Your time is up.
Evidence of meeting #73 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was drugs.
A recording is available from Parliament.
Evidence of meeting #73 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was drugs.
A recording is available from Parliament.
4:35 p.m.
Senior Director, Costing and Budget Analysis, Office of the Parliamentary Budget Officer, Library of Parliament
As well, looking at that, drug prices are of course moving targets. We have probably the best dataset available within the public sector right now with respect to the composition of drugs and drug consumption. That is changing dynamically over time.
Going back to a point I made earlier, which my colleagues will likely strangle me for saying, we produce these forecasts not because we're going to be right. We produce these forecasts to set up a planning environment for parliamentarians. Conceptually, based upon this paper, are we comfortable that this is a balanced estimate of the potential savings? Absolutely. In order to achieve those savings, are there many open questions with respect to the implementation? Absolutely. Will that implementation directly affect the actual savings that could potentially be realized by the federal government? Most certainly.
4:35 p.m.
Liberal
The Chair Liberal Bill Casey
Okay. Thanks very much.
It's twenty minutes to five. We have time for another round of five-minute questions. Is that the consensus?
Before I do that, I want to clarify that the next meeting on Thursday is the round table meeting. On the 24th and 26th, we have no meetings scheduled. On the 31st, we have drafting instructions. I wanted to make sure everybody was clear on that, because there was a little confusion.
For the next round, I have Mr. Oliver up first.
4:35 p.m.
Liberal
John Oliver Liberal Oakville, ON
Thank you.
I first wanted to ask again about this and make sure I understand what is in the public insurance plans and what is in the private insurance plans. I'm trying to figure out what taxpayers are already on the hook for.
If I think about the CHUMS group—colleges, hospitals, universities, municipalities, schools, and government—those employees are covered by employer plans. Would they be in the private insurance plans or the public insurance plan...?
4:40 p.m.
Financial Analyst, Office of the Parliamentary Budget Officer, Library of Parliament
They'd be in the private insurance plans.
4:40 p.m.
Liberal
John Oliver Liberal Oakville, ON
Taxpayers, then, are already paying for the $13 billion that is in the public insurance plans. Of that $10.7 billion, do you have any idea on what are private employers and what are the CHUMS publicly funded private employers?
4:40 p.m.
Financial Analyst, Office of the Parliamentary Budget Officer, Library of Parliament
No, we don't.
4:40 p.m.
Liberal
John Oliver Liberal Oakville, ON
Taxpayers are already, then, covering a much greater proportion of these drug costs. I thought they were just in that $13 billion. That makes this even more affordable if I think about implementation going forward.
In the exclusion of the roughly $3.8 billion that was excluded based on the Quebec formulary, I saw a sub-note saying that it was mostly medicinal dressings or dressings with medicinal additives. What else is excluded? What would somebody in a private plan today not have access to because of the Quebec formulary? Is it mostly lifestyle drugs, besides dressings?
4:40 p.m.
Financial Analyst, Office of the Parliamentary Budget Officer, Library of Parliament
The medicinal dressings you're talking about were the drugs that I wasn't able to.... They're on the RAMQ formulary. I just wasn't able to link them into our dataset. It's not that they're missing from the private plan.
The amounts you're talking about that are missing are only exclusively in the private plan and would fall into that $3.9 billion that we didn't look at. We didn't take another look at what was in there at all, but we do have that information.
4:40 p.m.
Liberal
John Oliver Liberal Oakville, ON
Maybe you were asked, but is that something you would easily be able to produce for us just so we can see what would be excluded? We could get some sense if we went forward with this plan of currently what people who are employed would have access to and what they wouldn't. Is that an accessible file for you?
4:40 p.m.
Financial Analyst, Office of the Parliamentary Budget Officer, Library of Parliament
Yes. We could break down that $3.9 billion.
4:40 p.m.
Liberal
John Oliver Liberal Oakville, ON
That's great. It would be good to know just what would be excluded.
For me, then, if I look at this, let's say we have a single mom, unemployed, who takes her kid to the doctor's office and doesn't have benefits. Under this model, she would get a prescription from her family doctor or nurse practitioner. That prescription would be tested against a formulary of some kind—hopefully one that's national and put together by the feds, the provinces, and the territories—and she would then go to a local pharmacy and have the prescription filled.
Depending on the means test, there may or may not be a $5 copayment; I guess that's whether or not she chooses generics. The cost of those meds, if we went to a single-payer system, would likely be covered by the province or territory through the existing payment systems in place in pharmacies for the ODB and other provincial plans. She would be able to go home.
The cost to us of the government doing that would be about $20.4 billion, and we already have more than $23 billion being spent just on employed people in Canada, so we could set that mom up with an insured plan and still save public funds on top of the $4 billion that you've identified as savings.
4:40 p.m.
Financial Analyst, Office of the Parliamentary Budget Officer, Library of Parliament
Ultimately, Canadians are the ones paying for everything here. If you're talking about who's paying that way, then yes, we're still talking about the taxpayer.
4:40 p.m.
Liberal
John Oliver Liberal Oakville, ON
Yes, but they're already putting in $13.1 billion, and then some big chunk of that $10.7 billion is the CHUMS and government employees, so the taxpayer is already there.
Then for the private employers—the true private employers, not the businesses that have a number of employees and have their own benefit plans—we could say to them that we could insure their employees and offer them a significant.... We could say that we could cover their employees for them and they'll get a significant portion of their current benefit plan payments back. Is that correct, depending on how the assumptions are made around how we make the payment happen, the $20.4 billion?
4:40 p.m.
Financial Analyst, Office of the Parliamentary Budget Officer, Library of Parliament
If I understand correctly, I think what you're asking me is not how much Canadians are paying, but how much governments are paying. Is that correct?
4:40 p.m.
Liberal
John Oliver Liberal Oakville, ON
It's governments and the private sector employers who have plans for their employees. We could say to them as well that we will cover their employees, make sure they have access to the drugs they need so that they're healthy for their workplace, and they'll get some savings back on top of that.
4:40 p.m.
Financial Analyst, Office of the Parliamentary Budget Officer, Library of Parliament
I don't know the breakdown of that $10.7 billion, but the idea is that, yes, the federal government would be responsible for paying this and all other insurers would go away under the pharmacare plan for those drugs. I'm sorry that I can't be more specific about the breakdown of that $10.7 billion.
4:45 p.m.
Parliamentary Budget Officer, Library of Parliament
I'm sorry, Mr. Chair, but could I add something?
4:45 p.m.
Parliamentary Budget Officer, Library of Parliament
There is something interesting in the report that is exactly about what you are mentioning. I think the question was raised about how the members here and all in the public service are covered by the private insurance of the public service, which is at $654 million. It's exactly—this is the magic of numbers—what the national pharmacare plan would cover for the same public, which means the public service and the members of this committee. It tells you that a national program will cover exactly what private insurance companies are covering right now for the public service.
4:45 p.m.
Voices
Oh, oh!