Thank you very much, Mr. Casey and committee members.
You have copies of both our submission and my speaking notes, and I'll try to stick to them.
First of all, merci, and a big thank you to your team, Monsieur Gagnon and company. My first scheduled appearance was May 17, and we've been juggling dates because it's been so important for us to appear in front of you.
As stated, I am national president for the nurses unions. We represent close to 200,000 working nurses across the country, including nursing students, and we are one of the strongest advocates for a national pharmacare program.
We commend the committee for your mandate, which is the development of a national pharmacare program. It's not another study; it's the to-do list on what we're going to see.
We've lobbied the Council of the Federation, and I'll talk about it. We've directly lobbied federal and provincial health ministers and gained lots of support there, and of course we've lobbied in federal election campaigns and provincial ones.
We've also published research material from Dr. Marc-André Gagnon of Carleton University, “A Roadmap to Rational Pharmacare Policy in Canada”. You would have had copies of it in the past.
Some may be asking why nurses are the strongest advocates for a national pharmacare program. It's simple: on every shift, every night and day, we see either the impact that not taking their prescribed medication has on patients or we see the impact of the provinces and territories having to struggle with their health care budgets and having to cut, because $30 billion of the health expenditure in this country is spent on prescription drugs. That is four times what was spent 20 years ago—and yes, 20 years ago I was a nurse.
We are about to publish a new paper on the cost of drugs, but it's going to have a different economic twist. It's going to be about the billions that this country is wasting. That will come out in early December, and I'm sure you will all get a copy, probably laminated with pictures to make sure you all read it.
We have heard that many Canadians pay some of the highest prices in the world for prescription drugs, and these costs are predicted to increase further in the future as we pay for more complex drug therapies, an aging population, and expanding patent protection regimes.
We know that the provinces and territories, through the Council of the Federation, have moved to lower drug costs through bulk purchasing. We also know that there are limits to what they can accomplish compared to a national prescription drug program with scope and efficiency. Not properly controlling drug costs directly hits provincial and territorial budgets and leads to cuts in health care budgets as a knee-jerk reaction.
It is frustrating for the nurses of this country to see governments spending far more than necessary on prescription drugs and then choosing to cut health services, leaving patients with poorer health care and more vulnerability. Based on the evidence your committee has already heard, it seems that there is only one answer, and it is clear.
To your committee and all elected representatives, on behalf of the front-line nurses I represent, I say that now is the time for action. The evidence is strong and the evidence is clear. What we need, and the challenge that we have, is to muster the political will to take action. We need to be asking not if but how we can implement the structure of a national prescription drug program for Canada.
To do this we must include the best practices from around the world and design a system that will fit within our Canadian context. It certainly can be done, and anyone who says it can't be done doesn't know the history of our country in achieving solid public policies that benefit all Canadians.
Yesterday I met with Minister Philpott. One of her team members said, in a little snarky remark, “Well, Linda, you just want the New Zealand model.” My reply was simple: we need a Canadian model, a made-in-Canada model based on all the evidence from around the world. What we're doing now is inefficient and too costly and, honestly, not too smart.
To be clear, we need a reform of our health care that will meet the needs of all patients. It could save billions of dollars. These billions of dollars need to be reinvested into first nations health priorities, a safe senior strategy, and health human resources, mental health, long-term care, and home care, just to name a few.
The Liberals promised $3 billion in home care. Studies have said that a national pharmacare program would cost between $1 billion and $4 billion, with savings of between $7 billion and $11 billion. In my quick calculation, that's a pretty good rate of return, and that could pay for home care, mental health demands, and everything else we've been hearing about on health care.
Of course, implementing a national pharmacare program should be done with clear steps, and this is what we're hoping this committee will be able to give the federal government: clear steps to implement a national pharmacare program. It will require governments across the country and health care professionals to work together.
It will also look at the covered workplace benefits. Moving to pharmacare will limit the open formulary currently used by insurance companies. As a union leader and negotiator, I know that and I support it, but just as they've done in the past, insurance will adapt and offer different products. I am not worried about the insurance companies at all.
Private insurance will continue to have a part in our health care system in some form, but having 60% of drug coverage for Canadians managed by private interests at a very high cost and without universal coverage is not in our national interest. Let's remember that government exists to ensure the needs of citizens are protected, and corporations have long adapted to shifts in public policies.
Our members favour national pharmacare based on the evidence and on an evidence-based formulary, and it will not result in workers rebelling. This is fiction. Many unions, including mine, have passed many resolutions promoting a national pharmacare program, and we continue. It is time that we applied a health lens to all government policy, and the best place to start is with prescription drugs.
I was there when the provinces and territories struck their first deal, co-operating on bulk purchasing. This saved about $490 million annually, and it will increase, but this is peanuts. We have to remember that we're a very small country in population. We're the same size as the state of California, and we need to do more than bulk purchasing. We have to change the way we do things with our prescription drugs, period.
I was also there during the last negotiation of the health accord. We don't want the same repetition. We don't need another committee to study national pharmaceutical products. That was my message to Minister Philpott yesterday. We need actions and we need them now. The provinces and territories cannot wait for another study on what to do with the health accord or what to do with pharmacare.
Let me conclude on a personal note. Many years ago I was a young nurse activist stomping my little feet and making noise because health care had been cut in my own beautiful province of New Brunswick. Some of you might remember. We had Premier McKenna, a full house of Liberals, and no opposition at all. Premier McKenna said, “Linda, stop complaining. Find solutions. I have no more money.”
Premier Gallant, Premier Notley, Premier Wynne—I can name the 13 of them—are all saying the same thing now: “We have no more money for health care.” We have to find a solution. We know the solution is about stopping the waste of billions of dollars in over-inflated costs of inappropriately prescribed prescription drugs. We have to start now with a national pharmacare program, reinvesting in the health of our communities and finally doing our job—or your job, as MPs.
Finally, we have to talk about trade, and I only have 10 minutes, so I'm finishing it right there. You have to exclude health care and any new programs when you negotiate trade with any other countries around the world.
Thank you very much.