Madam Speaker, I will be sharing my time with the member for Winnipeg North.
Thank you for the opportunity to speak to the motion of the member for Vancouver Kingsway on national pharmacare.
For me, it is pretty simple. Any Canadian who needs treatment should be able to meet with their family doctor, or equivalent; receive a prescription for a drug, if it is required; proceed to their local pharmacy, and have that prescription filled at no cost, or at very low cost.
Today approximately 10% of Canadians cannot afford to have that prescription filled. Further, one in four Canadians report they cannot afford either to fill their prescriptions or complete their prescriptions. Traditionally, this under-treatment burden has fallen most heavily on our more disadvantaged populations, particularly those who are working in low-paying jobs, which often have no benefits. Often these are temporary jobs, and the people who hold them face periods of unemployment.
I believe Canadians would not want to hear that a temporarily unemployed mother with two children cannot afford to provide basic drug treatment when needed because it is unaffordable to her, yet that is the case in Canada today. Increasingly, even with full-time jobs, many of us are experiencing difficulty affording prescriptions as employers reduce their percentage coverage to lower levels, increasing the self-pay burden.
New treatments for rare and uncommon diseases are emerging, but they are very expensive. One of our most famous Canadians, Paul Henderson, who in the 1972 Russia summit series scored the winning goal, was diagnosed later in life with chronic lymphocytic leukemia. I understand the cost of the life-saving drugs to treat his condition is over $50,000 a year, and that could last for the rest of his life. Who among us can afford this life-saving pharmaceutical intervention without all of us sharing in the cost? All of us and our families face the risk of not being able to access essential medicines because we cannot afford them. We need to work together, pool risk, and support each other, as we have in other important health services.
Our government is already working to improve the affordability of prescription drugs and our access to them. Our current focus is on reducing the price of drugs, which will help improve access to necessary medications. We join provinces and territories as a member of the pan-Canadian Pharmaceutical Alliance, which negotiates lower drug prices on behalf of public drug plans. In the year and a half since joining, we have been able to use this bulk buying power to negotiate 60 agreements that are already saving Canadians money. We continue working collaboratively with the provinces and territories on other ways to make prescription drugs more affordable and accessible for Canadians.
Through the Patented Medicine Prices Review Board, the Government of Canada regulates the maximum allowable prices of patented drugs. The board recently completed the first phase of a consultation with Canadians on changes to its guidelines that would enable it to better protect consumers from excessive patented drug prices.
While much has been done to make pharmaceuticals more affordable for Canadians, I believe more can be done. I do not believe that lowering the cost of drugs would make them any more affordable for that single, temporarily unemployed mother of two. The problem is that prescription drugs outside of hospital care are not covered by the Canada Health Act.
As Canadians, we are proud of our national health care program. Today our national program covers doctor care, most diagnostic services, hospital stays, and prescription drugs while in hospital. It does not cover the $28.5 billion that was spent on pharmacy-filled prescription drugs in 2015.
The Standing Committee on Health, of which I am a member, began a study of the development of a national pharmacare program in 2016. We have heard from dozens of witnesses, including patient advocates. We have heard from experts in medicine, social policy, constitutional law, and pharmaceutical manufacturing, as well as pharmacists and the insurance industry.
In September 2016, the House of Commons Standing Committee on Health asked the parliamentary budget officer to provide a cost estimate of implementing a national pharmacare program. The committee provided the program's framework. We included the inclusive list of drugs to be covered by pharmacare, based on Quebec's gold standard formulary; eligibility requirements; copayment levels; and eligibility requirements for copayment exemptions.
The committee received the report, which is a public document, on September 28, a short week ago. The paper estimates the cost to the federal government of implementing this particular framework for pharmacare. It incorporates assumptions of the potential savings resulting from a stronger position for drug price negotiations, consumption or behavioural responses of providing universal coverage, and potential changes in the composition of the drug market.
After accounting for pricing and consumption changes, the PBO estimates that total drug spending under a national pharmacare program would have amounted to $20.4 billion if the program had been implemented in 2015-16. This would have represented savings of roughly $4.2 billion on the actual expenditures, which I believe is a conservative estimate.
In 2015-16, $13.1 billion was paid by public insurance plans for prescriptions, while private insurance plans, mostly through private employers, covered $10.7 billion. These two existing coverage streams would cover the entire population of Canada with a national pharmacare program and yield savings back to the employers. This is a win-win scenario.
I agree fully with my NDP colleague that Canada needs to adopt a national pharmacare program. As a caring society, I believe all of us are interested in ensuring that no one in Canada has to go without essential prescription drugs. Why, then, as caring Canadians, would we not move immediately to adopt a national pharmacare program, as proposed in this motion?
As I mentioned earlier, the Standing Committee on Health has heard from many witnesses on this topic. We have heard that affordability is not the only challenge. There are other complexities that need to be considered. Should there be a formulary to decide what drugs are insured? Should the formulary be set nationally or set by each province and territory? How do we ensure that research and development continues in Canada and provide patent rights while ensuring that we can all access generic drugs to make the program affordable? Should there be a single-payer model, or would we continue with the multiple private insurance system? How would our model of federalism be applied?
There are many complexities around this issue. For example, the U.K. has created the National Institute for Health and Care Excellence, whose role is to improve outcomes for people using the national health system and other public health and social care services. It produces evidence-based guidance and advice for health, public health, and social care practitioners, but, most importantly, it advises on the use of new and existing medicines, treatments, and procedures within the national health system. If we are to proceed with a national pharmacare model, we would need a corresponding scientific and evidence-based body to advise on what drugs should be in the insured plan.
The Standing Committee on Health is currently engaged in the final stages of its study of a national universal pharmacare system. We can bring recommendations on all of these complexities and on the cost model. The committee asked the PBO to prepare a report, given certain parameters, to guide the committee in its evaluation of policy options, and we are looking at options.
We have not even had the chance to meet with the PBO, examine his PBO's work, and ask about the assumptions and procedures used to produce the report. As a committee, we have not finished that work on this report. I strongly feel that it is premature for Parliament to call upon the government to act when the committee has not even drafted, let alone tabled, its report. I am disappointed that a valued member of the standing committee would rush to the House to table a motion asking Parliament to direct the government ahead of his own committee's report. Therefore, I say to my fellow committee member from Vancouver Kingsway that we should let the committee finish its work.
I also believe we need strong federal leadership to drive this change, starting with amendments to the Canada Health Act, and not just by initiating conversations with the provinces and territories, as is proposed in this motion. We need federal leadership on this issue.
For these reasons, I will be voting against the motion, but I want to be very clear on this issue to the residents of Oakville, my colleagues in the House, and those across Canada who are championing a push for national pharmacare: I fully support this initiative. One of the primary reasons I entered politics was to do my best to see that all Canadians are entitled to receive prescription drugs.
As I said earlier, all of us and our families face the risk of not being able to access essential medicines because we cannot afford them. We need to work together, pool risk, and support each other, as we have on other important health services.
I support national pharmacare, but it must be implemented appropriately and with thoughtfulness to ensure that Canadians receive the excellence in care that they deserve.
