Evidence of meeting #46 for Finance in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was dementia.
A video is available from Parliament.
Board Member, Canadian Doctors for Medicare
Yes. It seems counterintuitive, the idea being, for those who propose it, that you can take people waiting in line who have resources, move them into the private sector, get them off the rolls, and that will make both systems function well and the public system will be more efficient. But it's not true.
We cite a number of documented situations where that's happened in other jurisdictions: Australia, New Zealand, and Europe. What happens is that you move a whole lot of resources, such as physicians, nurses, and physiotherapists, out of the public system into private, for-profit care. The result is that those who can afford to pay—and our vulnerable population certainly can't—will get care sooner. For everybody left in line in the public system, the wait becomes longer.
NDP
Murray Rankin NDP Victoria, BC
Thank you, and thank you again for your organization's intervention in that case.
The third thing you talk about is pharmacare. I understand that one in ten Canadians today can't afford the medications that have been prescribed to them by physicians. I understand that Canada is the second worst in terms of drug costs in the OECD.
You called for federal leadership and you said that it needs a national formulary for your pharmacare reform to take effect. Could you elaborate on what a national formulary would mean and how you see the pharmacare strategy unfolding?
Board Member, Canadian Doctors for Medicare
In essence, what we've looked at, and what a number of other organizations, including the CMA, have now looked at and agreed with us is we are overpaying drastically in terms of our drug costs. Part of that has to do with where we're located on the planet, but the other part of it has to do with simply not having a large bargaining unit to be able to cut a better deal.
There are ways to do that, if provinces can get together. We do that at the cancer agency where I work. We essentially have pharmacare for all drugs that treat cancer. We negotiate for the whole province for those drugs. We would be much more efficient and we could cut a better deal if we were all negotiating for the entire country.
Similarly, it is a saving of scale. If we can come to the point of being able to negotiate for all of the pharmaceuticals that are necessary to treat a population base of 35 million, we simply would have more power to be able to deliver more for less.
NDP
Murray Rankin NDP Victoria, BC
In a footnote in your submission you referred to the work of Dr. Marc-André Gagnon of Carleton, who shows the tens of billions of dollars Canadians would save if we had such a pharmacare program.
Board Member, Canadian Doctors for Medicare
It is a huge amount. If you look at the figures, it is quite shocking how much more expensive certain drugs are here than in other jurisdictions. That's detailed in the brief.
Liberal
Conservative
Dave Van Kesteren Conservative Chatham-Kent—Essex, ON
Thank you all for coming. It's a great discussion.
Dr. Klasa, I'm going to keep going with you. It's great to hear somebody who is in the medical profession who has first-hand knowledge and a bird's-eye view of what's going on. It must be frustrating at times to see how....
I think in essence we all agree that the health care system that we have has to be preserved. This government has provided more funding than any government. I believe it's a 60% increase, $20 billion since we formed government, and it will be at $32 billion this year.
How does that help? Can you perhaps talk about your ability as an organization to do its critical work and how that helps you?
Board Member, Canadian Doctors for Medicare
How specifically the funding helps?
Board Member, Canadian Doctors for Medicare
Again, funding is necessary to deliver the services that we deliver across the country. There is no question that our population demographics are shifting somewhat. This requires perhaps a modicum of more spending, but that really isn't the big issue. To me the big issue is the distribution of that spending and how we're using those dollars.
Innovations are never cheap. New drugs in cancer tend to be very expensive, and fortunately, they actually do prolong people's lives these days. The question we have as a society is how we are going to distribute the money and how we are going to spend for the best outcomes.
If your question is whether the extra funding that's being put in, the funding being put in by the federal government, is something that is obviously a good thing and used well, the answer is yes.
Conservative
Dave Van Kesteren Conservative Chatham-Kent—Essex, ON
I want to go a little further. The issue isn't so much funding, because there seems to be.... I don't want to pick on anybody here, because I think everybody does great work. I think most members of Parliament can testify to this, especially those who are on the finance committee, that as we are visited by the different organizations, there seems to be a lack of coordination. It has been brought up in a number of other questions that possibly we need to coordinate a little better.
If you were king of the medical world, how would you coordinate heart and stroke, mental health, all the others? Are we doing that right? I'm going to give them a chance to defend themselves. I'm not here to criticize them either, but there seems to be that lack of coordination. Do you want to comment on that?
Board Member, Canadian Doctors for Medicare
Well, one can set up coordinations, I guess, in different ways.
I'll let my colleagues speak to their areas of expertise. In mine, if I could do it all my way, then I would say, if we had a national cancer program as opposed to just provincial cancer programs, we could be more efficient, take the best innovations that are present in each province and spread them across the whole country, and deliver uniform care that Canadians deserve at the very highest level, in that way.
Conservative
Dave Van Kesteren Conservative Chatham-Kent—Essex, ON
Would you close cancer research centres possibly in one province, but not another if they did better work or if they're more advanced or had better equipment?
Board Member, Canadian Doctors for Medicare
I don't think that would be the approach. I think the approach would be to bring people up to speed. In all provinces there are pockets of expertise; there are areas of expertise. Some provinces have a little more than others, but there is expertise in every part of Canada. Here the idea would be to build upon that expertise and to really exploit what is being done much better in one province, and that then could be translated to another.
We've done some of that even in our own work, where we've talked to other provinces and said, “Here are all our protocols. We put everything up on the web. This is how we treat every patient with this cancer in this province at five cancer centres and 75 smaller outlets.”
Conservative
Dave Van Kesteren Conservative Chatham-Kent—Essex, ON
I'm going to put you on the spot with this one.
Board Member, Canadian Doctors for Medicare
I'd better make sure I hear this one right.
Conservative
Dave Van Kesteren Conservative Chatham-Kent—Essex, ON
If, for instance, Mr. McLellan had a research centre to work with mental disorders, would you possibly suggest that Heart and Stroke would fund him and raise the money for that? Is that a better approach? Or should we keep on doing what we keep doing, which is let all these other different organizations do, basically...? I know it's not the same work, but it's trying to achieve the same thing.
Board Member, Canadian Doctors for Medicare
I think it's important to have different approaches to the same problem, because unfortunately we actually don't know.... We are involved in research, and the reason we're doing research is that we don't know the answer. Preconceived notions of how to go ahead sometimes turn out to be wrong. I think that different approaches from different jurisdictions and from different groups with expertise that spans a much larger spectrum is what I would do.
Conservative
Dave Van Kesteren Conservative Chatham-Kent—Essex, ON
Okay.
I'll go to Mr. Sculthorpe.
As an organization you have identified a number of things to stop. You have slowed down heart disease and stroke. Now you want to expand that to first nations.
If we know what causes it, what exactly do you want to do within the first nations groups to implement what you already know causes the exacerbated problem?
Chief Executive Officer, Heart and Stroke Foundation of Canada
It's a great question.
On your last question, I mentioned before that we have unified, so we are now all one. We are looking at best practices that go on in each province and sharing them across the country. We're getting rid of our duplication. We have formed alliances with the top 20 leading research hospitals and universities across the country, and we're committing $30 million to them. Sunnybrook is one of them. It's one of the best in the country.
We would do the same thing we have done in B.C., Manitoba, and Ontario, taking the best practices from programs that are already very impactful, and we would offer them to first nations and all the different communities, including Inuit and Métis, on reserve and in urban communities, with our partners at the CDA and the YMCA.
Conservative
The Chair Conservative James Rajotte
Thank you very much, Mr. Van Kesteren.
Mr. Adler, go ahead, please, for the final round.
Conservative
Mark Adler Conservative York Centre, ON
Thank you all for being here today, and thank you for all the great work you do across the country.
I do want to focus my line of questioning on Mr. McLellan.
At the end of this process, what we are doing here is prioritizing and assessing. There are so many worthy causes, but of course we can't fund everything, as much as we would like to do that.
You spoke about creating a centre whereby disorders of the brain and mind would work hand in glove with each other. Could you please explain in layman's terms what exactly that means? Is that being done now at Sunnybrook? Can you give a concrete example that stands out in your mind of that process taking place?
