SPER Committee Meeting

37th PARLIAMENT, 2nd SESSION

Subcommittee on the Status of Persons with Disabilities of the Standing Committee on Human Resources Development and the Status of Persons with Disabilities

EVIDENCE

CONTENTS

Wednesday, February 5, 2003

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1545

The Chair (Ms. Carolyn Bennett (St. Paul's, Lib.))

Ms. Sherri Torjman (Vice-President, Caledon Institute of Social Policy)

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1555

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1600

The Chair

Mr. Michael Mendelson (Policy Analyst, Caledon Institute of Social Policy)

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1610

The Chair

Prof. Michael Prince (Lansdowne Professor of Social Policy, Faculty of Human and Social Development, University of Victoria)

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1620

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The Chair

Ms. Sally Kimpson (As Individual)

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1635

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1645

The Chair

Mr. Reed Elley (Nanaimo—Cowichan, Canadian Alliance)

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Mr. Michael Mendelson

Mr. Reed Elley

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1655

Ms. Sherri Torjman

Prof. Michael Prince

The Chair

Ms. Madeleine Dalphond-Guiral (Laval Centre, BQ)

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Ms. Sherri Torjman

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1705

Sally Kimpson

Mr. Michael Mendelson

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1710

Ms. Madeleine Dalphond-Guiral

Mr. Michael Mendelson

Michael Prince

The Chair

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1715

Ms. Sherri Torjman

The Chair

Ms. Sherri Torjman

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1720

Mr. Michael Mendelson

Mr. Reed Elley

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Sally Kimpson

Mr. Reed Elley

Sally Kimpson

The Chair

Sally Kimpson

Michael Prince

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1730

The Chair

Mr. Michael Mendelson

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1735

Ms. Sherri Torjman

The Chair

Ms. Madeleine Dalphond-Guiral

La présidente

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CANADA

Subcommittee on the Status of Persons with Disabilities of the Standing Committee on Human Resources Development and the Status of Persons with Disabilities

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NUMBER 005

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2nd SESSION

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37th PARLIAMENT

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EVIDENCE

Wednesday, February 5, 2003

[Recorded by Electronic Apparatus]

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[English]

    The Chair (Ms. Carolyn Bennett (St. Paul's, Lib.)): Welcome.

    I've been apologizing on behalf of my Liberal colleagues who are either sick, at another committee, or whatever. We've been a bit devastated in the Liberal ranks for this. As all of you know, the reason our tiny perfect committee has done so well is we've never accepted conscripts sent by the “way up”. We only take passionate volunteers. We hope we will proceed on a recruitment process for passionate volunteers, as well as hope that the sick members will get better—

    An hon. member: And we won't get sick.

    The Chair: —and we won't get sick ourselves.

    Also, we may have to talk about changing the time of the meeting. Aboriginal affairs is meeting five days a week, night and day. There's a bunch of stuff going down that's nuts, right?

    An hon. member: It's too much.

    The Chair: Yes.

    Our tiny, perfect committee is tinier today but still perfect, and the witnesses are perfect as well. We're always thrilled to have the kind of expertise that's represented this afternoon, in that it makes our life so much easier to have serious people who care desperately about this issue and can be objective and honest about what's working and not working in the system. We thank you for coming.

    I guess we start with Sherri.

    Ms. Sherri Torjman (Vice-President, Caledon Institute of Social Policy): Thank you very much, Madam Chair. I also wanted to thank the tiny, perfect committee for the invitation to present here today.

    I have to actually commend you, because you have opened up your consultations to Canadians through a web-based process, which I believe is actually quite unique in the country and is setting a precedent. I'm sure it hasn't at all been easy to do this. You've faced many barriers, and you actually have to figure out a lot of the procedures, so I congratulate you on that process.

    Through that process, I think you're going to hear a lot about the Canada Pension Plan. Clearly, you've opened up the door or window of opportunity. So you will likely hear many, many things about the program that are probably quite negative, such as difficulties people have experienced with the program, including applicants, beneficiaries, or people making referrals to the program. That's to be expected, because you have in fact asked for comments and asked people to tell you what's going on in their lives.

    I guess what I want to say is that while I think it's so important we're all here with our concerns and expectation of improving the program, I would hope that any of the concerns raised are not taken to be justification at the end of the day for withdrawal, dismantling, or making the program or its beneficiaries worse off. I just want to say this because we've seen it in other processes. We and many other people across the country have come in good faith, in the hope we will improve circumstances for people who are disabled. I think a bottom line of any of your work should be to seek that improvement.

    I understand we've been asked to talk about income security and the Canada Pension Plan today. I'm pleased to be able to do this. I just wanted to put forward a few concepts before going into some of the specifics.

    It is important to understand the major concept of income security as distinct from disability support. I know you have had many discussions about disability support. These two areas are intrinsically linked in the real world; in other words, if you have disability support, you have access that enables you to earn an income. Similarly, if you have adequate income, you're able to purchase disability support.

    But we're looking right now at the income security system and its adequacy, because there are a number of questions in and of themselves that have to be resolved relative to income security. Do current programs enable people to pay for basic needs? Can they pay for housing, food, clothing, and utilities, and are they adequate and efficient? Then if we look at other needs, or the additional cost of disability, we try to deal with them in another way.

    So conceptually, what we're dealing with today is this income security system. There are a few major building blocks to the system. I want to say I use the word “system” advisedly; it's an undeserved compliment in the sense that it doesn't really work as a system. There are many different pieces to it that don't work together, as you know. Primarily it's because your eligibility is based mainly on the cause of your disability. So you may have the same level of functioning as somebody else, but you receive an entirely different level and set of benefits, and you're living under entirely different circumstances because of the cause of your disability.

    In this country, we primarily have a set of insurances and a few additional programs in the disability field. Insurances mean you are making contributions to a program and you are expecting that when the contingency occurs from which you are protecting yourself, you will have access to that program. That's the assumption of an insurance program. I think it's really important to understand that the major building blocks in the country are insurances. If we're going to be moving to any different kind of approach in disability income, we have to think of the implications of what it means to move away from that insurance foundation or insurance base.

    Basically, we have workers' compensation, which provides insurance in the event of a work-related injury or illness. There is employment insurance, which provides short-term protection in the event of an interruption from short-term disability, illness, or unemployment. We have long-term protection from the Canada Pension Plan disability benefit, which provides protection or income in the event of a long-term interruption of earnings from retirement, disability, or death. Then we have a whole set of private insurances. There's also automobile insurance in several provinces, such as Ontario, Saskatchewan, Manitoba, and B.C. Quebec also has a complete no-fault program.

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    There are other categorical programs like veterans benefits and criminal injuries compensation. But anybody who doesn't qualify for any of those then ends up on provincial social assistance. The rules vary widely, but generally speaking they are very tight programs and don't provide very much income, as you know.

    What concerns us today is the disability benefit under the Canada Pension Plan. That's what we're looking at. It's important to consider some of the possibilities for short-term immediate reform within that system because if we use that as the vehicle, it will lead the way to greater reform of income security.

    What are some of the concerns? I'm sure you've been hearing about them already. They have to do with adequacy, eligibility, work-related components, and the appeal system.

    If we look at adequacy, this is a disability benefit that provides a limited amount of income a month. It's in the order of $971 in 2003--that's the maximum amount. It's important to look at the average because it's actually much less than that. It's in the range of $700 and something a month for 2002, which is our latest figure. That is well below poverty figures.

    One of the concerns--and I guess we have to understand this from an historical perspective--is that when the Canada Pension Plan was first introduced, it really focused on the retirement component. It was not intended to be the only benefit to which people were entitled; it was meant to be a step or one tier in a set of tiers. So the benefit that was provided was never meant to be an entire income, in and of itself. It was to fit together with other pieces.

    But with the Canada Pension Plan disability benefit, in most cases it's the only income to which people have access, if indeed they qualify, and that's the next big issue. “If indeed they qualify” is the operative term here.

    There are two major eligibility screens for the Canada Pension Plan disability benefit, one of which is the contributions you've made. You must have contributed in four out of six years. That is an expansion from what it used to be. It was extended in 1998.

    The second screen is that it must be a severe and prolonged disability that regularly interferes with your ability for any gainful occupation. That is an extremely tight standard. It means you must have a disability that is very severe, and for all intents and purposes you're not able to work.

    The problem with that definition is that it has been inconsistently applied across the country. Some people who have applied with certain conditions or abilities have qualified for the Canada Pension Plan disability benefit, while other people with similar circumstances have been denied. So there's the whole question of how this severity criterion is being interpreted under the act.

    One of the really interesting things for the committee to look at is that some rulings on appeals in recent years have questioned the way the severity criterion has been interpreted by the administrative procedures. In some cases the rulings have said, this is fine; we've always intended to have a very narrow program. In other rulings that have been quite substantial, they have pointed out that the intent of the program was never to be so narrow, and socio-economic factors should be taken into account in understanding what severity is.

    I'll come back to some of the remedies in a minute, but I just want to highlight some of the major concerns that people are expressing.

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    A third one has to do with work ability. It's not easy to work under the Canada Pension Plan disability benefit; in fact, you're not supposed to be able to work if you qualify. It's a bit difficult to say you're able to do some work to supplement your income. It's only recently that the program has begun to ease up in this area and give people some vocational assistance to see if they're able to make some extra earnings that will help them. It has been a real conundrum for people, and many do not want to even go on vocational rehabilitation because they fear it will disqualify them. If they are disqualified, then there's nothing else other than social assistance.

    These are some of the areas that have to be looked at. It's really important that with changing technology and changing medications, many people are able to work. But the Canada Pension Plan operates on the basis of a world that's very black and white. The world is grey right now. We really need to have a program that is far more flexible and far more able to meet a whole range of needs.

    This applies not only to the disability benefit. In fact, partial benefits should be looked at as a general issue within our retirement income system. How we deal with that is a real concern.

    What can we do? What are some of the proposals for reform in both the short term and the long term? In the short term, we want to look at adequacy of the benefit. Is it paying an adequate benefit? It is indexed on a regular basis, which is more than you can say for some other benefits, but its adequacy should be reviewed.

    The issue of eligibility certainly has to be considered, whether four out of six years is too long for some people, and definitely the severity criterion has to in some way be made far more consistent.

    There are many ways of doing this, but if somebody who had a certain condition applied to the program, you might want to say they would automatically qualify if you knew very clearly the trajectory of that condition. I'm thinking of someone with ALS, and you would certainly be able to name a number of other areas where you know that person would likely be unable to work over an extended period of time. There are ways we can actually facilitate the eligibility process.

    Another area is to provide far more vocational rehabilitation at a far earlier stage. We need to recognize that people should be supported in working where possible, but they have to be enabled back into the program if things are not working out.

    Another aspect to examine is whether it's possible to have a variable benefit, so if people were able to raise their levels of earnings the benefit might drop somewhat, but at the end of the day they would be better off. We can't do this right now under the Canada Pension Plan disability benefit. It is a flat-rate amount. It's up to a certain amount and you either get it or you don't. It is not a variable amount that depends on the earnings you might have. It's something to think about, although it does change somewhat the whole structure of the plan. Some serious thought would have to be given before we would move in that direction.

    Another possibility for improving the current circumstances would be to integrate some of the assessment components. We have all these plans all over the place, and everybody is assessing and duplicating that intake procedure. I think we could go a lot further if we had a far more consolidated intake procedure and earlier vocational rehabilitation.

    Finally, there's a whole range of areas in which we could improve the appeal procedures. There's some interesting work going on in Quebec around mediation, conciliation, and trying to work out disputes around the plan before it actually goes to an expensive, difficult, and exhausting legal process.

    In the long term, what would you do if you wanted to have a far more comprehensive income security system? There have been many proposals for reform, but one of the areas where you could move in the near future if you wanted to do that would not be specifically around the Canada Pension Plan right away. It would be around moving people off social assistance, trying to ensure they had some adequate income.

    It doesn't make sense that people who are disabled have to be on welfare for the rest of their lives. Welfare was never intended to provide an income benefit on a long-term basis. It's a last-resort short-term benefit. So that's one of the areas where I would move right away.

    The other is to work on CPP in an incremental way, but move toward the broader reforms through income testing, partial benefits, and the provision of vocational rehabilitation. That will ultimately move you along the road to a far more comprehensive view.

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    Finally, here's where I get back to my first point. You must look at the issue of disability supports at the same time, which I know you have, and consider how the two might fit together. At the end of the day, you might make a lot of progress on the income front by working on the disability supports front and ensuring you have a good solid system in place. So I think there's a lot that can be done right away, and there's a lot of thinking that can be done about what can be done in future.

    But fundamentally, what's really important is that before we change profoundly the Canada Pension Plan disability benefit, we really have to have some serious dialogue in the country as to whether we want to remove the insurance part of the protections that the benefit provides. It was a hard-won program, which parliamentarians fought very, very hard for, and provides a protection most Canadians would not otherwise have. So before we make a fundamental change to it, I would work on gradual improvements, to move it along and modernize it, ultimately integrating it with some of the reforms we make on the social assistance side. This is a realistic way of having some fundamental reform to the system.

    Thanks.

    The Chair: Thanks very much, Sherri.

    Michael Mendelson.

    Mr. Michael Mendelson (Policy Analyst, Caledon Institute of Social Policy): Thank you for the invitation. I am very pleased to be here. I hate speaking after Sherri, as I do all too often, but it seems to be my role. Somebody has to provide a contrast to her articulate capacity.

    I did your web-based poll, by the way. It is very good, though I hope I didn't skew your results.

    Some hon. members: Oh, oh!

    Mr. Michael Mendelson: But it is very good.

    A voice: How many times did you do it?

    Mr. Michael Mendelson: I only did it about half a dozen times, because I didn't get it right the first time. But it is very good, and my compliments to the committee. I think you've really opened up a new element for Canadians, and it is just a beginning. There is incredible potential for your committee, and I hope others will take your lead.

    I want to do something a little bit different. When I thought about coming here, I considered either addressing some of the specifics you're involved in or trying to take a step back and talking about a bigger picture. Seeing that I'm going to be here just this once, I'll try to take a step back and talk about a bigger picture.

    I looked at some of the issues you've been working on and have discussed. My compliments to you, as I think the committee has done great work.

    I think there's no question that addressing some of the specific fine-tuning—if I can call it that, and some of it isn't that fine, but maybe is just tuning instead—of the CPP disability benefit is possible. Improvements are possible, which I suspect there are going to be along the way.

    But I want to ask the question today about whether some of the kinds of problems you've been addressing, and trying to cope and deal with and come up with solid recommendations for, are endemic to this type of program. Once you solve a set of them, and do some better fine-tuning, are others are going to pop up again?

    What do I mean by this type of program? Well, at its heart, the Canada Pension Plan disability is a kind of program working by binary categorization. By this I mean you set up a fence. On the one side of the fence are the people who are entitled to the program, who acquire the label of being disabled or of having a certain kind of disability; and on the other side of the fence are those who don't manage to make it through that barrier. We know that people don't come in categories, which is something Sherri mentioned. We know that people come in spectrums, if we can call it that. These are not even one-dimensional spectrums, but very complicated multi-dimensional ones.

    We've changed our language about disability over the years. We now use language referring to a person with disability. We don't talk about disabled persons anymore. The question I have for the committee, and I suppose beyond the committee, is whether this language is just being politically correct and polite or whether it also has programmatic meaning. Do we actually mean there isn't such a thing as a disabled person? Could we think about the possibility of designing an income security system and a services support system that never uses the word “disability”, or at the very least doesn't require categorization of human beings as either disabled or not disabled?

    I think this is a very difficult question to ask. In the Anglo-American countries—Canada, the U.K., and the United States—we're in a world of categorical programs. Living in that world, it's almost impossible to imagine a world where we don't rely upon the definition of disability as a way of defining and allowing entry into a program.

    I'm told, and have heard in various meetings, about other countries like the Nordic countries, who would look at our programs and say, well, how do you define disability? They would have as much trouble seeing this world of categorical programs as we have in seeing the world of non-categorical programs. Where you live seems ordinary and natural, which makes it very difficult to see the alternative. But maybe there is an alternative.

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    The question I'd like to ask the committee to consider is whether the problems of fairness, of ongoing appeals, of inconsistency, of having to develop definitions whose meanings are questionable, whether all those are ultimately an unavoidable feature of any program that requires us to fit round people into square holes, if I can put it that way, to define some people as in and other people as out. Of course, the most important thing is, is there any alternative?

    I'm not going today to spell out an alternative. I just want to talk about some of what that might look like in sort of broadest parameters. I think the question we might want to ask as an alternative to CPPD disability is this question, a different question: should we have a Canada Pension Plan in which an earlier pre-retirement pension, so to speak, is available based on an assessment of individual circumstances and what would those circumstances be? This would be a question we would ask. It is a question that does not necessarily involve asking someone if they are two-legged or one-legged or no-legged? Are you a disabled person or are you a non-disabled person? It's a question that asks about the circumstances. What are the suitable circumstances? And that's a different kind of question.

    I've heard a few times a description of the system in the Netherlands. I don't know if you've heard the Netherlands' story. Have you had this pitched to you before or not? I'll tell it as I understand it and then if you ever have a person from the Netherlands he or she could say “No, no, they got it all wrong and this what we really do”. So let me tell you my interpretation.

    The Netherlands found itself in a world where they had a categorical program on disability--you were either disabled or not. They found their disability program was being used essentially as an early retirement program when economic circumstances were poor in the country. Sounds familiar. And enrolments were getting out of hand.

    So they thought through how to go about addressing this. They did away with the concept of categorization and substituted instead a much broader set of criteria in which they looked at the individual employability circumstances of a person. Essentially what they do is, when a person comes before them, they apply what I suppose I would call a cost-benefit criterion.

    It sounds sort of cold-blooded, but they asked whether there are two jobs in the geographically accessible area of the individual that the individual could either access.... It doesn't mean two empty jobs, by the way, but two jobs that exist. In other words, it doesn't have to be available employment, but two types of jobs that the person within the accessible geographic area could either have, do, or be trained on a cost-benefit basis to do. In other words, would it make sense to train that individual? If the answer is no--and there are some issues around age and so on--then the person may be entitled to an early retirement benefit.

    There are a few other circumstances as well. If the answer is yes, then the person might either be told, go and get a job and good-bye, or the person might be entitled to vocational rehabilitation or sometimes just plain training at the equivalent of a community college that would allow the person to access one of those jobs.

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    You've heard the different circumstances. If a computer programmer finds himself in a wheelchair at age 55, that doesn't affect his employability. A person who does not have good literacy and numeracy skills who has worked all his life as a construction labourer and is good at it and makes a good living but finds himself at age 55 in a wheelchair, that person is not likely going to be retrainable as a computer programmer and he is likely not going to be employable. Their disability is identical. In the Netherlands' kind of circumstances you don't judge the disability; you judge the individual circumstances.

    Now I'm not fully spelling out a program here, but what I'm asking the committee to consider is whether it's possible to think about a program, an income security system in Canada, that does not rely upon categorization of individuals.

    I'd like to add, if I have a moment, and I'm not sure if I've taken too long, that I'm much more concerned about categorization with respect to children, for the simple, pragmatic reasons of my belief--for which I think there's some evidence--that categorizing a child as disabled can be very negative on that child's aspirations and on his or her future. I think it's odious that we would put a family and a child into a circumstance where they have to choose between being labelled or not being able to eat or to access services. If we can do away with that, I think it would be a much more profound and important reform than the issue of disability in CPP.

    However, I think at heart both are the same fundamental question, and I'd urge the committee to think about the possibility of resolving the problem not by making the fine-tuning, if I can call it that--it's not all fine-tuning; some of it, like the substantive issue of the rates, is pretty big-tuning, I'd say--but also by considering whether or not some of the problems they are addressing are indeed structural and whether they can be addressed by looking at this major kind of change.

    The Chair: Thanks very much.

    Michael Prince.

    Prof. Michael Prince (Lansdowne Professor of Social Policy, Faculty of Human and Social Development, University of Victoria): Thank you, Madam Chair.

    I have a brief that I sent to the clerk. Has it been circulated? Thank you.

    I appreciate the opportunity to once again appear before the subcommittee. Along with my co-panellists, my purpose today is to try to assist in your massive undertaking, which I applaud you for taking on. I have also done the poll on the website, which I'd like to commend you for. It's very user-friendly, and a very clear exposition of issues facing the program, for which this committee wants answers. For the record, I only did it once.

    Some hon. members: Oh, oh!

    Prof. Michael Prince: There are so many issues and so many possibilities. What I wanted to do today was to provide more of a sense of your overall task in terms of a vision or values and to suggest some solutions or policy options to keep in mind as you embark on your hearings.

    My central message is that in addition to examining the CPP disability, I would urge the committee to also pay close attention to other existing income benefit programs and tax measures. My colleagues, and Sherri in particular, have nicely canvassed what those are and what some of the issues and connections are.

    I'd also ask you to consider looking even more boldly, farther afield and farther ahead, and to undertake considering recommending a new disability income benefit, or a refundable tax credit, and to link this with the national strategy on disability supports. I think a comprehensive approach like this is essential to your work to address the issues of categorization, which Michael has just spoken of, and the longstanding and well recognized fragmentation in the current systems of disability income and support. And if we really mean it, a comprehensive approach is essential to advancing the vision of full citizenship that has been expressed over the last five or six years in intergovernmental agreements, both by the Quebec government on its own and by the federal, provincial, and territorial governments, through the “In Unison” documents.

    I list for you some values I think are important. They're not the only ones, but I just put these forward for your consideration. They're values that echo the kinds of things we say when we talk about medicare and health care in this country, and they are no less important, no less relevant, or no less significant. In discussing children and adults with disabilities, we're talking about some of the most vulnerable, disadvantaged, and marginalized people in this country.

    As for solutions, you'll see that Sherri has already mentioned eligibility criteria with respect to the CPP disability benefit. You'll recall that the eligibility criteria were tightened up in 1998, which was the first and only time in the history of the program that eligibility was constricted. The history of the program since 1966 has been of successive measures by the federal government in concert with the provinces, including Quebec every single time, to liberalize and to enhance access to this much needed program. The exception to that history is 1998, which might be understandable in the context of the debate in 1996 or 1997 around the federal deficit. You'll recall that the planned seniors benefit for elderly benefit reforms was withdrawn at the same time by then Finance Minister Martin as budgetary conditions improved. However, the constriction on CPP disability went ahead. So although we did not go ahead with constricting elderly benefits on OAS, GIS, and the spousal allowance, we did for Canadians with disabilities under the CPP. It has been locked in ever since.

    But we know times have changed. We talk about surpluses and, as at Christmas time, we had visions dancing in our heads for the next several years. We may argue whether it's $30 billion, $60 billion, $50 billion, or $70 billion, but no one seems to dispute the fact we're looking at a future of surpluses.

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    I would suggest that if it was okay to pull the seniors benefit off the table, it's time to visit the constriction of the eligibility requirements and to return to the pre-1998 rules. And for the additional reason Sherri and Michael just referred to, this would better recognize the episodic and degenerative nature of some disabilities. It would provide a more flexible and realistic eligibility criterion.

    You've heard about the definitions of “severe” and “prolonged” in the legislation. The Federal Court of Canada, particularly in a decision two years ago in the Villani case, talked about a strict abstract approach versus a “real world approach” to determining severe and prolonged, and employability prospects. I think the intentions of Parliament in 1966, when Judy LaMarsh brought this legislation in, and the intention of Parliament today, in 2003, is a real world approach, not a strict abstract approach. We need to take into account labour market opportunities that vary across the country from city to city and from region to region, as we do in the EI program.

    Under CPP, we hold to this myth that labour markets are exactly the same everywhere and that individual circumstances, be they of the computer programmer or of the construction worker in the wheelchair, are exactly the same. We know they're not. So whatever other reforms you'd suggest, I think we need to ensure that one of the values guiding the reforms is that this and other programs have clear, coherent, and consistent eligibility criteria that respect the intentions of Parliament and the legislative assemblies of the provinces agreeing to this program.

    Let me move to talk briefly beyond the CPP disability program. There are many other reforms one can talk about, and I mentioned a few others in my brief. Sherri talked about the definitions of disability. I think it's fair to say, or I think the MPs in the room would agree, that perhaps disability is the topic, if not one of the top three topics, on which you get the most correspondence. I know that the Canada Customs and Revenue Agency sure get a hell of a lot of mail on this.

    One of the things that confuses ordinary Canadians is why they may qualify for one federal program under one definition of disability, but not under others. Now, as Michael said, it might be the categorical nature and different histories of all these programs, but that's not a terribly satisfactory answer for most Canadians. It's a very disenchanting and alienating answer.

    I know that HRDC is undertaking a review of these definitions across various federal programs and services. I would urge that this process become more transparent, more public, more accountable to this committee, and more participatory, so that groups are involved in it. I think this subcommittee should play a role in reviewing the exercise sometime over the next two to five years.

    Let me end with some bigger notions that will probably take you further down the road over the next three, five, or seven years. Sherri mapped out for you the existing disability income system in the country. I agree with Sherri that we should always put the word “system” in quotation marks, because it is a rather generous phrase to call it a system.

    You can compare the disability income system to, for example, the retirement income system in Canada and see what programs stack up under those two systems. If you do so, one thing among others that might strike you as quite dramatic off the top is that the disability income system is missing a vital building block, which the retirement income system has. On the retirement income side, we have a national public program—the guaranteed income supplement and the spousal allowance—that is indexed, funded by government revenues, and provides income support to low-income seniors. We do not have a comparable program under the disability income system. The risk is that we will expect the CPP disability to do too much, and try to twist it out of shape away from its social insurance base. In my opinion, I would say that would be a mistake.

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    However, what we do need is a national public program funded from government revenues and delivered through the income tax system in the form of a refundable tax credit. This could be based on replacing one or more of the existing federal tax credits and tax measures. In my view, it would be indexed and income tested and it would include a right to reviews by the revenue agency, as well as appeals—probably to the Office of the Commissioner of Review Tribunals.

    The model I'm thinking of here is comparable to the national child benefit strategy, because in concert with this new tax benefit would be an effort to move Canadians who are on disability off provincial and territorial social assistance programs. We should get them off welfare. They do not deserve to be there and shouldn't be there. So as the federal government invests additional funds, over a five-to-ten-year schedule, into this new Canada disability tax benefit, it would allow provinces and territories to reinvest moneys from the assistance into supports. So the federal government would play a role on the income support side, and the provinces and territories would have, as is their jurisdiction quite properly, responsibility for services and supports.

    The national child benefit strategy, with the Canada tax benefit and the reinvestment strategy, has been widely regarded as a successful collaboration between federal and provincial governments over the last five or six years.

    I think what I'm suggesting here is also consistent with the “In Unison” vision, addressing employment issues, income support, and disability support. I think it's consistent with the Social Union Framework Agreement. It would also help to expand the supply of disability supports and probably improve their quality, and it would support the mobility of Canadians moving within cities and within and across provinces and regions.

    So I think this national strategy could include a federal-provincial agreement, and we can go into details as to what that might look like. It ties in with what Sherri said so eloquently earlier, that when we look at the income side, we should not forget the support side and how these two interact. So I would urge the committee to look boldly, and to look at the long term as well as the short term, in the specifics.

    To conclude, Madam Chair, I think the CPP disability is an important program. It was a significant achievement of Canadians and federal-provincial governments in the 1960s. It's worth keeping, and doing so within the Canada Pension Plan. It needs some internal reforms, but perhaps even more importantly, it needs to be reinforced with other major changes.

    Thank you.

º  (1625)  

    The Chair: Thank you very much.

    Sally Kimpson.

    Ms. Sally Kimpson (As Individual): Thanks, Madam Chair.

    I really appreciate the opportunity to be here to speak about the lives of women with disabilities, especially with respect to CPP disability.

    I'm also here on behalf of Dr. Tanis Doe, with whom I conducted policy research in 1999 under the aegis of the Status of Women Canada. Our research looked at how the lives of women with disabilities could be improved through pension policies that responded to changing circumstances in their lives, such as fluctuating health and ability to work. I think you'll find that some of my comments intersect quite well with previous comments, so I'm glad of that.

    One unique aspect of our research is that both Dr. Doe and I are women with disabilities with experience in a variety of income support programs. We used that experience partly to design the research, but also as insight into the findings.

    I'd like to first provide a very short overview of the substantive inequality of women with disabilities in Canada. Then I'd like to present some of our policy recommendations.

    Historically, the CPP program was designed as an income replacement support to workers who were no longer able to work because of disability--primarily male household heads. Women continue to enter the workforce in increasing numbers and are now also eligible for CPP benefits. But because of persistent labour force inequities, the CPP disability program disproportionately benefits men in two important ways.

    First, there are significant gender differences in eligibility decisions, with 67% of men compared to 52% of women successfully meeting eligibility requirements. Second, there are significant gender differences in the benefit amount. These are 2000 figures. Men receive an average of $737 monthly, and women $625 monthly. In 2000, men's average monthly benefit was 80% of the maximum amount, which is $11,473, and women's was 68.1% of the maximum, which is $7,800 yearly. Women are also less likely than men to receive employer sponsored long-term disability benefits.

    Women with disabilities are among the poorest Canadians. The monthly CPP benefit income is more likely for women than for men to be their only source of income, beyond top-up by provincial disability income support. That, of course, varies from province to province.

    Throughout their life spans, women with disabilities have lower average incomes than non-disabled women and men with disabilities. Stats Canada figures from 1990 show that the incomes of women with disabilities, in both the 35 to 54 and 55 to 64 age ranges, were only about 55% of their male counterparts. That's in comparison to a 72.5% average of men's earnings nationwide.

    At a rate of 48.2%, almost 10% more disabled women than disabled men are living below the low-income cutoff when they live alone. Women with disabilities are more likely to live alone.

    While the cost of living with a disability is only somewhat accounted for in CPP policy through the basic amount, it is not adequately offset through tax credits or provincial social assistance. Even with supplementary social assistance, disabled women receiving CPP benefits still do not have enough funds to cover disability-related and basic living costs. That was spoken about quite nicely by former panellists.

º  (1630)  

    For women receiving CPP disability benefits, it is not surprising that economic inequality is largely related to gender differences in earnings prior to disablement. Women have different experiences of work from men, and consequently different experiences of the benefits that accrue from working.

    Women have unequal access to higher-paying employment such as professional worker managerial positions. They more often work at non-unionized temporary or part-time employment that frequently fails to provide benefits or access to pensions beyond CPP. This is some of the “system” we're dealing with.

    Interrupted careers as a result of childbearing play a role in this inequality, but women are also more likely to be single heads of households, divorced, or living on their own, compared to men of similar ages with disabilities.

    The requirement that CPP claimants must have worked four out of six years prior to disablement discriminates against women, who are more likely to be employed temporarily or part-time. Exclusion of the child-rearing years, while useful in eliminating the low-income years for determining eligibility, prevents women from ever reaching parity with men who do not use those years to care for small children.

    Raising the disability basic exemption to $3,900, which was done in 1998, disproportionately affects women who will not qualify for CPP because of low earnings.

    Because women's occupations tend to be more sedentary than men's and women suffer less often from injury-related disabilities--they're not the construction workers in the wheelchairs--they're less frequently judged to be unable to perform their former work.

    Major impacts on work disability among women include the gender division of household labour, including the presence of adults needing care, which disabled women participate in equally with their non-disabled counterparts in the population, and the nature and quality of child care arrangements. Hence, fewer women are eligible for disability benefits, fewer of those who are eligible apply, and fewer of those who apply are successful applicants.

    Hidden disabilities, particularly those affecting cognition and stamina, have emerged as substantial problems facing women. Women are more likely, as has been mentioned previously, to experience episodic--i.e. fluctuating and cyclical--conditions such as debilitating fatigue and chronic pain associated with autoimmune conditions such as systemic lupus, arthritis, and multiple sclerosis. These are just some examples.

    In addition, illnesses like chronic fatigue, environmental sensitivity, fibromyalgia, and unipolar depression are more frequent in women, are difficult to diagnose, or are believed to be primarily psychological. Not only do we experience these types of impairments more often, we are also more likely to be refused because of the ill-defined nature of some of these conditions.

    From January to December 1997, there were just over 28,000 new beneficiaries of the CPP disability pension. Of those, just over 15,000 were men and just over 12,000 were women. The breakdown of diagnostic category revealed a gender trend in disability type. Of the new women claimants, 25% had psychiatric or mental illnesses and diseases of the musculoskeletal system in connective tissue, while just under 18% of men receiving benefits had these kinds of conditions.

    Our policy recommendations, by and large, focus on a return to work for disabled women. We really believe that a proper reconceptualization of disability focuses on allowing people to work without penalty--without loss of benefits--when they are well enough to do so.

    The way disability is currently defined for CPP purposes makes it close to impossible for a person to be both disabled and gainfully working. Despite larger structural inequalities impinging on the economic status of women with disabilities, we suggest that at the very least CPP, rather than contribute to this inequality, should support workforce reintegration. For those women who live with chronic fluctuating conditions, part-time employment may be most suitable.

º  (1635)  

    We acknowledge that disabled women working part-time will earn less than those working full-time, may not have access to employer-sponsored extended health benefits, and will unlikely be able to afford child care or home support. Both of those social services are either lacking or have been stripped or privatized by the state. By allowing women to return to work while retaining benefits, the CPP could reduce the impact of some of these gendered inequities.

    Our research revealed a strong desire amongst most of the women we talked with to return to work. We interviewed people across the country. We also interviewed CPP plan administrators. Women do want to work if they're medically able, and if it could happen without the threat of losing benefits. This desire to work reflects the well-known fact that despite disability, discrimination, and economic disincentives, people with disabilities do want to work and they want to be supported in their efforts to earn an income that provides independence for them and their families.

    I'll go on to the recommendations.

    Our research didn't include the 1998 changes, so the figures that we came up with are actually pre-1998. The 1998 changes hadn't been fully instituted when we designed and proposed the research, so we just kind of plowed through it.

    The October 1996 task force--that's “the Will to Act” task force--was on the right track in wanting to remove penalties for returning to the paid workforce and establishing incentives for reintegrating people with disabilities into the labour market. It is significant that beneficiaries can now earn $3,800 a year, but many women we spoke to, and many I've spoken to since, have been unaware of or confused about that. So that's not a well-known fact in the disability community.

    We support a return to work for disabled women that is voluntary, and not tied to eligibility for benefits, and not vulnerable to penalties. Women and men who have severe and prolonged conditions, including those that fluctuate, should be encouraged to return to work to their maximum capacity if and when they are healthy enough to pursue paid employment. Several related changes would make this more economically feasible for government, including, obviously, taxing the income earned by claimants, and also allowing CPP claimants to contribute to CPP from earned income above the basic exemption of $3,900, and below the maximum, the YMPE.

    Two further recommendations focus on addressing poverty in the lives of women with disabilities. The first is to raise the substantially gainful occupation limit from $8,500 a year to $12,000 annually. At the time of our research, the limit was calculated at 25% of the YMPE, the year's maximum pensionable earnings, which is below the low-income cutoff. I can talk in the discussion a little bit more about this, but this was the policy directive that was given to us by the plan administrators, which was kind of an eye-opener. We actually designed some of our recommendations around it.

    We are suggesting that the calculation be raised to 30% of the YMPE, or approximately $12,000 yearly--that's before taxes. This would allow working beneficiaries to earn up to $1,000 monthly, before taxes, and retain their benefits.

    The second sub-recommendation in this one targets a very small portion of disabled women who might have the potential to earn more than $12,000 while remaining disabled. We believe it is important that they are not automatically cut off if they earn above the recommended first benchmark of $12,000. This is the whole issue about whether a person is being productive and profitable, or just profitable. So these are some distinctions made by the people at the ISP when they're doing the assessments. Therefore, we suggest implementing a second level of income-based work for those earning between $12,000 and $24,000 yearly, calculated at 60% of the YMPE, or twice the new benchmark.

    These high achievers--obviously this would occur less often, to be earning this money, as most women receiving CPP are not high achievers--would be able to retain a portion of their benefit, that's the baseline rate, and a pro-rated portion connected to their earnings. So between $12,000 and $24,000, we are suggesting that 50% of what they earn would basically be clawed back.

º  (1640)  

    Our third recommendation--and this is something that Sherri, I think, mentioned--is the idea of creating a permanent disability status that allows beneficiaries to engage in a fast-track reapplication process even it has been over five years since they have received benefits. Basically this recognizes that people may come in and out of the workforce when they're living with a long-term disability. The five-year period is somewhat arbitrary, because people may work for five years and then they're ill again, and then they have to kind of revamp to get back into the program.

    The fourth recommendation is there is now a three-month trial of employment that happens post-vocational rehabilitation, and also I think for people returning to work, and we want that replaced with an indefinite trial period of work. And for people, women especially, living with chronic fluctuating conditions, a three-month period is not long enough to establish themselves in any kind of work setting and adjust to the kinds of lifestyle changes that would be required in order to return to work.

    The women we talked to were concerned about the difficulty of finding suitable, accordingly paced work in accessible environments. This overlaps with some of what's been said before about the definition of disability being tied to the condition rather than the circumstances.

    I don't know this for sure, but it looks to me that this three-month limit is a policy lifted right from the insurance industry and is then somewhat suspect, in my view. The CPP administrators we interviewed during the research admitted that it has been very hard for them to convince people to enter retraining because of the fear of losing benefits after three months. That's the way it's stated in the brochures, and people look at that and say, “Why bother?”

    Our fifth recommendation is to establish--and this is some of what Michael is talking about--provincial provision of the resident's extended medical benefits. Anyone who actually qualifies for CPP benefits should be automatically eligible for benefits provided by the province of residence under the CHST. We're referring here not to social assistance benefits but to the extended medical coverage that reimburses prescription drugs and many types of durable medical equipment necessary for women with disabilities to return to the workforce. It would also include things such as dental work, eyewear, and assistive devices. CPP eligibility currently doesn't allow for those kinds of things and often women who had been working part-time have no access to employer-sponsored extended medical benefits.

    Our last recommendation--and this is something like what Michael is talking about too--is to allow Canada Customs and Revenue Agency to adopt the CPP definition of disability for eligibility for the disability tax credit. Many disabled women are not eligible for this benefit because of highly restrictive medical criteria. It's particularly ironic that those disabled women most likely to benefit from this credit, those who have wage-based income, are often not eligible because they don't meet the medical criteria. And those eligible due to the severity of their conditions benefit less from it or not at all because of inadequate income.

    That's all I have to say today. I appreciate it and I'm really looking forward to the discussion.

º  (1645)  

    The Chair: Thank you very, very much.

    Mr. Elley.

    Mr. Reed Elley (Nanaimo—Cowichan, Canadian Alliance): Well, you have certainly provided me, and I'm sure all of us, with a great deal to think about here, and I do want to thank you for coming. I am sorry we don't have more members of the committee out to hear your very fine presentations, but be assured that the quality people around the table have just taken it all in and will pass the word along.

    As our very capable chair has indicated to you, those of us who are on the committee are on it because disability in one shape or form touches our lives and we're here to try to make it better for people. I have a disabled daughter who is in a wheelchair. She's 12 now. But as we look to the future for her, we think about things like the possibility of her gaining enough skills in the educational system to at some point be able to somehow, to the max, contribute to society to give her the kind of sense of self-worth that she needs and also to at some point be able to provide for herself in some way through some kind of job situation.

    All of the things you are talking about come home pretty forcefully to me. I'm sort of at the front end here, looking forward to all of these things happening. I would prefer of course that she not have to go on this, that somehow all of the things in our society that might help disabled people would make it possible for her to not have to go on social assistance and have to claim disability tax credits and all these kinds of things.

    So I'm very interested in what I see as a common thread running through what you're all saying here. I think it was Michael Mendelson who brought it up with his description of the Netherlands experience. I think the phrase he used was that “you don't judge the disability but the circumstances of the individual with the disability”. I think that's perhaps the essence of what you were saying about the Netherlands experience.

    I'm wondering, if we really took that seriously in our approach to all that we're talking about here, how would it start to flesh itself out in terms of the kinds of supports we're talking about here? Let's talk a little bit more about how that might just play itself out if we started to put it into practice here.

º  (1650)  

    Mr. Michael Mendelson: I was in a meeting a couple of years ago this summer in Sweden, an international social security something-or-other. I gave a paper on child benefits, a great paper.

    It was an interesting meeting, because the people from Sweden, Denmark, and Norway were able to get up and, in their papers, assume that any family with a child with a disability wouldn't have any additional economic burden as a family. They didn't really talk about it; they just sort of assumed it. People from other countries said, well, we didn't really understand what they were talking about at first, and after people probed a bit the individual in the particular paper I'm thinking about from Norway, they found there was no question about this issue, that the supports were there socially for families with a member who had disabilities or other particular needs in terms of service supports. There wasn't a requirement that they go beyond that in terms of a particular labelling process.

    There wasn't a defined program for persons with disability. There was a defined program to provide, say, a wheelchair. A wheelchair is a very visible form of disability. There are many that are much less visible and much more difficult.

    So I think the first element of an income security system that does not rely upon categorizing people is not in the income security system; it's in the support system. It's to ensure that there are supports available to people based upon what their needs are.

    In this case, really, the policing of such a system, if I can call it that--which is something we all have to be concerned about; it's a reality--is done by the individuals themselves, because, frankly, there are very few people who want a supportive device if they don't need it. I suppose we live in a world where everything is possible and there are always going to be a few, but it's not exactly going to be your big problem. So the whole concept of providing supports on the basis of an as-needed kind of system is very possible with respect to supports.

    If those supports are there, and are fully there, then the issue becomes, what would an income security system look like? Some of my friends on the more radical side of the disability movement who talk about citizenship more than they talk about concepts of having a particular assistance program will say the income security system to which people with disabilities are entitled should be the same as for anyone else, given that the other supports are there that are particular to their disability.

    I'm not sure what your daughter's circumstances are, obviously, but they would argue that there are many people who will have difficulty earning an income, for one reason or another, some because of physical disabilities, others because of other disabilities, and some because of personal circumstances of their lives, which can be that if you're in and out of four, five, six, ten, or a dozen foster homes before you are 12 years old, you are going to have, I would predict, difficulty making a living in your future. The income security system should be designed so that it is based upon the needs of the individual, not upon their disability.

    I'm sorry I'm taking too much time responding, but I think that's the essence of the concept.

    Mr. Reed Elley: Really, I think what you're saying is “flexibility“ is a big word in terms of how we approach this.

    I think Sherri mentioned that moving people off social assistance is a long-term goal. Let's hope they don't have to get on social assistance to begin with, and that's where the support systems come in at the front end. But if you are going to move people off social assistance, then there has to be more flexibility in the system to determine what the severity of the disability is, to begin with, and all this sort of stuff.

º  (1655)  

    Ms. Sherri Torjman: I wanted to make a few comments based on your question. I agree with Michael's answer. When you asked your question, I made myself a note saying the best way to reform the income system is working in the other associated systems right away and making sure those are functioning properly.

    One of the options we did not talk about today was the issue of what's called individualized funding. Although some jurisdictions do in fact have that in place...and there are problems with it, so I'm not in any way pretending that this is the answer and a panacea, but it is important in terms of looking at a possible model that is very individualized and allows flexibility. It ensures that you can spend a pot of money, in effect, based on the individual needs and the supports for the family.

    I think the issue you're raising is extremely important, because I think one of the areas of the national children's agenda where we did not do a very good job had to do with children with disabilities and support for their families. I think if there's any one area of the children's agenda where we really should have put a lot more resources, and still should be doing that, it's in that area, because there's a whole range of areas to move to try to keep people off income supports in future. You're talking about a preventive approach, and I think that's extremely important.

    Prof. Michael Prince: I have one comment on that.

    Mentioning your daughter and her age 12 makes me think of when she hits 18 and 19 and the inevitable experience of people with disabilities, which is that they may have the advantage of some good supports, depending on the school board they're in, what part of the country they live in, at the school, but once they get classified or categorized as an adult, as you well know, then they move off one ministry's responsibility or department's. So that's primary a provincial responsibility. However, I think there is a national role here of federal leadership down the road in terms of cost-shared disability support initiatives, so that the phrase “continuity of care”, or a seamless provision of services to people, becomes a reality and not just a sound bite.

    The Chair: Madeleine.

[Translation]

    Ms. Madeleine Dalphond-Guiral (Laval Centre, BQ): Thank you, Madam Chair.

     Good morning to you all. Thank you for being here in spite of this bone-chilling weather. I listened to you all very carefully and, I remembered that it was within the framework of the health care system in the 70s, that we started talking about individual care, especially in the context of nursing care.

    According to this idea, a child with pneumonia does not necessarily have the same needs as the patient next to him who is suffering from the same condition. So we have to take the support network and the specific needs of the individual into account, among other things. People with a disability are in a similar situation. What we are talking about is a philosophy; if you want to provide individual care, it means that you have to be able to be fair, which is not always easy.

    On the other hand, I would welcome a debate on the underlying values of these systems. Our country is rich and proud to endorse such values as compassion and justice, and I believe these values should benefit its citizens.

    One thing we could do, to start with, Madam Chair, would be to change the name of our Sub-Comittee; instead of being called the Sub-Committee on the Status of Persons With Disabilities, why wouldn't we say something about the support to persons with functional limitations? We're all suffering, each and everyone of us, from functional limitations. Is there someone here who is not suffering from that?

     In Quebec, this terminology has been used for a few years, and I think it's extremely fair. In fact, over a year, we're all faced with a functional limitation at some point or other; just a serious headache could be a functional limitation. This could be a start.

    I am very concerned to see that we're unable to come up with a definition that would be inclusive enough to be fair. I wholly agree with people--whether parents fighting for their children, adults fighting for themselves or for other adults--who say that the situation is a total chaos and they don't have a clue as to what they should do.

    So I wonder if it might be a good idea, and this could eventually become a priority, to set up a group--in spite of the fact we have an extraordinary committee here--who would define what it means to suffer from functional limitations. You have to start at the beginning, and when you don't know what you're talking about, it is very difficult to determine what you are going to do. Everyone will understand that there can be a huge difference in levels.

    In Scandinavian countries, many things seem taken for granted by sensible people, and in fact the people themselves don't understand that things may be different elsewhere. In addition, I want to emphasize that in these countries, there is a very large proportion of women in power. In my view, until we have more women in decision-making centers, in politics, it will be very difficult to reverse the process.

    We know that in the future, more and more people will be facing disabilities. The number of disabled children is increasing rapidly. They will experience those functional limitations during their entire lives. In certain situations, these people can fend for themselves very well. But I think that our society has a responsibility for supporting them.

    Don't you think that we should try to help all the stakeholders come to an agreement, especially those people living with disabilities and the people supporting them, that is the health organizations and health care professionals who provide support and services to these people and who are in the best position to act? In a sense, this is very similar to the report we have tabled and in which we recommended this kind of initiative. But these are things to come.

    I would like you to tell me if you believe it is realistic to think that there could be a real support system. At some point, it was very much the in thing--it might still be true today, I don't know; I've lost sight of all this--concerning the system, in science as well as in humanities; we used to talk about these famous interrelated systems.

    Is it realistic to consider this option when we know how deep the power struggles are within the department or the organizations working with persons with disabilities? I am sure I am not mistaken in saying this. I have enough experience to know that these things are real. We are reading facts very differently, however. I fully realize that I am talking about theory, but I believe that you can't change things unless you have a very strong theoretical basis. I would like to hear your comments on this.

»  (1700)  

[English]

    Ms. Sherri Torjman: Wow, you're asking some incredible, very profound questions. I have a few thoughts, because obviously it's important to take some time to think about what you're asking.

    I'd like to comment on a few aspects. The first is with respect to the supports and the fact that this is something of importance to the population, generally speaking. And I wanted to point out that we had done a report in October 2000 called “Proposal for a National Personal Supports Fund”, and it was called a “personal supports fund”, not a disability supports fund, explicitly. It was done for the purpose of pointing out the fact that this is an issue that's of concern to the entire population, and if we want to get away from categorization and narrowness, and you have to qualify on 75 tests, we have to understand that this is something that everybody should be concerned about and supporting properly.

    Some people may require more supports--and a whole range--than others, but nonetheless it's a population issue. So I certainly like the way you're thinking, and we've tried to put forward that notion to make it a broader issue.

    In regard to your question as to whether we can have a big system, conceptually and in theory, I would say absolutely. I think the problems are that when you actually get into practice and design, the costing issues become important, because obviously, when you open up your eligibility criteria, you open up potential cost.

    Another reality issue has to do with who pays, and I think one of the reasons we have so many different patchwork pieces right now is the fact that you have different payers and so you share in effect some of the costs by having some differential payment. If you're moving toward one big system, you're consolidating your payment and then you have to look at, at the end of the day, who pays.

    But in theory I don't think what you're asking is unreasonable at all. In practice and design, it comes down often to finance questions, and that's always where we hit the wall.

»  (1705)  

    Sally Kimpson: I want to say I agree with Sherri, and I think embedded in this is that personal supports are so important for working. If people with disabilities are working, they are contributing to the economy, so they're not just a drain, and I think we need to keep remembering that. We need to remember that once we're working, then we are contributing and we are exercising our citizenship, as Michael was pointing out. I actually fall into line with the radicals, whoever they are.

    I want to reiterate that to have the supports in place.... I will argue that home support is one of those, and thank heavens that it is being looked at federally. I hope it's going to include people with disabilities, not just people who have been discharged from hospital. I hope people with disabilities are going to have the kind of home support they need to exercise their citizenship, because if you can't get dressed, you can't go to school and you can't go to work. And you can't contribute.

    So we need to remember the importance of personal supports and how they enable us to contribute to society, financially and otherwise.

    Mr. Michael Mendelson: I was just going to add that in Canada we can never ignore the federal-provincial reality. If we do more fully develop a system of personal supports, no doubt it'll be in the context of some intricate federal-provincial dance. It would also not be homogeneous among the provinces. Personally, I think that's fine. In fact, I think there's a lot to be said for that, because then we can learn from one another.

    There are other more serious issues. You've asked some profound questions, actually, which are difficult to....

»  (1710)  

[Translation]

    Ms. Madeleine Dalphond-Guiral: I am sorry.

[English]

    Mr. Michael Mendelson: The paper I was really taken with at this conference I went to in Norway was about the extent of the paternalism, if I can use that word, of social agencies acting on behalf of persons with disabilities. It wasn't a matter of whether the services were there, but rather whether they were being given by agencies or taken by the persons who needed them, so to speak, if I can translate it that way. It's a serious issue. They did quantitative testing and found that it made a big difference.

    I suppose the lesson from that is we'll always be in a situation where we can be better. Even if we had a wonderful system, I'm sure it would always be in need of improvement. That's a good thing about the human condition, I suppose, that we're always able to do something better.

    Michael Prince: Just briefly, Madam Chair, I would echo Michael's comment in terms of what a system means. I quite agree that it doesn't mean a homogeneous or comprehensive system.

    I've suggested one possibility, which is based on a working model, the national child benefit initiative, where there's still lots of room for provincial discretion. Another one would be to use the early childhood development agreements as an exemplar. Another would be the employability assistance for persons with disabilities cost-shared agreements.

    Another would be to use the Canada Health Act à la Romanow and Kirby, what the first ministers are talking about today. What will happen to the home care transfer fund that Mr. Romanow has proposed? That has implications for people with disabilities and home supports. He has proposed a very dazzling vision of $2 billion over two years targeted directly at home care. Part of that would be post-acute care, some of it would be palliative and end-of-life care, and some of it would be personal supports for Canadians of any age with disabilities. That's the closest we have come nationally to talking about what I'm suggesting. But I wouldn't put all my bets on that one.

    So this committee has to step up to the plate and provide us with an equally bold vision, which is not a made-in-Ottawa, top-down vision, but a partnership that recognizes variety across the country and some innovation.

    The Chair: Maybe on that note, and after Mado's wonderful outside-the-box questions in terms of what we've all been struggling with in language, if we were going to figure this out, start from scratch and say, this is what we're going to do, what would it actually look like? I don't care if for the next 20 minutes we abandon this committee and have a conversation about language, because somehow the medical model gets in the way in regard to whether this is really part of the health system or not. Rights do get in the way, because it's what people are entitled to instead of what they need.

    And then we keep getting into issues of disability and capacity, what you called “functional limitation”, and always who pays. I used to think there were two questions, whether it was a CPP disability or the disability tax credit, and they were: can this person reasonably be expected to support themselves; can this person reasonably be expected to look after themselves?

    So there were a lot of those sorts of questions. If somebody wanted to take the CPP disability form down to that question for me, I would be more than happy to tick it off, sign my name, and forget the rest of the form. But we've never really asked those questions in terms of what actually we're trying to do.

    I think what Mado was saying is that in health care, we tried to move to this more customized approach of needs assessment--what does this person need to not have pain, or to get to the bathroom--instead of giving everybody a wheelchair when some need a cane. Even though you're entitled to a wheelchair, you don't take the wheelchair if the cane would do.

    I think we keep going off dopily in all directions. What I keep coming back to is if I had a tool to measure somebody's dignity or self-esteem, if somebody could tell me how this person is feeling about their full citizenship or whatever, I bet we could then figure out what we could do to bring that up.

    And for the people who have never heard me say this before, I only wanted one stamp in my office, and that was that this person would rather be working--highly motivated. Almost every form I filled out presumed this person was trying to rip off the system. That seemed to be the question I was being asked time and time again.

    How do we do this? How do we then figure out what our role as government is in terms of public policy? How do we not forget that the private sector has certain things? If we have such a fantastic public system, why would anybody ever pay private insurance again? If we're the first payer, why would any employer bother to do that, and what would be the value added of that?

    I like the approach of the Netherlands, because the kids going through 52 different foster homes.... You know, I've never been able to get somebody a pension for a personality disorder, but there are some people we don't want working, because they'll be stealing everything, and it's mainly because they had such a terrible upbringing that they just can't work.

    So help me with where we would go if we were going to get this right from the beginning, including the federal-provincial stuff. You know, every question you ask--whether it's about single parents, health care or whatever.... What these guys over there are sorting out this afternoon, I have no clue, but the question about who pays....

    You know, on my quiz, “Twenty Questions to Save Medicare”, the first question is, “If we could have an excellent health care system, with 10% of the GDP and a 70-30 split, we should (a) get on with it, or (b) keep squabbling about who pays”. I don't think there is a Canadian in this country who doesn't think we should get on with it.

»  (1715)  

    So if the same question were put to what we would do to get people full citizenship, what would it look like? I think we're down the road of trying to at least tweak the CPP disability to be more flexible and more understanding of what's going on. At some point, we should figure it out. As Reed said, the labelling is really hard on people. We're all disabled or variably abled. Some people are jerks. I think they cause more trouble in our society. The question is to help us build it from the bottom.

    Ms. Sherri Torjman: There are many things that you can be doing to promote citizenship. We're talking about income security today, in particular. One of the ways that I think is really important to start is to get in place a good single disability income benefit that the federal government would take responsibility for.

    Our principles with respect to income security reform have to do with the federal government ideally taking responsibility for the payment of income benefits, because that's where the equality and the single payment across the country are actually important. That's where you probably don't want innovation, because you're into the welfare program, if you can call it that. You want consistency. You want stability. You want people to be able to move. So you create a national income benefit.

    As I said, you can move by helping people get off social assistance, in the first instance, by having it as an adequate benefit that would be decent for people. You can do a whole other set of initiatives in terms of disability supports. We were talking about the offsetting of the costs. There is a model in the country for doing it. In terms of the national child benefit, there is precedent for doing it.

    You can do that. It should be seen as the beginning of an initiative. The costs that will be displaced may not cover everything that you need. Provinces and territories will have to invest more. I think that is an important and concrete way in which to move. In the first instance, the federal government can take the leadership in that regard.

    If you're asking about citizenship more generally, I think we're talking about education, access to recreation, and a whole set of other issues. I don't know that you want to get into that right now. In terms of income security, I think that we have some very clear directions here.

    The Chair: Are we calling it disability support or are we calling it independence support? Is the language getting in the way?

    I think that's what we're hearing, all of the committee members.

    Ms. Sherri Torjman: It is income support.

    The only reason that Finance is going to tell you that you need another screen for disability is because then you will open up the whole program to the entire country, if you're doing this only on an income-tested basis. I'm putting forward what the reality is when you're thinking through this.

    What you want ideally is a program that people would qualify for on the basis of their income only. It's ideally what you're looking for. You're going to be pushed, I believe, into having another screen for disability only, because otherwise you're moving into a form of guaranteed annual income. You could decide that you want to do that. But beware in terms of the Finance people who will come to you and say we can't move in that direction. At some point, you get back into that disability screen in the real world.

»  (1720)  

    Mr. Michael Mendelson: I think you asked the right question. Actually, it's exactly the right question, except that it should be expanded by the question, can this person reasonably be expected to support themselves? That question in itself can be used as the one that would determine eligibility for an income program. I would not call it a disability program, if there's any way to avoid it, but I would use a screen.

    I would supplement that question with a second one, and that is, would it make sense to provide supports or training such that the person would be enabled to support themselves? So there's a secondary question about whether training or other kinds of personal supports are such that the person wouldn't be able to support themselves.

    But if the answer to both of those questions is no, then you are in a situation where the person is obviously in need of income support, and can there be a program designed such that the individual would then be able to obtain income support? I think the answer is yes. Can it be at the federal level? We would have to talk about that in a more serious way.

    The one element of this, though, that I want to stress, and I think it is important for us to recognize, is that there must be a rigorous determination process in any income support system. We can't rely upon goodwill and human nature. Although, in my experience, most people are utterly determined to work and to be productive, the reality is that there's a small minority who aren't, and that can wreck a program. That can result in a rapid and unplanned escalation of costs. So whatever program is designed, there does have to be a rigorous determination process.

    But I think you can make a rigorous determination process based upon those two questions, that question plus the supplement, that you actually posed. In fact, when I asked the question before--just coming back to CPP disability, if I can--the real question about CPP is not around the definition of disability. If you want to get to the basics, the real question is, should there be circumstances under which the Canada Pension Plan will pay early retirement benefits, and what are those circumstances?

    I would say that question is the right one. You don't need a disability program. You may need an early retirement benefits program. That early retirement benefits program could then pay benefits when the answer to your two questions--as to whether this person can reasonably be expected to support themselves and whether it is sensible to provide supports or training such that they could support themselves--is no, rigorously determined. If we accept that there is to be an insurance program, which is a whole other debate, the next question is, if they have been a worker who has established an entitlement with an insurance program, then they would trigger these early retirement benefits.

    They're not disability benefits, because frankly, the answer to those two questions could be no and a person doesn't have a “disability”--whatever the heck that is, seeing as how, if you ask enough questions, we all probably have some disability.

    So that is my answer.

    Mr. Reed Elley: On the whole question of our role, and I think Sherri was correct to bring us back on a focus here--it's great to think outside the box, and we all need to do that in terms of all these other questions--I think we all know the impediments to this. You listed them well in terms of what the barriers are to doing this across the country.

    However, in terms of these two questions, which I think are excellent, is there a role for this committee, then, to somehow facilitate some kind of national strategy for individual support that would somehow get the interest of the provinces--because they have to be on board--so that we can have shared responsibility in this?

    One of the biggest concerns for people I talk with back in my riding on Vancouver Island is that they're sent all over the place to try to find help. They're discouraged. First of all, their health isn't good, they don't have the money to do this sort of thing, and they're sent all over the place. Why can't we have some kind of shared jurisdiction here that results in one agency dealing with people who need support? Why do we keep sending them all over the place on this sort of thing? Surely we can work this out with the provinces so that, even at this very elemental level, we can start to have some help for people and cooperation.

    Is there a place for us in this committee to start suggesting that sort of thing? I'm sure that as someone who has lived with this kind of thing, you know exactly what I'm talking about.

»  (1725)  

    Sally Kimpson: You're absolutely right. The reality is that for some people it turns out to be a full-time job getting benefits. All their energy is going into getting benefits and supports. That doesn't make any sense. That leaves them without any energy or resources to do anything else, so then they become utterly disabled.

    In terms of the provinces, they are already paying. If you get people off social assistance, a lot of money will be freed up, and that could maybe contribute to some kind of cost-shared arrangement. I don't think asking the provinces to completely pay....

    I agree with you that if there could be one-stop shopping for people with disabilities, that would really change their lives in big ways. Part of it is about attaching the money to the person and the idea of independently supporting them in that way.

    Mr. Reed Elley: Could you comment on the role of this committee in facilitating some of that?

    Sally Kimpson: I'm not sure of the nature of your influence. You're not sure either, apparently.

    The Chair: It's unquantifiable.

    Some hon. members: Oh, oh!

    Sally Kimpson: Oh, good. I see that as hopeful.

    You're in a position to influence in different ways. I think you know best how to approach that. I can't really say. You're working hard for your constituents. You know who the people are in the disability community, for one thing, but then you're also in a sense connected to those who are going to make these decisions. I think Sherri is right. Finance is obviously a place that's going to be problematic and challenging.

    Michael Prince: I would say that I'm encouraged by what happened in the fall in the House of Commons around the disability tax credit. I've written a policy history of the CPP disability, which is available in both languages on the website of the Office of the Commissioner of Review Tribunals, and Sherri has done one as well that's in both languages.

    The history shows the role of MPs. This is a pretty special policy file in that committees like yours, or subcommittees like yours, and MPs in all parties have played a much more positive and significant role than they have in many other policy fields at the national level. So the potential for this subcommittee is, I would say, very encouraging if the last 35 years are any guide in this policy.

    So I think you could, and I think you should, take in the tradition of this committee and those who have been in these seats before you in this committee, or other standing committees, with fuller mandates than this subcommittee. There's been a proud history on all sides of all parties, because it touches all of your lives as MPs. This is a universal challenge, this is not a partisan issue, it's not a federal-provincial issue. You all know that, and that's why there's been such cooperation over the last 35 years on this issue.

    On the finance concern, when you look at the latest health activities limitations survey that was done in 2001, the proportion of the population that reports a disability did not go up from the 1991 baseline; in fact, it's down slightly. So in regard to the fears of those who believe we're seeing a huge growth, the proportions of mild, moderate, and severe are more or less the same. So, in my view, we shouldn't be losing sleep at night over some moral hazard that this is going to bankrupt us.

    But the assessment question is a big one. I would recommend taking one small step and then one big one. One small one is, when you have HRDC here, or other federal officials, ask them about the work they're doing on standardizing the definition of “disability” and against what standard are they harmonizing it. Is it an existing federal definition, a hybrid or a blend of two or more, or creating a new third definition that might be inspired by Norway, the Netherlands, or something else?

    The original definition was inspired by the social security system in the United States when the U.S. brought in disability insurance in 1956-57. We took that definition and slightly tweaked it, but that's the origins of our definition of “severe and prolonged”.

    Does that still work for us? We know the answer. Of course it doesn't work for us. It didn't work for us in 1993 or in 1983, and it sure doesn't work today. That's why we have 19,000 or 20,000 appeals every year on CPP disability. It's a huge industry now and bureaucracy. Surely to God we can do better on that, too, and the time you spend and physicians spend.

    So I think there is a role if the federal government plays a role like they've done on children. About 20% to 25% of any province's welfare caseload are people with disabilities. That's billions and billions of dollars a year spent on this. So if the federal government plays a leadership role, you free up a substantial amount of funds. That gets the provinces interested.

    Thank you.

»  (1730)  

    The Chair: On the pre-retirement pension, I like the sound of this in that the whole of idea of it is to presume somebody had an attachment to the workforce before. So it isn't really reinventing the wheel, because the CPP disability does presume that somebody has had an attachment to the workforce in that sort of way. Then you do this other thing in terms of support for the people who haven't and probably won't.

    Mr. Michael Mendelson: Australia doesn't have insurance programs, by the way. Australia operates a system without social insurance programs. It's possible to think about a system without social insurance programs, but within the context of our Canadian world, being reasonable, I think we have to think in terms of the continued existence of a social insurance program like the CPP, which would pay some pre-retirement benefits under certain circumstances.

    I want to answer the question about what I thought was most effective. I certainly agree with Michael that particularly in the area of “disability”—and I put those quotes around it—parliamentarians have been very effective, because for one thing there's non-partisan consensus in the House, obviously, around these issues. For another thing, you're dealing with your constituents every day. This is one of the major things you're dealing with all the time. You know what you speak of. That's very important.

    I would say that while it's great to think about the broadest questions of national programs—and I would encourage you to do so—having been a provincial administrator, I also know that whenever that happens I always think, “Yes, but what are you doing about your own programs, federal government?” So I would at the same time challenge you to challenge very thoroughly the Canada Pension Plan. I'm not sure who's running it, whether it's Finance or someone else; it's never clear to me. Maybe you could figure it out.

    Often the people you're asking aren't the people who actually make the decisions. I would challenge them to ask whether we can rethink the basis of the CPPD. Is it possible to get rid of the “D”? I would say you've outlined here today some of the potential possibilities that could be explored. Bureaucrats, of course, don't like to be pushed to do things like that, but that's the role of parliamentarians. I would say if Canada can show that it can reform its program, that will stand in a hell of a lot better stead for getting the provinces on side with a more general and even more ambitious reform program.

»  (1735)  

    Ms. Sherri Torjman: Just to add a note on that, if Finance or any branch were to be encouraged to get rid of the “D”, I would make sure that anybody who's on it now is not sent off with nothing—all of a sudden, if you get rid of the “D”, you get rid of $280,000. There has to be that caveat.

    I just wanted to answer briefly the question you asked about the role of parliamentarians, because I worked for the parliamentary committee on the disabled and the handicapped in 1981. That was the International Year of Disabled Persons. I'll tell you, the role of the MP was profoundly important. The MPs were so committed—from all parties—and it helped put this issue on the agenda and keep it alive.

    I would encourage everybody here, number one, to be champions, because disability more than anything else needs a champion. It needs to be embedded in every single federal department. It would be nice as well if you could have some discussions with your provincial counterparts as members of Parliament, members of legislatures, because the discussions take place right now at the level of officials. That's really important, but the officials themselves need political direction. They need to know they are responding to political directives and have to come back with results. Speaking of outcomes and results that we're now embedding in every process, we need to see results. That would be perhaps something to do in terms of moving forward the agenda. I think your role is absolutely crucial in that regard.

    The Chair: I can't thank you enough. We certainly had quality this afternoon, if not quantity of the members.

    Did you have...?

[Translation]

    Ms. Madeleine Dalphond-Guiral: I have to go. I have another meeting.

    La présidente: Yes, yes, it's over. It's blessing time.

    The meeting is adjourned.