Mr. Chairman, this is an interesting evening as we enter this health care debate. Members from all sides of the House have been expressing their views on this important issue.
What can we do to satisfy the health needs of Canadians? It is an important issue to many of the constituents in all of our ridings. Many Canadians have expressed to all of us individually as members of parliament their concerns about the state of our health care system and where it is going.
I was interested in the health minister's comments tonight as we started off debate. She indicated that Canadians are concerned about timely access to quality care. Tonight she started off by saying she wanted to address values. What should be covered? How should we pay? How should we provide the services? What values do Canadians want to see in their health care system and what values are needed?
My colleague from Yellowhead mentioned that in our consultations with Canadians we learned quickly that Canadians are concerned about timely, quality, accessible care and they want care available to all Canadians. My colleague from Kelowna spoke tonight. He mentioned that seniors are particularly concerned about the setting of their preference, in addition to timely, quality, and accessible care.
We are now over $102 billion in health care spending. Why are we doing so poorly in outcomes? Why do we have such long waiting lists, shortages of personnel and why are outcomes so poor when we are spending so much?
I heard the minister say earlier that Canadians are tired of seeing their valued health care system sliding away while politicians argue and blame each other over funding, jurisdiction and their visions. Could it be that we are spending a lot of money for a high cost system that delivers what has become a low value product? I am one who believes we are spending enough money on health care. We could do a lot better if we perhaps spent it in a different way. A lot of Canadians would share that perspective.
This subject has been studied and studied. In British Columbia the Justice Emmett Hall study was done in 1979. In 1997, just prior to the last election, there was a National Forum on Health which spent about $12 million. We have had provincial studies: the Fyke commission in Saskatchewan and the Clair commission in Quebec. We have had the Kirby Senate reports that are ongoing on health care and the Mazankowski report recently tabled in Alberta. Now we are waiting for the Romanow study to be completed in the next few months. That is another $15 million of taxpayers' money going into a study. What will we do to fix this situation?
My colleague from Yellowhead indicated earlier tonight that researchers from the Library of Parliament studying this said that the federal Liberals have spent $242 million studying the health care system. We do like to study health care.
One I did not hear mention tonight is hot of the press and sure to add fuel to the fire of discussion. It is the Canadian Medical Association document “Prescription for Sustainability” that was just released on June 6. Its prescription is on behalf of more than 53,000 physicians. I am sure there will be valuable and interesting suggestions and no doubt will add to the debate in the days to come.
I want to address a few major concerns. One of them is the cost of drugs and the effect of drugs. Health Canada has received in the vicinity of 7,400 domestic reports of suspected adverse reaction to health products in 2001. These were reported for the most part by health professionals either directly to Health Canada or indirectly through another source. It is unknown how many cases go unreported. According to the government's own data doctors report less than 10% of all reactions.
About 51% of Canadians have taken more than one prescription or non-prescription medication on the same day. Yet 61% of the same people do not always check with their doctor or pharmacist about possible interaction, according to a Pollara study. The need for mandatory reporting of drug reactions is something that needs to be addressed. The high number of casualties from iatrogenic causes, that is doctor caused, or inappropriate use of medications, is a terrific cost driver and a mortality driver and a serious concern for Canadians.
Another issue is independent drug approval for children. Children are routinely given lower doses of drugs than are approved for adults and yet they are at a greater risk than adults for developing a severe reaction. Drug research is not currently performed on children, and without a more reliable regulatory body the safety of adult drug use in children is unknown.
Emphasis needs to be placed on the differences in the pathogenesis of adverse reactions between children and adults. A recent study indicated that physicians are notoriously bad at mathematics when it comes to deciding what a dose should be for a child. This was responsible for overdose situations for children in a large number of cases. Nurses are a bit better with a pencil. This is a serious concern and something that needs to be addressed.
In addition, we have problems with drugs being imported, ordered by mail or on the Internet and mailed into Canada. I am speaking of drugs that are not available in Canada such as Prepulsid that Vanessa Young died from. Drugs coming across the border are a serious issue and we have no means of controlling it.
The increased cost of drugs is a huge problem for seniors as well as their safety. My colleague mentioned that about 30% of seniors are addicted to prescription drugs and with questionable clinical outcomes. The amount that we are currently spending on drugs is about $15.5 billion of that $102 billion.
Another serious issue involves aboriginal communities. In the Regina Leader Post on May 13, Dr. Henry Haddad, president of the Canadian Medical Association said, “Aboriginal health is a national tragedy and a national shame”. That is in spite of $2.3 billion in federal spending for aboriginal health.
Diabetes is three to five times more prevalent in aboriginal communities as it is in the general population, according to Health Canada. It is increasing at a rapid rate among aboriginal people. Before 1945 diabetes was almost unknown in aboriginal communities. If it goes unchecked at the current rate it is expected that 27% of all aboriginal people in Canada will have diabetes. Even aboriginal children are now being diagnosed with type II diabetes which was generally associated with older people.
What is happening to our aboriginal people? In coastal aboriginal communities in my area there is a saying, a philosophy, which is called Hish Tukish T's Awalk . It literally means “everything is one”. We are part of nature and nature is a part of us.
I want to address this issue on a different angle. Health is not something that is here one day and gone the next. Health is built over time by the choices we make, including lifestyle choices: what we eat, what we drink, the quality of air and the quality of water that we drink. All of these are part of building healthy bodies.
Exercise is also an important part. Exercise is promoted in cancer therapy for breast cancer and there are higher survival rates for those who actually pursue physical exercise such as the dragon boats that are popular with breast cancer survivors and even those undergoing treatment. Building healthy bodies ought to be a focus for Health Canada, and indeed it is a focus for many Canadians.
Many Canadians find that if they look after their physical, mental and spiritual well-being they will not get sick. They find that they do not get sick as often and if they do they recover more quickly. Building healthy bodies ought to be as much a concern for the health department as it is for Canadians. That has been my vocation for quite a while. I have spent some 25 years as a health care provider trying to build healthy bodies.
We need to address effectiveness and cost effectiveness. The system needs to become more patient focused rather than system focused. A lot can be said about manpower shortage as mentioned earlier tonight. Nurse practitioners could play a large role by helping out doctors with the care they have trouble providing. According to some studies perhaps 80% of what a physician does could be done by nurse practitioners.
Low back pain is a major factor in our society and also a major cost driver. A study was done by Dr. Pranlal Manga, a health care economist at the University of Ottawa, on the effectiveness and cost effectiveness of chiropractic treatment of low back pain.
Hundreds of millions of dollars could be saved provincially and on the national scale up to $2 billion by simply sending the patients preferentially to a treatment that works better than drugs or surgery. Why is it that there are financial disincentives when people choose another form of health care?
Simple nutritional supplements can make a big difference in a person's outcome. Why is it a substance like chromium picolinate which is very helpful and necessary in the management of blood sugar and necessary for the glucose tolerance factor is on a restricted list with Health Canada? These questions and others are ones that Canadians ask me. Why is Health Canada not more interested in promoting health than in continuing to fund a system that focuses so much on illness?
With these questions I add to the others that have been raised tonight and with my colleagues submit them for consideration as part of the dialogue. We are looking for answers. I believe there are more cost effective ways to deliver health care to Canadians and that is what we are looking for.