Evidence of meeting #14 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was cost.
A recording is available from Parliament.
5 p.m.
Commissioner and former Premier of Saskatchewan, Commission on the Future of Health Care in Canada, As an Individual
I take the easy questions; he takes the hard ones.
5 p.m.
Conservative
Len Webber Conservative Calgary Confederation, AB
We had Dr. Abby Hoffman here a few weeks ago, and she was of celebrity status. I still rank her above you, Mr. Romanow, but you're a close second.
5 p.m.
Commissioner and former Premier of Saskatchewan, Commission on the Future of Health Care in Canada, As an Individual
She certainly is. She can run; I can't.
5 p.m.
Conservative
Len Webber Conservative Calgary Confederation, AB
You made a couple of comments. You said that the feds must take a strong leadership role with regard to looking into pharmacare and that Canadians want a strong national role. That was obvious from the Angus Reid poll as well.
You've experienced this in your days as the premier, and know that there are health care silos throughout the country. Trying to get provinces and territories to participate....
Dr. Marchildon, you mentioned that perhaps if provinces do opt out of a national pharmacare system, there should should be no financial contributions going to these provinces. I wasn't quite sure. That question is for Dr. Marchildon.
With regard to you, Mr. Romanow, how do you break down those silos? Obviously, we haven't been able to do that in the 14 years since your report. How do you get provinces on board?
5 p.m.
Commissioner and former Premier of Saskatchewan, Commission on the Future of Health Care in Canada, As an Individual
First, I'd like to think that they didn't do it in the 14 years since my report because a pharmacare plan has not been initiated.
Secondly, I will make the point that it will not be easily implemented. There's no easy way in a federal system such as ours, in my experience. I do think that it is a divided jurisdiction between the federal and provincial governments. Ideally you'd like to have a co-operative set of negotiations and agreed-upon facts in public policy. What propels that kind of mechanism is a common agreement on what the values of Canadians are—and I'll spare you the talk about that.
However, what happens if there is an impasse?
The reason I cited Mr. Pearson is that at some stage or another, there simply has to be federal leadership. Then the question is whether or not it will stand if it is not effective. I think that any coercive policy federally is not going to stand if it doesn't, first, do the job, and second, resonate with the values of Canadians.
Medicare in Saskatchewan was introduced all by itself by little old Saskatchewan, in 1962. I was there as a young student on the side of the medicare battle, so I'm a little bit biased.
At a national level, for it to be taken as it was after the Hall commission report appointed by John Diefenbaker.... We're talking about a pan-political group of people based on science. There was opposition. There is always opposition. I suspect there will be opposition on this as well. I think that at this stage in the game, the federal government's obligation, and your obligation—with the greatest respect to this outstanding committee—is to weigh the facts, take a look at the values, and make some decisions as to what you recommend. If the recommendation is that we want a national pharmacare plan, the federal government's spending power, the rationalization, the cost-savings that will flow, and most importantly, the benefits to the Canadian public will lead everybody to come into it, as it was with medicare initially.
I don't think there's any way around that.
5 p.m.
Conservative
Len Webber Conservative Calgary Confederation, AB
When you were doing this study back in 2002, did you look at other countries?
5 p.m.
Commissioner and former Premier of Saskatchewan, Commission on the Future of Health Care in Canada, As an Individual
Yes, we did.
5 p.m.
Conservative
Len Webber Conservative Calgary Confederation, AB
What other countries would you recommend we look at when it comes to our study here today as a good way to move forward with what we're doing?
5 p.m.
Commissioner and former Premier of Saskatchewan, Commission on the Future of Health Care in Canada, As an Individual
First of all, the study is 14 years old, I'm sad to say. There has really been an explosion of pharmaceuticals since that time. I think it's safe to say—I'm not a medical person—that some of those work and some don't work, and so one has to be a little bit careful. In the years since that time, I would argue that the numbers—which are set out in one of the documents I presented to you as a model of what to follow—indicate in effect that 13 or 14 countries have followed a universal pharmacare program, which means that it has to have worked.
Why do I say that? Because it is accepted by the governments and by the public both on a cost basis and within a values structure.
The two outliers, strangely in my judgment of history, are Canada and the United States. What are the grounds for that? There don't seem to be sufficient grounds, at least there are none that I've seen. I've tried to keep up to date on the studies. I'm not as current on them as I was. There just seems to be a reluctance in terms of either federal-provincial co-operation or federal leadership.
I think the evidence, with some little discrepancies here and there, which are important to consider, overwhelmingly indicates that a single pharmacare plan complements our program. To me, it fits with our values, and it fits with the evidence that is there. Fourteen years ago, we didn't have nearly the numbers we have today.
5:05 p.m.
Commissioner and former Premier of Saskatchewan, Commission on the Future of Health Care in Canada, As an Individual
I'm not answering your question quite fully, and I apologize for that.
5:05 p.m.
Conservative
Len Webber Conservative Calgary Confederation, AB
The chair cut you off, so you weren't able to anyway.
5:05 p.m.
Liberal
The Chair Liberal Bill Casey
It is really a good question. If you were to pick a country or two or three, which ones would you say best reflect a successful system that delivers a viable process, a viable pharmacare program?
5:05 p.m.
Commissioner and former Premier of Saskatchewan, Commission on the Future of Health Care in Canada, As an Individual
I'm using here some of the evidence of Dr. Marc-André Gagnon from Carleton University. I think the chart he has, which coincides with what we've been doing from time to time, indicates that the countries that seem to be the ones we would model are the U.K., Australia, and New Zealand, perhaps down the pike with regard to the arguments that have been set out in this particular brief.
To be honest with you, this is not my area. One would have to really plough into this in some detail to make sure that the broad statement I am making would coincide with the facts and outcomes.
5:05 p.m.
Liberal
John Oliver Liberal Oakville, ON
Both Mr. Romanow and Dr. Dutt have referenced submissions to the committee. Just through you to the clerk, we didn't receive their submissions.
5:05 p.m.
Liberal
The Chair Liberal Bill Casey
They were just in English. They can't be presented unless they are in both languages.
5:05 p.m.
Liberal
John Oliver Liberal Oakville, ON
So we won't have access to them? Dr. Dutt had some very significant points. For the first time, we had some estimate of the ongoing costs to the system of people who had not taken their medicines.
5:05 p.m.
Liberal
5:05 p.m.
Liberal
John Oliver Liberal Oakville, ON
Is there any way we could expedite these in the future so we could have them prior to committee meetings?
5:05 p.m.
Liberal
The Chair Liberal Bill Casey
I'm learning as we go. If they are in one language, we need unanimous consent to distribute them. In the future if we do have them, we'll seek unanimous consent at the beginning, because I miss them too.
5:05 p.m.
Liberal