Hello, everyone, and good afternoon.
Thank you for the invitation to appear before you today.
The Canadian Health Coalition has been working for over 40 years to protect and improve public health care in Canada.
We are a national, non-partisan organization made up of health care workers, unions, community organizations, seniors and academics, as well as affiliated coalitions in the provinces and one territory.
Canadians are very grateful to have a universal public health care system that provides care based on people's needs and not on their ability to pay. This system has been put to the test over the past few months. The COVID crisis has highlighted the incredible strengths in our health care system as well as some persistent gaps and challenges. As we slowly begin recovering from this pandemic, we have an opportunity to rebuild our health care system to be even stronger and more responsive to the evolving needs of Canada's population.
Today, I'll be discussing three areas that require the federal government's attention: pharmacare, funding and seniors care.
As you may know, Canada is the only country in the world with a universal public health care system that does not cover prescription medication. As a result, millions of Canadians have been falling through the cracks. Before the COVID-19 pandemic, 20% of Canadian households were struggling to pay for their medication, either because they didn't have a drug plan or because their drug plans were inadequate. One million Canadians were having to choose between putting food on the table and buying the medication they needed. These numbers have increased exponentially during the COVID pandemic. The mass layoffs triggered by the pandemic have left millions more Canadians struggling to afford their medications without work-based drug plans. The need for universal public pharmacare has therefore never been more urgent.
Two years ago, this committee studied this issue in detail. I know a few of you served on the committee at that time. After holding 23 hearings with nearly 100 witnesses, the committee recommended that Canada adopt a universal, single-payer public pharmacare program that would cover prescription medication in the same way as doctors and hospitals.
Over the past 50 years, countless government and academic reports have all made the same recommendation, most recently the government's Advisory Council on the Implementation of National Pharmacare, led by Dr. Eric Hoskins. The Hoskins report from 2019 provides a blueprint for how to build this essential new program. The government must implement its recommendations immediately.
Universal public pharmacare would save money while saving lives. When people skip their medication because they can't afford it, the technical term for which is “cost-related non-adherence”, they end up getting sicker and visiting the hospital and the doctor more often. That's something we want to avoid in normal times, but during this pandemic it's absolutely critical. Research has shown that removing out-of-pocket costs for the medications used to treat just three health conditions—diabetes, cardiovascular disease and chronic respiratory conditions—would result in up to 220,000 fewer emergency room visits and 90,000 fewer hospital stays annually. This could save the health care system up to $1.2 billion a year, just for those three conditions.
Canada's current patchwork of drug coverage is inadequate and inefficient. There are over 100,000 public and private drug plans across this country that each offer different types of coverage. Many plans limit the amount that people can claim per month or per year, and many include expensive deductibles and co-payments that make medications unaffordable.
The current system is also unsustainable. Canada pays the third-highest prices among OECD countries for prescription medications, and spending on medication continues to rise. The number of drugs on the market that cost more than $10,000 per year has more than tripled since 2006. Canada currently spends more on medication than it does on doctors. Universal public pharmacare would allow us to limit this spending by negotiating lower drug prices through bulk purchasing. This new program would allow Canada to save $5 billion every year. Families would save, on average, $350 per year, and businesses would save an average of $750 per employee per year.
Last fall, nearly 200 national and provincial organizations signed a joint statement calling on all parties to work together to implement universal public pharmacare within the current government's mandate. We simply can't wait any longer to implement this program. Canadians are suffering, and some are dying prematurely because they can't access their medication. The government must implement pharmacare immediately as part of its response to the COVID crisis.
Now is also the time for the federal government to reaffirm its commitment to public health care. Public health care is our best defence against the COVID pandemic and other health crises. Regrettably, our health care system has been eroded over decades through systematic funding cuts and privatization. Even in normal times, the system is functioning at capacity.
The federal government must increase health transfer payments to the provinces to expand the capacity of public health care across the country, both in normal times and in times of crisis. The 10-year health accord from 2004 guaranteed the provinces an annual 6% increase to Canada health transfer payments. When that accord expired, the federal government reduced the annual increases to nominal GDP or 3%. We've known for years that this is simply insufficient to keep the system running effectively. At least a 5.2% escalator is needed just to maintain existing services.
In addition to long-term increases to the CHT, extra funding will be needed to handle the backlog of surgeries and services that have been put on hold during the pandemic. Instead of turning to the private sector to address this backlog, the federal government should support the provinces in implementing inexpensive public innovations to reduce wait times such as centralized wait-lists and team-based care.
The government must also protect our public health care system by actively enforcing the Canada Health Act. Many private, for-profit health care companies have taken advantage of this crisis to expand their markets, particularly in the area of virtual health care. Many of these companies are violating the Canada Health Act by charging patients out of pocket or billing private insurance companies for virtual doctors' visits.
In addition to raising concerns about the privacy and security of patients' medical information, this is draining resources from the public health care system. It is also threatening the foundational principle of equity that underlies our public health care system. The government must take action to prevent further erosion of this system and ensure that patients always come before profits.
I think we would all agree that one of the greatest tragedies of this pandemic has been the widespread devastation in our long-term care homes. The suffering of residents, staff and their family members in recent weeks is simply unfathomable. According to recent estimates, approximately 80% of all COVID-related deaths in Canada have been in long-term care facilities. Our deepest sympathy goes out to all those who have lost loved ones during this crisis, and we express our ongoing gratitude to all front-line workers who are putting their lives at risk every day to help care for patients in need.
Although we may not have been able to prevent the COVID pandemic, we could have limited its devastating impact in our long-term care homes if we had implemented fundamental changes to this sector sooner. My colleagues from CUPE testified before you last week on this issue, so my recommendations here will be relatively brief.
To ensure equitable access to safe, high-quality care, we must bring long-term care and home care into our public health care system. Over the past several decades, we've seen widespread privatization in this sector, in part because these services aren't currently covered under the Canada Health Act. We need new, dedicated federal funding for long-term care that is tied to national standards of care. These standards must include things like minimum staffing levels. The federal government must support the development of more public long-term care facilities and home care services, since abundant research shows that public not-for-profit facilities provide higher quality care than private for-profit facilities. All public funding should go toward patient care, not corporate profits.
We also need a national health human resource strategy to help recruit, train and retain high-quality care workers. These workers must be paid decent wages and guaranteed stable, full-time employment. We can significantly improve patient care by improving the working conditions for staff. The seniors and people with disabilities living in long-term care facilities and relying on home care are counting on us to rapidly make these changes. We must not let them down.
We can't undo the harm that has been caused by this crisis, but if we implement these changes, we can help prevent similar harm from occurring in the future. Let's learn from this experience and rebuild a public health care system that we can all continue to be proud of, a system that provides the high-quality care that everyone in Canada deserves.
Thank you.