong." That's precisely the sort of initiative we need to say that health is more important than the profits of drug companies, and we're going to act on it.
I hear members opposite talk entirely too much about how we should resist some of the moves we're making to move services from an institutional base to a community and home base. They attack the accord that provides health workers some transition and hospitals some ability to manage through this difficult time. I think that they simply wish we would let the system moulder on the vine and not do a thing to change it.
What have they ignored? Well, they wish to ignore the reality of federal off-loading. The Liberals in this House particularly wish to ignore the action of their federal counterparts, who are proposing, quite clearly, to reduce funding for health, post-secondary education and the social safety net from some $17.2 billion in transfer payments this year to just over $10.5 billion two years from now -- a cut of $6.6 billion, a cut to this province of $800 million, a 36 percent cut. Those are real cuts. At the same time, the federal Liberal government proposes to maintain and retain over $7 billion of subsidies to corporations, of tax breaks to businesses. I think that every British Columbian knows that that's the wrong priority. It may be the priority of the federal Liberal government; it may be, God forbid, the priority of a provincial Liberal government should it ever come to power. But it's not the priority of this government; it's not the priority of this minister; and it's not the way to make health spending a priority, which we have done.
Finally, I hear not much talk, really, about what the real choices are. We have sought cooperation with the physicians of this province in making the necessary changes to delivering medicare, and cooperation is the byword of the day. It's going well. Taking care of health care is a joint initiative of the BCMA and the Medical Services Commission. It's more than an advertising campaign, and it will save $60 million over the next three years in medicare services.
Interjection.
Hon. P. Ramsey: The member opposite asks how much it costs. In the entire period, the stuff in doctors' offices, on television, on radio and in print will cost around one-tenth of that. That's what we've budgeted. We're going to save $60 million by spending $5 million. I think that's a wise investment of tax money.
We're working with the BCMA on clinical practice guidelines to make sure that necessary surgery is performed when it's needed and not performed when it's not needed. We're working with the Medical Services Commission, which is now the model across the country for governing health services through a tripartite commission of doctors, government and the public. We're working on physician supply, and we're working on a huge range of measures.
Finally, we are working with them on how we deal with the threat of two-tier medicine. We have had extensive negotiations with the BCMA. I have heard the members opposite ask: "So why are we legislating, and why now?" This act isn't a surprise to the members opposite. It was announced in the throne speech. This initiative is no surprise; I and the Premier of this province have been talking since January about the necessity of making sure that one-tier, Canadian-style medicare is the reality for this generation of British Columbians and for future generations. There are no surprises with this bill.
The reason it's coming in now, rather than two months ago, is that we took the advice of the members opposite: we have been negotiating very seriously with the BCMA. We plan to continue to negotiate seriously with the BCMA, and the terms of this bill will set the groundwork under which those negotiations will be concluded. These are the principles we went into those negotiations with, and these are the principles we will continue with in those negotiations with the BCMA. We will continue to have cooperative efforts with doctors of the province to preserve medicare.
Some members here have spoken, though, about how this is a political bill. If the essence of politics is choice -- and I believe it is the essence of politics -- then this is a political bill. It is a choice about what we wish to have our medicare system look like for ourselves and for our children. What do we wish it to look like? I have heard two visions today. One vision is clear; I'd call it the Alberta vision. I surely see it across the border in Ralph Klein's Alberta. I hear it promulgated by the leader of the federal Reform Party. I even hear it in this House, upon occasion, from the provincial Reform Party; it even slips
[ Page 16776 ]
out between the lines from the Alliance and from the Liberal Party. It's a vision that says that the issue for medicare, above all, is debt.
All governments have to get their fiscal house in order. The issue here is fiscal priority, and the priority for this government is spending on health care. The issue here, I believe -- or that vision of debt -- is one shared by the federal Liberal government, regrettably, which would put subsidies to corporations above spending on medicare, that would simply slash health transfer payments to the provinces without any analysis of what the impact of those cuts would be on health services for Canadians in British Columbia and in provinces across the country. That vision says that two-tier medicine is something we simply have to accept, that user fees or extra-billing is okay. They would ignore the reality of what the Seaton commission reported about every study that's been done on user fees, which says that this is a zombie solution. It's one of those walking-dead solutions that stop the earth and should be told to lie down in the grave and go away. It's not a real issue.
I keep hearing again and again in various versions: "Look at Great Britain; look at New Zealand." Let's look at them. What has two-tier medicine done for them? Has it increased or decreased wait-lists in the public health sector? It has increased them. Has it "taken the pressure off" the public health system? No, it has not. Instead, it has drained resources from the public health system and made it worse for person after person in New Zealand and Great Britain.
We have versions of that vision before us. We surely have it from the former president of the BCMA, as has been referred to by other members of the House. We surely have it; I've heard him speak. He believes that two-tier medicine is the way to go. I don't know whether he speaks for his party. We don't know which tier of medicare speaks for the Liberal Party right now. We have a Liberal Health critic who says "one tier." We have Gur Singh, who says "two tier." Maybe they are one-tier, two-tier Liberals; eventually we may find out. But the Jim Nielsen-Gur Singh spirit is alive and well in the Liberal ranks, and it has nothing to do with protecting medicare and everything to do with protecting profits for a few.
It's also a vision that is, quite frankly, shared by the Reform Party. I heard the leader of the Reform Party stand in this House and say that extra billing or user fees or whatever you call them were a good idea; they should be considered -- same as the federal Reform Party said, and that they too would move towards a two-tier system.
But I think we have a bit of hypocrisy going on here, because I'm not sure I'm going to see many of those members from the Liberal Reform or the Reform Reform stand up in opposition to this bill. I did hear one forthright speech from the Socred Reform party in this House. That member for Okanagan West had the guts to say what others only implied. He had the guts to advocate actively for the two-tier system, to say that extra billing was right, to say that protecting medicare involved a reversal of the direction this government has chosen. That I respect. And I expect he will stand up in opposition to this bill. That's good. But from what we've seen in this House today, quite frankly, the majority wish to have it both ways. They spoke against the protection of medicare we have embedded in this act. They said that as British Columbians, we should not have protection for ourselves from extra billing and that the principles of medicare are outmoded.
I believe otherwise. I think this act does several things that we can be proud of as legislators in this province. It says very clearly that the 3,000-item set of medicare services available under this act will be provided to British Columbians on the basis of their need, not on their ability to pay. The governance and delivery of those services will be in accordance with that principle. That's not in the preamble; that's in the body of the act itself. It says that all medical services in this province should be run, planned and delivered in accordance with the principles of the Canada Health Act, which we are now for the first time embedding in provincial legislation.
The act says that any extra billing -- whether it be called a tray fee or a facility fee or a user fee or just a fee -- is no longer on in British Columbia, not just for the small number of physicians who are currently engaged in it or the hundreds of thousands of people who now have to pay tray fees or facility fees. All future administration of this shall be done in accordance with these principles.
These are the principles under which the medicare services of the province should be delivered and protected. This is not the last act we need to debate in this Legislature to protect medicare nor is it the last initiative of this government in protecting medicare. We have done much in the last three and a half years, but there is still much to do. This bill says that we will do it in accordance with these principles, regardless of the way we move this forward.
Hon. Speaker, I'm pleased to have presented this bill to the Legislature and to rise in its defence. I'm pleased that we've had an invigorating debate this afternoon, and now I would move second reading of Bill 54.
[6:30]
Motion approved on the following division:
|
YEAS -- 49 | ||
|
Petter |
Dosanjh |
Cashore |
|
Zirnhelt |
Charbonneau |
O'Neill |
|
Garden |
Hagen |
Hammell |
|
B. Jones |
Lortie |
Giesbrecht |
|
Miller |
Cull |
Harcourt |
|
Ramsey |
Barlee |
Sihota |
|
Evans |
Farnworth |
Conroy |
|
Doyle |
Janssen |
Lord |
|
Simpson |
Jackson |
Tyabji |
|
Wilson |
Mitchell |
Hanson |
|
Weisgerber |
Hurd |
Farrell-Collins |
|
Campbell |
Reid |
Dalton |
|
Jarvis |
Anderson |
Symons |
|
K. Jones |
de Jong |
Fox |
|
Chisholm |
Boone |
Hartley |
|
Schreck |
Copping |
Brewin |
| Krog | ||
|
NAYS -- 1 | ||
| Serwa | ||
Bill 54, An Act to Protect Medicare, read a second time and referred to a Committee of the Whole House for consideration at the next sitting of the House after today.
Hon. P. Ramsey: I move that the House at its rising stand recessed until 7:10 this evening.
Motion approved.
The House recessed at 6:35 p.m.
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