April 4, 1957 (22nd Parliament, 5th Session)

PC

William Gourlay Blair

Progressive Conservative

Mr. Blair:

It is not our intention to hold up this bill in any way. We have been in agreement so far as the bill is concerned. At the resolution stage, I pointed out certain things with which we were not in agreement. However, we do welcome this bill and we want to see it in operation. It is not our purpose, therefore, to hold up the bill by prolonged discussion. I intend to repeat some of the matters with which we are not in agreement. One of these is the question of depreciation. At the resolution stage I pointed out that depreciation should be allowed as a cost of these hospitals. I am aware of a hospital which lately wrote off some of their depreciation costs and this became a debt. Once this bill is passed, as I pointed out at the resolution stage, it is going to be very difficult for the organizations concerned with hospitals to go out to the public and seek donations, or try to raise money by the various means used by hospital committees.

Health Insurance
It is very apparent, and has been for years, that there is a need for a bill of this kind. I cited figures at the time of the resolution stage showing the high cost of hospitalization. The cost per patient per day, as I indicated at that time, has gone up from $7 and some odd cents to $14 and $15, a cost that makes it imperative that some measure of relief should be given to people who find it necessary to go to hospital. Such a cost is beyond the means of the average person in this country. When there is added to the cost of a severe illness, laboratory fees and fees for special nurses and the like, the fees of the medical man or the surgeon, sickness becomes a terribly expensive proposition.
I do draw your attention again to the fact that depreciation costs are something which should receive consideration in this bill on account of the difficulty of raising money, because the public feeling will be that once this bill is put through the federal or the provincial government in some way will be responsible for hospitals.
Another thing I do want to point out is that we should make very clear that this is a hospital insurance bill. Since the time that the resolution was brought in I have heard it discussed as health insurance. This is a hospital insurance bill.
The other matter that I brought up at the resolution stage was the question of tuberculosis and mental patients. It is true that tuberculosis is being well taken care of at the present time. Indeed the lists are going down. The number of cases is rapidly being reduced, and we are coming to a position that has not been common for a good many years. It is possible to get a patient into a sanitarium because we are arriving at the place where beds are available. That is owing to the fact that the measures which have been taken by the provincial departments of health, especially in Ontario, are cutting down the incidence of this disease year by year. The mass surveys conducted by the province have done a great deal in the cutting down of tuberculosis; but at the same time, those people who remain in hospitals are still hospital patients; they are still afflicted with an illness, sometimes a long-term illness. They are sick people. The same thing applies to mental diseases. There are some other things that I wish to say, in a consideration of mental disease, while we are on this bill.
In the estimates committee last year the minister gave his reasons for not recognizing mental disease. He agreed to accept mental disease while the individuals were patients in hospitals; that is, in the psychiatric wards of general hospitals; but his argument from there on was that mental disease patients, if accepted under this plan, would raise the cost

so that it would more or less defeat the plan and raise the cost of the insurance to the person wishing to obtain it. I point out to you, sir, that we have a problem in mental disease in Canada that we will have to cope with some place somehow. I do not like the fact that mental disease is not recognized because I feel it is a backward step. It is a backward step for this reason. Mental disease may occur just as you may have pneumonia or any other disease in the categories of diseases that are treated in hospitals at the present time.
The very fact that the statistics of Canada show there must be something done about this beyond the amounts that are given in the health grants for certain clinics and research proves my point. The number of people, as I pointed out the other day, suffering in mental hospitals is 10,000 more than the people who are occupying beds in all the other general hospitals put together. Something has to be done about this.
There was one bright spot brought out the other day. I noticed in statistics issued about a week ago that there were some signs of a letting-up of mental disease in Canada. We hope the percentages shown there will continue to grow, and that we may feel we are adequately dealing with this disease. We require more than what is laid down in the health grants for the treatment of mental disease.
I am sorry that some place in this bill the minister cannot go a step farther and give further financial help to the mental hospitals. It would be of great assistance. We need something more than the fact that under this scheme, when they are patients in general hospitals in this country, they qualify.
It is true that this bill is only the beginning. From time to time certain changes will be made in this legislation. I think that certain conditions laid down in the legislation at the present time may even have to be changed by legislation in the future. But in discussing this hospital situation, there is one point that I wish to bring to the attention of the minister. He did not say it the other day when he was speaking on the resolution but I have noted his remarks in the press. I have read his speeches and I have heard him say that the health grants were responsible for the addition of 70,000 beds in Canada. May I say to the minister again, as I have said on previous occasions, and for the benefit of the committee, we ought to look at it in this way. Suppose we were building a hospital in the Ottawa valley-and I think the cost would run around $12,000 per bed-under the health grants the dominion government would give $1,000 for each new bed

and the province would give a matching grant. The donation of the federal government would be $1,000. If you took the $1,000 that is added by the province, and if the cost of the hospital bed in this year would be $12,000, it would leave $10,000. That money would have to be put up either by the municipality or by the various organizations interested in building hospital beds.
I feel very jealous on behalf of those people who have worked and are working to produce the $10,000. Therefore I think it is not altogether fair to say that the program has been responsible for 70,000 hospital beds. It is helping. Certainly, the assurance of $1,000 by the federal government and $1,000 by the provincial government is an incentive, but it is a long way from producing the 70,000 hospital beds.
The hon. member for Winnipeg North Centre spoke of this as an election argument. I have said before in this house that in dealing with health I hope this matter will never become a political football. One must realize that every party in this house has been committed to some form of health or hospital insurance, and has been saying it over the years. I do not know how many speeches I have made on behalf of this party-the minister will agree with this-asking that something like this be done. I hope that when we go to the country we will not have any supporter of the government, any cabinet minister or anyone else, spreading his chest and saying, "I brought in health insurance". We have been asking for it; we want it. We are not going to delay this bill in spite of the fact we do think it has imperfections. We are going to vote for this bill. We want it passed and we want it passed as soon as possible.
The other day I brought in an amendment regarding the required six provinces and a majority of the people. The amendment was thrown out; it was not in order. We did express our opinion at that time regarding the number of provinces necessary to bring this bill into effect.
If this bill is necessary at the present time, if it is going to help people, let there be as little delay as possible. Again I point out it is not necessary to have the six provinces, or a majority of the people agreeing to it to bring it into effect.
Under these conditions the sooner we get this bill into operation in any province the better it will be. It is possible that when the bill is being discussed in the house we will make suggestions from time to time but we want to see this bill passed and the plan put in operation as soon as possible.
Health Insurance

Topic:   HEALTH INSURANCE
Subtopic:   AUTHORIZATION OF PAYMENTS FROM CONSOLIDATED REVENUE FUND
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