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View Sean Fraser Profile
Lib. (NS)
View Sean Fraser Profile
2020-03-12 13:04 [p.2002]
Madam Speaker, I will be sharing my time with the member for Bonavista—Burin—Trinity.
Today's motion is about pharmacare. Perhaps I will lead with my conclusion. I will be supporting this motion. I will be supporting it because quite frankly I am sick of knocking on the doors of seniors who tell me they have to split their medication because they cannot afford it, not only putting themselves in a difficult financial position but reducing the effectiveness of the medicine they have been prescribed.
Most of the people I talk to at home, and I dare say most Canadians, are happy with their own coverage right now. However, the golden thread that runs through the social fabric of Canada is that as Canadians, we care as much about our neighbours as we do about ourselves. It is incredibly frustrating for me to know that one in five Canadian households report that a family member is not taking his or her medication because he or she cannot afford it. I am sure that the 36 million Canadians who do not suffer from this problem are disappointed to know that one million Canadians cut back on their food or home heating because they cannot afford the cost of their pills. When my neighbours cannot afford the cost of their medication, it decreases the quality of my life to know I live in a society that does not adequately take care of its vulnerable.
One of the greatest frustrations I have as a federal member of Parliament is that the number one issue for my constituents is their health care system, whether that is access to a family doctor, the quality of mental health services, in-home care for their aging parents or a lack of access to quality medications. They sometimes end up at my office, despite the fact that health care is primarily a provincial responsibility under our Constitution. It is cold comfort for the people who bring these kinds of concerns to my office for me to say that I have to wash my hands of it because it is a provincial responsibility. What they are looking for is help in often desperate circumstances.
Despite the fact that there is this constitutional division of power, there are concrete things the federal government can do, such as transfer more money to the provincial health care systems, invest in research, invest to ensure we can do something to combat the family doctor shortage, or, yes, implement a national pharmacare program to ensure people have access to the medications they have been prescribed so they can be healthy, regardless of the financial circumstances they may have been born into through no fault of their own.
There are two categories of problems I see with the lack of access to an adequate national pharmacare system.
First is the lack of access to medication because of issues surrounding affordability. I find this to be a real problem. It discriminates against our seniors on the basis of their age, because they do have increased health care concerns as they get older. It discriminates against people who are living in poverty, because they cannot afford to access drugs.
It is heartbreaking to knock on a door that is answered by a child who has not had enough to eat that day and then to sit down with his or her parents, who explain the child has been prescribed medication to which they do not have access. It also discriminates against people who have an underlying health condition that may not be the subject of coverage through private or public insurance plans. In fact, of the people who report they cannot afford their medication, 38% have access to a private insurance plan and 21% have access to public coverage that does not cover their needs.
Second, in addition to the lack of access is an issue around the lack of systemic savings that we are not benefiting from because we have not been moving forward.
The Parliamentary Secretary to the Minister of Health, a colleague of mine from Nova Scotia, quite eloquently has described the fact that Canada is the third most expensive country in the world when it comes to the costs of medication, ranking only behind the United States and Switzerland.
We are so proud of our public health care system and the universality of it. No matter where people come from or who their parents are, they will be taken care of when they fall ill. The same is not true, and a lot of Canadians do not appreciate this, when it comes to access to the medications they need, which are often to sustain life or remain healthy.
Part of the reason this is the case in Canada is that we have a very serious patchwork of provincial and territorial programs and over 100,000 private sector health care plans in Canada. We do not necessarily benefit from the opportunity that presents itself when we can negotiate bulk purchases of medications. Some efforts have yielded success by partnering with various provinces. However, if we adopt the Costco model and buy in greater volume, we can reduce the price per unit and extend access to people who currently cannot afford their medication.
I have seen estimates in excess of $4 billion of systemic savings that come not only from a reduced cost in the price of medication, but also fewer visits to emergency rooms, fewer hospitalizations and more seniors being taken care of in their homes because they can afford access to the medication they need to be well.
We all can appreciate that there is a problem with access to medication in Canada. Over the past few years we have been working toward solving this problem.
Just a few years ago, we appointed an advisory committee, led by Dr. Eric Hoskins, the former minister of health for the Province of Ontario. That effort led to a report that identified the path forward to a national pharmacare program. The committee flagged that it would not happen overnight, but there were certain things that needed to happen to bring down the cost of drugs so we could benefit from the systemic savings that would accrue once we implemented those steps.
One of the very first steps we thankfully moved forward with in the last federal budget, with a $35-million investment, was the creation of the Canada drug agency. This body would be able to assess the effectiveness of drugs that could be proposed to enter into the Canadian system. It would provide an opportunity to negotiate better prices because of the purchase of increased volume that could be administered through the provincial public health care systems. The creation of a national formulary would allow us to ensure we would have consistent coverage, regardless of which community of province in Canada one may live.
In addition to the creation of the Canada drug agency, we have created a national strategy for high-cost drugs and rare diseases. This is important. Quite a few Canadians live with a condition that, despite the fact they may have coverage, do not have access to the medication because of its exorbitant cost or their insurance policy may not provide coverage for their particular condition or its required medication. We have earmarked $500 million annually for this approach.
It is simply not fair that the circumstances of people's birth means they would not be entitled to benefit from the medication that could keep them alive. There are still problems in Canada. Tragic cases pop up in every corner of our country each week. However, by moving forward with this rare disease strategy, we will be able to help some of the most vulnerable Canadians.
In addition to the creation of a drug agency and rare disease strategy, we have also moved forward with changes to patented medicine regulations, changes that will save billions of dollars to our health care system. One of these changes adds additional factors that need to be considered so the cost of drugs reflect the benefits to public health care system in which they can enter. Some of the regulations will require better reporting to ensure our regulations reflect the actual cost of medication.
Perhaps most important, from my perspective, is we have changed the comparator basket of countries we look at to set drug prices for Canada by removing the United States and Switzerland, the two most expensive countries in the world, and added other comparator countries with similar economies, such as the Netherlands and Japan, which will lead to a systemic reduction in the cost of medication in our country and, most important, for Canadians who need that help.
Health care is front of mind for people back home, whether it is access to a family doctor, the fact that their parents cannot find a place in a long-term care facility or the underserved mental health services in their communities. I hear about these things non-stop because people recognize there are problems. Whether they live with those problems or not, they are equally concerned for the people who live in their communities who do not have access to life-saving services and, importantly, life-saving medication.
There is something we can do. We can implement a national pharmacare program to ensure that no matter where people live, no matter where they were born or their parents' economic situation, they will not be denied access to medication because of their financial circumstances.
It is Canada in the 21st century. Canadians expect that they and their neighbours will have access to the medications they need to be well. By implementing a national pharmacare program, we can turn that dream into a reality for the millions of Canadians who go without the medicines they so desperately need.
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