Thank you, Mr. Chair.
I thank the finance committee for inviting me.
First, here are my disclosures, because I'm an individual: I don't consult directly or indirectly with any corporation, association, NGO, union, government or person anywhere. Second, I don't have any investments of any kind, in any industry, so I have no conflicts of interest. Third, I do not belong to, or donate funds, directly or indirectly, to any political party.
You're reviewing the gargantuan budget implementation bill. I will not use up my scarce minutes on this topic, except to state that I am in complete agreement with Andrew Coyne on the topic of omnibus bills. They are most unfortunate because he thinks, and I think, they're hostile to democracy. Enough said.
There's so much to say, and so little time with this bill, so I decided to focus on one item that received precious little discussion, I think, and that is the seeming march forward to what is called a national pharmacare program in Canada.
First, we have to clear up terminological obfuscation, and engineered urban legends.
It has been stated repeatedly by supporters of a national pharmacare program that Canada is the only OECD country in the world without any pharmacare program. This is factually and statistically false.
CIHI, which, as everyone in this room knows, was established by former Liberal prime minister Paul Martin, collects and publishes superb statistics on all things health care. They've published an annual report on prescription drug spending in Canada for several years, with data going all the way back to 1985. It shows that approximately 45% of all prescription drugs in Canada, which cost around $30 billion in aggregate, are paid for by provincial health ministries with targeted pharmacare programs.
Restated, Canada has a very generous targeted provincial pharmacare program in every province. In plain English, “targeted” means it's based on needs measured by income, as many of our social programs are, including day care and tuition, in some provinces.
It's false and wrong to state that there is no pharmacare program in Canada, when CIHI's 2018 report on prescription drug spending states that $14.4 billion was paid for by provincial health care budgets for prescription drugs. Those who claim we don't have one are in complete denial concerning the massive empirical provincial government support.
The key finding of the 2018, and most recent, report is that $14.4 billion, or 42.7%, of all prescribed drug spending in Canada is financed by the public sector as distinct from individuals or private insurance.
This is, again, from CIHI. I'm reading it word for word, “About 1 in 4 Canadians (22.7%) received benefits from a public drug program in 2017. Individuals living in low-income and rural/remote neighbourhoods were more likely to have received benefits.” The third key finding was, “In 2017, the 2.3% of individuals for whom a drug program paid $10,000 or more accounted for more than one-third of spending (36.6%).”
The advisory report of the current government— I'm just going to focus on the one, and then go forward—found that too many Canadians cannot afford the prescription drugs they need. They estimated that 7.5 million Canadians, or 20%, are currently uninsured or under-insured. I have done work with the Macdonald-Laurier Institute. They've calculated it at 10%. Right now, I think it's fair to say that somewhere between 10% and 20% of Canadians, that is, somewhere between 4.5 million and 7.5 million Canadians, are uninsured or under-insured.