Thank you very much, and we'll miss you.
First of all, I'd like to thank our witnesses today.
I actually have a whole bunch of questions. I'd love to have more than five minutes, but the reality is that if we're going to be moving to a national pharmacare program, the rationale behind that is to decrease costs and have better coverage, but some of the evidence—even Mr. Ferguson's point 9—is that when government runs things, sometimes that's not exactly what we end up getting.
We've defined pharmacare. Some of the activists, unions, and groups that have come in front of us say it's a government-run, single-payer monopoly that would entirely replace Canada's current pluralistic system of federal-provincial-territorial publicly funded, government-run drug plans, and the employment-based private drug plans. One of the problems with setting this up is that a lot of the data we have is extremely old. What I'm concerned about is the cost to the taxpayers in the immediate costs, if you're moving toward this.
Mr. Ferguson, in your point number nine today, you said that you “noted recurrent problems with government programs that are not designed to help those who have to navigate them and that focus more on what civil servants are doing than on what citizens are getting”, that it is “critical for the government to understand that its services need to be built around citizens, not process” and that you “encourage the government to think at the design stage of how a pharmacare program could deliver services that work for Canadians.”
You gave an example, I think in point number four, about inefficiencies and it being two years before things are actually looked at.
I'm really concerned. We don't really know at this stage of the game how many Canadians are insured, uninsured, or under-insured. We don't know how access to newer treatments and drugs would be affected. We've seen in other countries that have national pharmacare that innovative drugs can be restricted. Under realistic assumptions, we don't even know how much cost is going to be shifted to the taxpayers under pharmacare, and we don't know indirect economic costs, for example, job losses, private sector job losses, or takeover of the private sector. We don't know what the NAFTA implications would be, how other countries are really doing this, and what we have in the pipe right now that's working very well.
My first question for you, Mr. Ferguson, would be this. The federal government only covers 2.1% of total prescription drug expenditures in Canada. How is it being done? Is it being done efficiently by the government right now? If we extrapolated that 2% to 100%, do you think the costs would be huge?
What are your thoughts on this? Maybe you can't even answer that question.