Actually, I have said that I am in favour of the federal government intervening in order to facilitate access to medications for all. My impression is that, for the intervention to be legitimate constitutionally, it has to be done pursuant to the Canada Health Act. Now, that act must be brought up to date.
As you have already heard or read in the briefs presented to you, when the Canada Health Act was passed, the most expensive medications were provided in hospitals. We now see that situation moving. Most medications, even those for the treatment of cancer, are provided in an out-patient situation, and are therefore excluded from the terms of the Canada Health Act.
Clearly, if the federal government expands transfer payments and broadens the term “medically necessary” that appears in the Canada Health Act, additional conditions will have to be included in the act so that the provinces can obtain the new federal transfers. Those conditions could indicate, for example, that all residents of each and every province are assured of reasonable access to medications. Because of the transferability condition written into the act, we could ensure a degree of consistency in the supply of medications, which is possible to do under the Canada Health Act.
We would then be choosing a flexible program that is acceptable constitutionally. I am sure you are aware of the latest positions of our Minister of Health, Dr. Barrette. That is, that provinces would not automatically agree to abide by new conditions governing medications. But the provinces could still at least take advantage of federal transfers that would allow their pharmacare coverage to be broader.