It's really the crux of the question, isn't it? It comes down to what we want from our health care system. It also comes down to what we, as a society, feel we need to do for specific populations or problems facing us. I've come today and said that my idea is that maybe what we're trying to get from the health care system is to maximize the overall health of the Canadian population. That's what I think the objective should be, to maximize.
If there are other issues that you want to deal with, we need to deal with that outside of the health care budget, in a sense. Otherwise, funding a drug for a rare disease that costs $500,000 per year is going to take money from the health care budget and is not going to provide as much health benefit as would be provided to other individuals through other interventions, and therefore the net population health is going to decline. That's just a fact. We can argue about that, but that's just numbers, and math doesn't lie.
The issue then is whether there is something that we actually value differently about patients with rare diseases. Is there something that we want to create a special fund for or a special process for? That is for you guys to decide, not for me. That's a process issue or a values issue.
All I can say is that society has been asked, many times, to try to trade off different aspects of populations to see what they think they should put more money towards. The research shows that rarity isn't something that society has valued. Now, U.S. politicians might decide that this is not what we, as Canada, should do, and I applaud you for that. If you let the world decide what we could do, we'd still have the death penalty in Canada, but we think that's wrong. We might want to think about what society's values are. We know what's happened down south when we trust society to express their values. Maybe you want to have something special or different here. That's a decision that politicians have to make; I'm sorry. You would have to say that we need to set aside this amount of money to have a separate process for marginalized populations or for populations that we care about, but take it out of the health care system, because all you're doing by keeping it within the health care system is making decisions that don't lead to what the health care system should be doing, which is maximizing the health of Canadians.