Health committee  Do you mean to get a sense of how much?

Health committee  Right. I won't name the company, but I'll give you an example of a company. It's unlike drugs, where you're talking about $1 billion or more to get to market. Med-tech products typically are in the range of $10 million, $20 million, or $30 million to get to market. They're not at the same level.

Health committee  There's been a sea change over the last three or four years in the medical technology world. In the old days, five to 15 years ago, particularly the U.S. health care system had almost a licence to print money, because you could take a product, improve it just a little bit, sell it into the U.S. health care system, and they would pass the added cost on to the insurance companies and on to the other payers, and patients, and others.

Health committee  The federal government, however, could assist in lessening the not invented here issue. If it were to partner with a province to deal with the technology, that would encourage more collaboration across the other provinces, because it would not be just one province footing the bill and then other people benefiting.

Health committee  Absolutely. Value-based health care financing is a model that's been showing great benefits in pockets all around the world. This has nothing to do with public versus private health care. This has everything to do with a way of funding that provides incentives so that people, patients and providers across the silos, do the right thing.

Health committee  With proper investment, you'd be surprised at how many benefits you get in the very short term. But you're right, the biggest benefits are long term. There are great books by Jeffrey Simpson and others that talk about how this other model with other emphasis will play out. We don't have time for it here, but there are lots of good references on that describing how the health care system could work.

Health committee  That's a very, very good question. A huge number of health care technology assessments are done. Depending on how they're done, they may be theoretical exercises that have to be contextualized to every individual hospital, and because of that theoretical nature, they may not be immediately usable by people across the country.

Health committee  I think I mentioned that one of the challenges for medical device companies is that 75% of the capital is spent on things like the clinical trials associated with their product, the evidentiary development for reimbursement for health care technology assessment, and so on. These are not certification exercises.

Health committee  There's no question there are pockets of expertise across the country. If you look at the very successful medical technology clusters in the world, in Boston, Minneapolis, Zurich, Palo Alto, and so on, what you find is that the number of companies they have, the universities and other things, are in a much tighter geography than we have in Canada.

Health committee  As you know, devices go through federal approval from Health Canada, but then they go through provincial approval because health delivery is a provincial jurisdiction. We're not going to change that. I had the great privilege of running an analogous process, which ended up being called pCODR the pan-Canadian oncology drug review process.

Health committee  Madam Chair, my other colleagues and I had the privilege of providing input prior to the announcement of that fund. Sam Duboc from the fund had public presentations on how the fund is going to be rolled out. We won't go into detail on that, but everyone I've talked to thinks that the way it's being rolled out right now looks pretty good.

Health committee  It certainly could, whether you build a new one or transmute the CFI into that function. All of my colleagues and I were saying that what you really need is not to change the hospitals from their very severe cost management, but in fact to give them another path that says if this technology has a great potential to bend the cost curve of health care, then you should not be penalized if it costs you more but saves more across the health system.

Health committee  I'm going to look for that money.

Health committee  Ilse may know about that fund, but I'll just make a comment on the CFI that I've been involved with. There's been this belief not just in Canada, but in the rest of the world as well that you invest in research, either philanthropically or in the public sector, because you want to help patients at the other end.

Health committee  Very briefly, I totally agree with what Ilse just said. There are two other things that government can do. I mentioned the quote from CIHR and we know that CIHR is moving quickly to address the translation aspect of what they're doing, but encouraging them to do so is very important.