Planification et partenariat dans le domaine des soins de santé, de l’environnement et de l’économie

Good morning.

Thank you, David, for that kind introduction.  Let me begin by saying how pleased I am to have the opportunity to speak here at the Woodrow Wilson Centre, and that you’ve come out today. I’m looking forward to your questions after my speech.

I’ll first talk about the battle for health care reform and dispel some myths about Canadian health care. Then I’ll say a few words about how health care reform will help economic recovery, and about working together to strengthen health.

Now – I didn’t come here to urge you to adopt Canada’s health care system. A good health care system reflects a country’s values, and each country’s values are different. In Canada our system embodies our values of equity, fairness and shared responsibility.  Yours has to be a “Made in America” health care system, one that shares your values.

It’s up to you to decide if that means President Obama’s plan for reform or a single-payer system like Bill HR 1200, currently before Congress, or a Kennedy-Bacchus Senate bill or another altogether.

What’s certain is this: America is shaping up for a fight on a health care – and it’s going to be tough. I know because in Canada my party has been there – we fought the long battle and we won.  We know: Health care reform is worth the fight.

Sixty years ago Canadians families were on their own to pay doctor and hospital bills. Those with the money got the medical attention they needed, but those without struggled. Some sold their farms, or re-mortgaged their homes, and still others went without care, suffered, and even died because they didn’t have the money.

Sound familiar?

One of my predecessors as leader of the New Democrats, a man named Tommy Douglas, knew that this was wrong. That this ran counter to the values of Canadians.  To correct this injustice Tommy and my party set out a vision in which everyone received the health care they needed regardless of their income.  And so, in 1947 in the prairie province of Saskatchewan, Tommy tabled the first piece of legislation that set us on the path to universal health insurance in Canada.  And while many take it for granted today, Tommy and his supporters fought a decades-long battle to usher-in Canadian Medicare.

There were opponents every step of the way.  Sometimes it was small business, other times it was the big corporations. Sometimes it was the patient groups, other times it was the doctor groups.

In 1961 when Tommy and my party launched Canada’s first public health care program in Saskatchewan, those vested interests responded with fury –  doctors even went on strike! In attempt to block change, those doctors left sick women, men and children without care. Leaving communities in desperate and dire need. But the hard-working women and men of Saskatchewan knew what was right. After just three weeks, under sustained public pressure, the doctors strike collapsed.

For the first time, health care was a right and not a privilege. For the first time, accidents and illness wouldn’t condemn families to poverty. For the first time, the health of Canadian families was put before profits, and by 1984 the Canada Health Act secured a national public health care system that has since become part of our Canadian identity. That’s because it reflects our values of equality and shared responsibility, but also because the Canadian health care system works.

This Easter I had both knees operated on. I saw a doctor of my choice, quickly got an MRI and just a few short weeks later – it was elective surgery – I had the operation and was on the mend. My credit card stayed in my wallet – I just had to show my Canadian Medicare card.

So take it from me – Public health care was worth the fight, and for Canadians, it’s worth fighting to keep it strong. Americans should know that when the battle begins here in earnest once again. It’ll be dirty, it’ll get nasty and victory isn’t certain.

The battle lines have already been drawn.  President Obama has thrown down the gauntlet and put a viable plan on the table – one that will cover the 46 million Americans without health insurance, and stop medical bills from being the most common source of bankruptcy in America. His grassroots campaign begins in earnest in just three days, and people across America are filled with hope that change will come.

But progressive leaders and the American people will need to be united in their resolve, because the forces of the vested interests are gathering against change that’s in the public interest. And they’re sowing the seeds of fear with myths and lies about Canadian health care.

Here’s the truth: Canada and the US spend about the same on public health care – around 7% of GDP according to the OECD. But in Canada public health care covers everyone and in the States it covers just one third of the population. In fact, when you add in the costs of private care, Canada spends 10% of GDP on health care and the US spends 16%. That’s $2,500 less per capita – and in Canada everyone is covered!

Canada does well on quality of care, too. Maybe you’ve seen those TV ads with Canadian private care promoter Dr Brian Day saying – quote – “patients are dying as they wait for care in Canada”. That’s simply not the case. In fact – half of acute care patients are seen within 6 minutes in emergency. And for much elective surgery, like knee and hip replacements in Ontario, there are no longer wait lists. Wait times don’t go away in a private system, but they are reduced by better practices like surgeons working in teams, as programs in many provinces have proved.

The truth is that Canadian health outcomes are excellent. The public data is very clear: From infant mortality to healthy life expectancy to injury recovery, Canada outperforms the United States. Satisfaction rates are high too – 85% of Canadians are “very” or “somewhat satisfied” with the service they receive.

Our system is founded on equality. That equality ensures everyone receives good health care, and good care in turn means a better chance in life, it means more equality and opportunity in Canada. What the advocates of for-profit health care in Canada are doing is putting wealth before the health of their patients.  You know, when the admitting nurse checks your credit card balance before your pulse, you’re as far away from patient-centred care as you can get. And to the vast majority of Canadians, that’s simply not fair.

The Canadian health care system isn’t perfect, but it works. And today America desperately needs a health care system that works here, too. I believe that with resolve, united purpose and bold vision what you’ll get it. You will – finally – have a health care system that shares the best of your values. A public health care system that works for the American people.

Spending on health care is good for the economy – it’s a win-win. Right now, the Canadian health care system gives businesses a competitive advantage. In the United States, health care is so costly that companies are being forced to choose between shareholder returns and care for their employees.

General Motors USA spends $10,000 every minute on health care. That’s $5 billion a year. It costs General Motors Canada $8 less per hour per employee to do business simply because Canada has a public health care system. Health care costs in the United States have contributed to the crippling of the auto sector, and reducing health care costs through the economy will boost the American economy overall.

And that’s critical for Canada and America. Neither economy will recover alone. Total trade between our countries exceeded $560 billion in 2007. Trade across the Ambassador Bridge linking Detroit and Windsor is worth as much as America’s entire annual trade with Japan. That means we need each other for economic recovery. And investment in a strong public health care system is investment in economic growth. So for economic recovery to work, we need to invest in health care to create a better business environment.

In Canada, that means we need to fix legitimate problems, not use them to deride the system.  But Prime Minister Stephen Harper – think of him as Canada’s George W. Bush – refuses to take the necessary steps.

My party, the New Democrats, has a clear vision. We need a national prescription drug coverage program, because drugs are now the second biggest health care cost and yet 3.5 million Canadians have no coverage. We need more doctors and nurses, because 5 million Canadians still don’t have a family doctor.

The Romanow Report of the Health Care Royal Commission – our version of a Presidential Commission and the last such review undertaken in Canada – was resoundingly endorsed by thousands of Canadians. We need to implement its recommendations now. We need to finish Tommy Douglas’s work and put in place community and preventative care programs.

Part of prevention has to be ensuring a healthy environment, because greenhouse gas emissions aren’t just raising our sea levels – they’re endangering our health. Over 20,000 Canadians are dying each year from air pollution.

I know first-hand what it’s like to rush an asthmatic child to the emergency ward on a day when the air is thick with smog.  Nothing could have made clearer the need to reduce emissions, and New Democrats have taken the lead in Canada. Our legislation, passed by the House of Commons, sets science-based hard targets for reducing greenhouse gas emissions with the long-term goal of reducing emissions to 80% below 1990 levels by 2050.

Those targets would put Canada in a leading position for the climate change talks in Copenhagen, but our Conservative Prime Minister refuses to support them. It’s my hope that the similar targets set out by President Obama will put pressure on Prime Minister Harper.

As Tommy Douglas once said “a nation's greatness lies not in the quantities of its goods but in the quality of its life." The bottom line is that a cleaner environment will take immense pressure off health care and deliver better quality of life in both our countries.

There is no doubt that strengthening of our system in Canada will be easier with better public health care in the United States. Just as Canada built a strong public health system through a united effort, and just as America must do the same, so too can we strengthen and reinforce the health of all our citizens through partnership.

Through partnership, we can make health care in both countries stronger. Together, we can build on world-leading medical innovation, on American efficiency in service delivery, and on Canada’s long experience with public care.

We’ll be on different paths to the same goal:  Quality health care for all our citizens.

Thank you, merci beaucoup.