Official Hansard
Madam Speaker, before I start my remarks, I would like to note a recurring trend. We are seeing more and more bills here in the House that originated in the Senate. As members know, the time allocated for debate on a bill is not unlimited, so I find it somewhat curious that the government continues to place so many Senate bills on the agenda. Let me turn now to Bill S-5. As my colleague from Laurentides—Labelle said earlier, its objective is certainly commendable. No one can argue with it. Unfortunately, however, this bill reflects a familiar tendency to believe that Ottawa knows best, that Ottawa knows better than the provinces what is good for them in areas under their jurisdiction, and that Ottawa possesses more expertise when it comes to implementing policies. I must say, it is getting a bit tiresome. There is a major problem, as my colleagues have pointed out. Despite what the Minister of Health said earlier, nowhere does this bill explicitly recognize Quebec’s and the provinces’ exclusive jurisdiction over the organization of health care delivery or the fact that Quebec can choose to develop its own digital infrastructure. If the Bloc Québécois is to support such a bill, it must include an explicit recognition. I would like to point out that, as my colleague from Laurentides—Labelle said earlier, the Government of Quebec has already indicated its intention to deploy its own digital health infrastructure. Unfortunately, this bill in no way reflects the autonomy that Quebec claims with respect to health care. Moreover, to my knowledge, Quebec has not committed to following the pan-Canadian interoperability roadmap. The major stumbling block in Bill S‑5 is that it does not respect jurisdictions. To convince my colleagues of this, I will reread clause 7(1), which my colleague from Montcalm referred to earlier. I hope the Minister of Health will listen to us. The Governor in Council may, by order, make any provision of this Act or the regulations applicable in any province or territory if the Governor in Council is satisfied, after applying the criteria and the process provided for in the regulations, that the province or territory does not have requirements that are substantially similar to or exceed those established under this Act. What does that mean, ultimately? It means that Ottawa is leaving the door wide open to tell the provinces how they should act. That is why I said in my introduction that this is, once again, a form of centralizing federalism. I will not use the term “predatory federalism”, but this is yet another form of federalism that is heavily focused on allowing Ottawa to define what is right and what constitutes good health care within the provinces’ areas of jurisdiction. This is very clear, and I want to make that point clear to the minister. In theory, Bill S-5 might not apply to Quebec, as my colleague said, but we must still speak out against clause 7, which would allow the government, by order, to effectively override provincial laws in areas that fall under provincial jurisdiction. Unless the government is willing to amend its bill, I do not see how the Bloc Québécois can support it. At the very least, a preamble should be added that clearly specifies that Quebec remains in charge of its health care. However, today is budget day, and we are always happy on budget day. This bill gives me the opportunity to talk about something that is central to the Canadian federation, and we will see it reflected in the budget: the perennial problem of health transfers. If we want to fix health care, we need to solve the funding problem. Year in and year out, and during every election campaign, when Quebeckers and Canadians are asked what their priorities are, health care is usually one of their top priorities. I want to go back to the issue of health transfers because, in the great history of Canadian federalism and the injustices and inequities in relations between Quebec and Ottawa, one thing is glaringly obvious. I am talking about the infamous fiscal imbalance. For those who do not remember what that is, I will explain. The Government of Quebec delivers virtually all social services and, in fact, Ottawa delivers very few services. There is EI, but that is paid for by workers. There is OAS, which is a social program. Ottawa participates very little in terms of social programs, although it takes up 60% of the tax room. In the end, Ottawa always has much more money than its responsibilities require, while Quebec and the provinces never have enough because they have a smaller tax base. That is the fiscal imbalance in a nutshell. Instead of piling on more and more health initiatives, encroaching on an area under provincial jurisdiction, Ottawa should focus on making health transfers more predictable and unconditional. We will see whether there is any good news in the budget and whether health care transfers will live up to the expectations of Quebec and the provinces. Right now, if we look at the big picture, Quebec is spending about 42% of its total budget on health care. Back in the 1960s, when the public health care system was first established, 50¢ of every dollar invested in health care came from the federal government and 50¢ came from the provincial government. Today, the federal government’s share is estimated at barely 22%. That means that, for every dollar invested, 22¢ comes from the federal government. Quebec has to cover the rest, and the infamous fiscal imbalance comes into play, as I mentioned earlier. That said, 42% of the Government of Quebec’s budget is a huge share. That means that Quebec has only about 58% of its total fiscal capacity left to address essential priorities, such as education, poverty, infrastructure, municipalities and support for Quebec businesses. We have been fighting long and hard over health care transfers in Canada. In 1980, the Mulroney government made the first drastic cuts to health transfers. Then came the famous Liberal era, when there were budget surpluses. Where did those budget surpluses come from? They came from the recurring cuts Paul Martin made to health care. In the wake of the 1997-98 referendum, $2 billion in recurring funding was cut from the provinces. Jean Chrétien boasted to the G7 that he had balanced the budget, which is pretty cynical, really, because he got his surpluses by cutting transfer payments to the provinces. He added that he would not have to pay the political price for this, because the public believed—members may recall Lucien Bouchard’s shift toward outpatient care—that the governments of Quebec and the other provinces were to blame for the shortcomings in health care services. However, it was the federal government that had just insidiously cut transfer payments and that was not shouldering its share of responsibility for health care. It is budget day. I hope the federal government will see the light. It needs to put an end to the predatory federalism and accept its share of responsibility for health transfers.
