Mr. Speaker, I am pleased to rise to speak to this issue and this bill, finally.
As others have already pointed out, Canada is the only country with a universal health care system that does not provide some sort of universal drug coverage. Under the British, Australian, New Zealand, French and Belgian systems, basically to some degree or another, people's medications are paid for by the government and they do not have to pay for them. Having said that, admittedly, in some countries there is copay.
This is an important bill. It is the first step in creating a national pharmacare system, and this I truly support. However, I did not always feel this way. As somebody who has long practised in the health care system, I was a bit worried, because with the health care system as it presently is, we are struggling to pay for it. It occurred to me that what the government ought to be doing in health care is making sure that this sucker stays on the road. Certainly, I had a bit of trepidation with the idea that we were going to add another cost like pharmacare. However, having thought about it and having sat through committee meetings where we talked to experts, I have changed my mind because I think that a national pharmacare system would save the health care system money, not increase costs.
The current system, as we have it, which is a patchwork of private and public plans, is really inefficient. Multiple studies and recommendations since the 1960s have all basically said that. In fact, one study from the Canadian Medical Association Journal in 2017 concluded that we in Canada pay 50% more for our drugs than people do in 10 other wealthy countries that have national pharmacare programs. In addition, the inefficiency of our pharmaceutical system is demonstrated by the fact that we in Canada pay the second most for drugs of any people in the world. The Americans pay more, but other than that, we pay more for drugs than anyone else.
The inefficiency of our system comes from the fact that we provide pharmacare in Canada like the United States does. We, like the United States, have a patchwork system of private and public providers, and the private providers are often set up through employers. At times, these are non-profits, but for the most part they are for-profit companies. Similarly, there are public systems and public plans, and there are multiple public plans. For example, in Ontario, there is the Ontario drug benefit plan for those over 65, there is a Trillium plan for higher-cost medications and there is OHIP+.
Basically, we pay for our medications in Canada like Americans pay for all parts of their health care system, but our system for paying for medications, like the U.S. health care system, is really inefficient. Americans pay twice as much for health care as Canadians do. On average, Americans pay $12,000 per person for health care, and in Canada we pay $6,000 for health care per person, and they have worse outcomes than we do. For example, they have a lower life expectancy than we do in Canada.
I studied health law and policy both in Boston and at Georgetown University in Washington, D.C., and learned a bit about the health care system. I was certainly impressed by the inefficiency of the American health care system. They have private hospitals, private health care providers and private insurance companies, and each of these organizations has administrators who basically spend half of their time scheming on how they can decrease costs and increase profits. They have to pay for these administrators. Similarly, they have to pay the CEOs and the higher-up executives, who all bring in the big bucks, for working in those positions. On top of that, and most of all, a lot of money goes to the shareholders of corporations, which are legally obliged to financially benefit shareholders. All this money comes out of the health care system, money that ought to be going toward trying to improve the health care of Americans.
Similarly, in Canada, we currently have 1,100 private and public plans according to a Lancet 2024 study, although according to the Hoskins report, we have 100,000 private plans. If instead of having all these plans, we just had one plan, then surely there would be tremendous savings coming from economies of scale. We would not need 1,100 organizations with 1,100 sets of administrators administering their own plans. We would not need hundreds of CEOs siphoning money that would otherwise go to health care, and there would be no profits going to shareholders rather than going to health care.
There would be all sorts of savings from economies of scale and increased bargaining power. For example, if someone went to a provider or manufacturer of drugs and bought 10 million pills rather than 10,000 pills, I am sure they would get those pills at a cheaper cost, so there are savings there. Also, shipping costs are lower when buying in bulk, and there are fewer inspections needed.
When we add up all these savings, how much do they add up to? Well, according to the 2019 Hoskins report, with national pharmacare by 2027, which is when it would come into effect, total spending on prescription drugs would be $5 billion lower than it would be without national pharmacare. That is money we could use in the health care system for other things. That means more money to afford expensive cancer therapies, more money to address the long waiting times for either surgeries or diagnostic tests and more money to do research and try to find new cures for things like cancer, ALS, etc.
However, it is not just about saving money in the system. It is also about helping Canadians who struggle to meet the high costs of medications. According to the Hoskins report, between 5% and 20% of Canadians are either uninsured or under-insured, which amounts to two million to eight million people. Furthermore, one in five households reported that a family member in the past year had not taken a prescribed medicine due to its high costs, another three million Canadians said they were not able to afford one or more of their prescription drugs in the past year and almost one million Canadians borrowed money in order to pay for prescription drugs.
For all these reasons, I support this legislation and moving to the next step toward a national pharmacare system. I also welcome that we will be able to provide diabetic medications and contraception to people as one of the next steps in getting to a national pharmacare system.
