Honourable senators, I rise today as the friendly critic to speak on Bill S-204, An Act to establish a national framework for heart failure.

I would like to begin by recognizing Senator Martin for bringing this important bill forward.

Heart failure is a clinical syndrome with symptoms and signs caused by a structural or functional cardiac abnormality with objective evidence of pulmonary or systemic congestion. Heart failure impacts hundreds of thousands of Canadians, and this bill recognizes the need for better coordination, data and access to care.

Today I will focus on three main points: first, the intent and importance of this bill; second, the current state of health care in Canada; and third, a broader reflection on what Bill S-204 reveals about health policy.

At its heart, this bill is aspirational. It imagines what health care should look like for every Canadian, no matter where they live. It imagines health care where everyone has timely access to diagnosis, guideline-directed care and holistic, multidisciplinary supports.

The bill’s intent is clear: to create a coordinated, evidence-informed national approach that improves outcomes for patients, families and caregivers. But as we discuss this bill, we should also reflect on why it is needed.

Each time we pass a framework bill for a specific condition, whether it is dementia, diabetes or eye care, we are reminded that our health care system is fragmented. People living with health conditions should not need siloed frameworks. They need consistent, coordinated care in a system that provides safe, high‑quality health care.

The bill is important because, behind it, are people and families whose stories remind us of the human cost of unequal, inadequate and delayed access to care. In particular, I think of the patients and families in northern Manitoba who have to travel for hours to Winnipeg for specialized and complex cardiac care.

As a reminder, while I will refer to “Canada’s health care system” in my speech in this chamber, what we have, in fact, is not a national system, but 14 provincial, territorial and federal health insurance plans that cover defined, medically necessary services to patients at the point of care at no cost. Also, please remember that the administration and service delivery of health care falls primarily under provincial and territorial responsibility. This complexity, shared among multiple jurisdictions, should give you an idea of why we are seeing more framework bills for various health conditions.

Now to my second point: the current state of health care in Canada. This is important because Bill S-204 must be grounded in today’s realities. Canada is one of the highest health care spenders among countries in the Organisation for Economic Co‑operation and Development, or OECD, spending anywhere from 11.2% of GDP on health to 12.1%, depending on which source one uses, which is above the OECD average of 9.2%.

Global data confirms that access to primary care decreases health care costs —