Thank you to the committee for the opportunity to speak with you today.
The Ontario Health Coalition is a network of organizations and individuals dedicated to protecting single-tier public health care in Ontario. We represent more than 70 local health coalitions, more than 400 member organizations, and more than half a million individuals.
There is widespread consensus among experts that the trade opportunities in the Trans-Pacific Partnership agreement are small to negligible. In fact, the term “trade deal” is from the health care perspective a misnomer; as it relates to health care, the TPP is much more a corporate control arrangement over government policy than it is about increased trade.
Such being the case, if this standing committee and our Parliament are acting in the public interest, then you must recognize and act upon the urgent concerns of public interest groups when it comes to the TPP's proposed constraints on our government's ability to set policy not strictly related to trade at all, in particularly in the new chapters of the TPP that contain implications regarding the regulation of the pharmaceutical industry and drug prices.
It's our testimony that the changes proposed in the TPP would increase costs for both public and private purchasers of pharmaceuticals. They would restrict future policy options for our government for the benefit of brand name pharmaceutical companies' profits at the cost of Canadian patients and of the public interest.
Public health care advocates and trade experts are united in warning that the TPP's most significant detrimental impact for Canada's health care system is its impact on drug costs. Higher drug costs will impact the entire health care system, placing competing demands on scarce resources, thereby increasing pressure to cut services across the health care system, accelerating privatization, increasing out-of-pocket costs for patients, and exacerbating inequities and suffering when people are facing illness and aging.
Imposing unnecessary costs and unpredictable risks on the Canadian health care system in exchange for negligible increase to our GDP is a bad deal for Canadians and Ontarians. As health and trade policy expert Scott Sinclair warns:
The increased burden on taxpayers and consumers from higher drug costs alone would likely exceed the full savings to Canadian consumers from the TPP’s elimination of tariffs on imports into Canada, undercutting one of the chief arguments for liberalized trade.
In addition, it's a deeply held principle among Canadians that we have an obligation to those less fortunate than ourselves. International humanitarian organizations are speaking with one voice when they warn about the TPP's damaging impact on access to medications for patients in some of the worlds poorer nations.
Canada's drug costs are already too high. According to the most recent data available from the Canadian Institute for Health Information, Canadians pay the second-highest cost of all OECD nations for drugs, second only to the United States, and our costs are significantly higher than average.
Across Canada, drugs are primarily paid for by private health insurance or directly by individuals: 36% by private insurers; 22% out of pocket by patients and households; and the remaining 42% by public drug plans, primarily provincial and federal government plans.
Among the provinces, the proportion paid by the provincial governments varies from 31% in New Brunswick to 51% in Saskatchewan. Ontario is in the middle at just over 40%. The burden of higher drug costs resulting from the TPP would fall on private insurers, individual households, and provincial governments.
In Ontario, there may be a bit of a misunderstanding that there is public coverage for drugs through the Trillium drug program and the Ontario drug benefit program. In our experience there are very significant gaps in those programs, leaving very high drug costs for individuals already, without the TPP's impact.
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