April 6, 1949

LIB

Robert Henry Winters (Minister of Reconstruction and Supply)

Liberal

Hon. Robert H. Winters (Minister of Reconstruction and Supply):

On March 31 the hon. member for Calgary West (Mr. Smith) asked a question in connection with the Bow River Construction Company: whether the cash payments which have been made will be returned to the persons concerned. The answer is that it is the intention of the joint mortgagees to refund the down payment made by any purchaser of an unfinished house on which foreclosure action is taken, if a refund is requested.

The house resumed from Tuesday, April 5, consideration of the motion of Mr. Abbott for committee of supply.

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NATIONAL HEALTH INSURANCE

CCF

Stanley Howard Knowles (Whip of the Co-operative Commonwealth Federation)

Co-operative Commonwealth Federation (C.C.F.)

Mr. Stanley Knowles (Winnipeg North Centre):

Mr. Speaker, at the time it was my privilege to move the adjournment of this debate last evening we had seen the discussion of a very important question, namely the matter of health insurance, turned into a political argument about what went on at the dominion-provincial conference of 1945-46. Again last night we heard the argument as to who broke up that conference and on whose shoulders rests responsibility for the failure of anything to come out of it. I want to say that I am convinced the people of this country are fed up with two things in particular. On the one hand they are fed up with the Progressive Conservatives-

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?

Some hon. Members:

Hear, hear.

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CCF

Stanley Howard Knowles (Whip of the Co-operative Commonwealth Federation)

Co-operative Commonwealth Federation (C.C.F.)

Mr. Knowles:

The people of this country are fed up with the Tories blaming the government for the failure of the dominion-provincial conference, when most people think that the blame does rest upon the provinces of Ontario and Quebec. On the other hand the people of this country are fed up with the Liberals for using the failure of that conference as an excuse for not doing the things they proposed to the country in 1945. In fact the feeling is growing throughout Canada that the government was actually glad the Tories made that conference abortive.

Topic:   NATIONAL HEALTH INSURANCE
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?

Some hon. Members:

Hear, hear.

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CCF

Stanley Howard Knowles (Whip of the Co-operative Commonwealth Federation)

Co-operative Commonwealth Federation (C.C.F.)

Mr. Knowles:

I hear Liberal approval of that statement; the truth will out. In the name of the people I say, "a plague on both your houses." Then last night we had the Minister of National Health and Welfare (Mr. Martin) from his side of the house still talking about the constitutional problem and accepting that as a barrier to the kind of progress in matters of health my leader

National Health Insurance was asking for. On the other hand, too many Tory statements are still being made in public which cause the country to wonder just how enthusiastic the Progressive Conservatives are in regard to measures such as health insurance and over-all social security.

In this connection I hold in my hand a clipping from the Stratford Beacon-Herald of April 2, 1949, which was Saturday of last week. It seems that last Friday night, April 1, a banquet was held in Stratford in honour of one Mr. E. J. Smith, president of the Whyte Packing Company. Mr. J. S. McLean, president of Canada Packers Limited, was present and donated a gold watch to Mr. Smith. The speaker of the evening was none other than Right Hon. Arthur Meighen. In that distinguished company, where it was quite safe to attack the alleged evils of socialism, Mr. Meighen did just that. I wish to quote a few sentences from the newspaper report of the proceedings at that banquet:

Making a strong attack on the "evils of socialism," Mr. Meighen said the virus of social security had penetrated to a greater or less degree into all Canadian political parties and would lead to eventual destruction of the world as we know it. The speaker-

That is, Mr. Arthur Meighen-

-termed himself a champion of free enterprise,-

He is a real Tory.

-and a sworn foe of socialism.

I ask his fellow Tories to listen to this:

He said that the unfortunates of the world should be helped through charity, but should not be granted the legal right to assistance.

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LIB
CCF

Stanley Howard Knowles (Whip of the Co-operative Commonwealth Federation)

Co-operative Commonwealth Federation (C.C.F.)

Mr. Knowles:

These words were uttered not in 1849, but on April 1, 1949. The report continues:

The present measures for social security, he alleged, are eating into the vitals of society and tend to induce decay of morale.

Mr. Meighen drew what he called a parallel between the present cry for social security and the "bread and circuses" that preceded the decline and fall of the Roman empire.

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LIB
CCF

Stanley Howard Knowles (Whip of the Co-operative Commonwealth Federation)

Co-operative Commonwealth Federation (C.C.F.)

Mr. Knowles:

Mr. Speaker, last night during the course of this debate the Minister of National Health and Welfare attempted to reply to the appeal that was made in the afternoon by the leader of this group for some forward steps in the matter of health insurance. I do not wish to detract by one iota from all that has been done by this government and the various provincial governments in seeking to advance the cause of public health. But after you have summed it all up and given it to the house and the country with the greatest amount of fanfare you can, even the Minister of National Health

National Health Insurance and Welfare, when he reflects upon it-as he likes to suggest to the rest of us-will admit that the amount of money spent is only a fleabite as compared with the needs of the country or with the amount of money the government spends on various public matters.

I point out also that in addition to the inadequacy of the amount of money now being spent on health, there is still nothing being done with respect to health insurance, or in other words with the problem of helping to pay for the medical expenses of our people. This was the question my leader raised yesterday when the motion was made for Mr. Speaker to leave the chair. I find, for example, that the estimates this year provide for only a minor increase in the amount for health insurance studies. Last year it was $43,987, and this year it is but $56,451. I find also that the total health grants last year were $29,885,000, and this year they amount to $30,790,000, which is really no increase at all. I submit that my leader, the hon. member for Rosetown-Biggar (Mr. Coldwell), was perfectly right in saying that, in effect, a retreat is taking place compared with the hope and enthusiasm with which this house and the country greeted the announcement of the Prime Minister in May of last year.

Lest the Minister of National Health and Welfare or the other members of the government think our criticism of the government for its delay is just the carping criticism of political opponents, may I call the attention of the government to an analysis of the situation recently made by Dr. Harry M. Cassidy, director of the school of social work at the university of Toronto. The minister will admit that Dr. Cassidy is an authority on this matter. Recently he contributed an article to the twenty-fifth anniversary edition of Canadian Welfare, entitled "Partnership Possibilities".

In this article Dr. Cassidy points out that there is a broad agreement in Canada that health insurance and an over-all social security program should be instituted. He admits that a difficulty arises out of the controversy between the provinces of Ontario and Quebec on the one hand and the dominion .government on the other, dating back to the dominion-provincial conference of 1945-46. There is no doubt as to the acuteness of that controversy; for it is still being carried on here on the floor of the house, and is still being used as the reason why progress is not being made. Dr. Cassidy says, however, that it begins to look as if the offer made in 1945 was in the nature of an appeal to the people of Canada that could be used as bait to try to persuade (a) the provinces to sign the required

tax agreements, and (b) the people of Canada to keep voting for the Liberal party.

This is what Dr. Cassidy says:

Moreover, it has been argued, the social security portion of the 1945 plan was attractive to the people of all Canada. It was, therefore, bait to lure the dissenting provinces to swallow the less popular tax provisions. Hence it would be politically unwise for the dominion to give up the bargaining powers implicit in its social security offer by proceeding to make it available to those provinces which did not accept the tax proposals as well as those which did.

Continuing from that point, Dr. Cassidy deals with the obstacles to which reference has been made in public discussions on this question of health insurance and an over-all social insurance program. In the main, he finds that there are four obstacles, and he deals with them briefly. I shall do likewise, pointing to the key sentences in each of Professor Cassidy's sections.

In the first place, he finds that health and other welfare services were originally regarded as provincial responsibilities, and that it is regarded by some as a new idea to have that cost transferred to federal shoulders. But Dr. Cassidy points out that this kind of shift has been taking place throughout the years; perhaps it has been imperceptible, but it is none the less real. He says, for example, that in 1913 the federal share of all the money being spent by the three levels of government on health and welfare was only 17-4 per cent. By 1940 it had risen to 36-2 per cent, and by 1947 to 76 per cent. This includes all the various forms of health and welfare expenditures in which the various governments are involved. Whatever the constitutional division may be, the fact is that the federal government is now paying the lion's share of the money that is being spent on health and welfare. Dr. Cassidy says that that trend should be pursued.

The next argument with which he deals is the argument we hear so often about the written constitution. He says, in effect, that the written constitution is much less of a barrier than is sometimes claimed. He puts it this way:

Everything else-

That is, everything else but actual contributory insurance.

-proposed by the council as appropriate for the dominion-

That is, the Canadian welfare council.

-as appropriate for the dominion could be done, quite legally, by means of grants-in-aid or other co-operative devices, with administration largely decentralized to the provinces.

He goes on:

Admittedly the barrier gainst the desirable social insurance legislation is very important. But this is one which might well be removed by constitutional

amendment, just as was done in the case of unemployment insurance in 1940. There is good reason to believe that all of the provinces except Quebec would not object to such an amendment to the B.N.A. Act; and that perhaps Quebec, too, would agree if the issue were diplomatically posed. At the least, the provinces should be asked their views on such an amendment before hope of it is given up.

An authority such as Dr. Cassidy suggests that the provinces should be asked for their views on an amendment to the British North America Act for this purpose; yet when I asked the Prime Minister the same question the other day, his answer, as it appears at page 1302 of Hansard, was to the effect that the government was given a negative answer back in 1945-46 and was not going to put the question to those same provinces again. That is indeed a strange attitude to take.

The third point made by Dr. Cassidy is that something could be done to work out a complete pattern of health insurance and social security within the framework of the constitution, making it available to those provinces that wish to accept it. I quote from Dr. Cassidy's article as follows:

The dominion plan of 1945 called for no constitutional change whatsoever, although it was open to a variety of objections. But it is very probable that a better scheme than the federal plan of 1945 can be worked out within the limits of the present constitution.

I ask the Minister of National Health and Welfare to consider an authoritative judgment such as this. To continue:

For example, the dominion might pass contributory social insurance legislation to become effective only in those provinces which adopt enabling legislation-with provisions for complete dominion administration, for provincial administration, or for co-operative administration. In this case the legislation would become effective across the country as rapidly as the various provinces agreed to take advantage of it, as happened in the case of old age pensions. Much more ingenuity is needed at Ottawa to explore what can be done within the terms of the B.N.A. Act.

That is what the people of this country are asking for-not that the two old parties carry on a running battle in this house as to how little they can do within the constitution, but that they use a little ingenuity to see what can be done within the framework of that constitution to meet the needs of the people of this country.

I come now to the final argument.

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LIB

Paul Joseph James Martin (Minister of National Health and Welfare)

Liberal

Mr. Martin:

Would my hon. friend be interested in knowing that Dr. Cassidy, to whom he has made reference, was in continuous consultation, if I may say so, with me and the department on this very question? Only last week he and I discussed this and other matters in a friendly way. He and I are not far at variance.

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CCF

Stanley Howard Knowles (Whip of the Co-operative Commonwealth Federation)

Co-operative Commonwealth Federation (C.C.F.)

Mr. Knowles:

If the Minister of National Health and Welfare and Dr. Cassidy are not

National Health Insurance far at variance, and since these are Dr. Cassidy's ideas that I am giving, he must agree with him in these arguments.

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LIB

Paul Joseph James Martin (Minister of National Health and Welfare)

Liberal

Mr. Martin:

Your interpretation is different.

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CCF

Stanley Howard Knowles (Whip of the Co-operative Commonwealth Federation)

Co-operative Commonwealth Federation (C.C.F.)

Mr. Knowles:

The minister says he does not like my interpretation, but what I have been saying over the last ten or fifteen minutes has been largely by way of direct quotations from Dr. Cassidy's article.

I come now to the fourth and final barrier that Dr. Cassidy finds standing in the way of progress in the matter of health insurance and over-all social security. He says that the final barrier seems to be a political one, and points out that:

. . . the political arguments against unilateral action by the dominion on social security seem to the writer-

That is my hon. friend's friend, Dr. Cassidy. -to have been given far more weight in Ottawa circles than they deserve. One of them, that the dominion should not surrender a bargaining point to use against the province in connection with taxation issues, has been disregarded already by the decision to offer the health grants in 1948. The other main one, that the dominion cannot risk heavy commitments towards social security without certainty of tax revenues and provincial co-operation on anti-depression policy, is understandable, but surely open to question. For if depression strikes again, will the provinces not look to Ottawa for fiscal assistance and leadership, as they did in the nineteen-thirties?

Shades of those days!

And will they not generally welcome public investment and other anti-depression schemes which only the dominion can properly initiate and co-ordinate? Finally, why should the dominion not take some risk on social security finances, when there are many other elements of risk in the total financial policy which cannot possibly be avoided by present policies?

Dr. Cassidy goes on to say this-and here is the crux of the matter as we in this group see it and as many people in the country see it:

The conclusion emerges that the dominion-provincial relations controversy-

Even the controversy we have on the floor of this house.

-is far less of a barrier to national social security policy than is commonly supposed. The difficulty is fundamentally political rather than constitutional.

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?

An hon. Member:

Does the minister agree with that?

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LIB
CCF

Stanley Howard Knowles (Whip of the Co-operative Commonwealth Federation)

Co-operative Commonwealth Federation (C.C.F.)

Mr. Knowles:

Yes; the minister agrees that the difficulty is fundamentally political rather than constitutional.

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LIB

Paul Joseph James Martin (Minister of National Health and Welfare)

Liberal

Mr. Martin:

But the constitutional difficulty is still there; and the reason it is still there is as a result of political factors.

National Health Insurance

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CCF

Stanley Howard Knowles (Whip of the Co-operative Commonwealth Federation)

Co-operative Commonwealth Federation (C.C.F.)

Mr. Knowles:

All right. Now that the minister has agreed with that statement by Dr. Cassidy, that the fundamental problem is political rather than constitutional, there comes this next sentence-and I presume the minister will agree with it as well:

A dominion government which was firmly committed to prompt action on social security could almost certainly do much to achieve results.

Dr. Cassidy goes on to point out that in fact what the dominion government is doing is using its proposals for health insurance and social security as bait on two counts: trying on the one hand to lure the provinces into signing tax agreements, and trying on the other hand to lure the people of Canada to keep on voting Liberal. But the bait has not worked throughout the country with respect to the one point, and some of us doubt whether it will work with respect to the other either. Dr. Cassidy goes on to say:

it-

The government.

-could proceed immediately, for example, to build a national program of public assistance and public medical care and to deal with the transient problem by means of conditional grants-in-aid. It could explore carefully, as has not yet been done-

I have said that and complained about it, but this is Dr. Cassidy complaining about it.

It could explore carefully, as has not yet been done, the problem of constitutional amendment for contributory social insurance.

So he goes on; and having shown that the problem is fundamentally political rather than constitutional, his concluding paragraph is an appeal to the government to separate these matters one from the other and to deal with one thing at a time. He says that if you tie the whole field of social security into an argument over the fiscal responsibilities of the dominion and the provinces, and if you tie it in with the whole question of dominion-provincial relations, you will never get anywhere. All of us in this house or those looking upon this house know that to be a fact. We have had, ever since this session opened, constant warfare between the two old parties, mixing these things all together. Dr. Cassidy says that one should be taken at a time. A government or party firmly committed to prompt action could separate the question of health insurance and social security from dominion-provincial relations, from fiscal responsibility and these other legal matters, and thus give a lead to the people and get something done.

Last night the minister said something about not wanting to get ahead of the wishes and desires of the people. The people want over-all social security and health insurance; and they want, not the kind of government

that comes along thirty years behind, but a government that gives them a lead. I appeal to the government, in the terms of the treatise on this subject by Dr. Cassidy, that they lose no more time but give a lead and get something done about these important matters of health insurance and over-all social security.

Motion agreed to and the house went into committee, Mr. Golding in the chair.

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April 6, 1949