Health committee  Most of the universal public systems that we would compare to—the U.K., Sweden, Norway, Australia, New Zealand—have fairly limited copayments, with the exception of Australia. Australia has about a $35-per-prescription copay for general beneficiaries. If you're disabled, low-income, or over 65, you pay what's called a concessional fee, which is significantly less.

Health committee  It would be very similar to the way that our drug benefit programs work in most provinces for populations that are eligible for public plans that exist today. Most of them they present their CareCard and pay their copayment. If they were exempt, they would pay nothing and get the prescription.

Health committee  Your member companies haven't obtained those savings for the last number of decades, so how can you tell us you can get the savings now? What are you waiting for?

Health committee  Yes. Just to be clear and to correct Stephen Frank, if you were to raise $9 billion in new taxes to pay for this system, the federal government would be a net winner by $5 billion a year on that system. You'd be bringing in money that would be paying for other federal programs.

Health committee  Yes. At the end of the day, every reasonable analysis shows that you'll save billions of dollars. There's no question. Most importantly, getting back to the original purpose, you will provide access to medicines that Canadians need. That is a fundamental human right, and Canada is the only wealthy country with a universal health system that doesn't provide it.

Health committee  This has been a long line: no pharmacare until there's cost control. I think the evidence is fairly consistent, both in terms of the analysis that's been done by the PBO and independent academics and from the international experience, whether it's the VA in the United States, the U.K.'

Health committee  If I fell back on the medicare formula at a 25% contribution, the federal government would put $5 billion into a $20-billion plan and the provinces would come up with the balance necessary to get themselves to $15 billion and you'd be there. In reality, I think the PBO report underestimates the copayment revenue that would be possible.

Health committee  Best estimates are that the private sector would get $2 back for every dollar it puts into a more efficient publicly run system. The thing about this is if we do it right and if we budget appropriately—not being cheap and making sure the system can be reasonably comprehensive—then in the future the private sector will be an ally and will realize the value you're providing for them as the pressures are taken off them.

Health committee  There's no doubt it will save Canadians money at the end of the day, because there's only one taxpayer. Only one source of money goes into buying drugs today. In the provinces there has been talk about catastrophic drug coverage as being at least a minimum safety net. That requires that every year people with chronic illnesses pay 3% to 10% of their household income on prescription drugs before benefits kick in.

Health committee  I'll wade into this one. I think this is the territory in which you need to sit down with representatives of employers and unions and talk about what would be a fair bargain. Eric Hoskins and Kathleen Wynne suggested that they will be doing this in Ontario with OHIP+. That's a massive windfall for the private sector because of children and youth being covered who are otherwise covered through family health plans or extended health benefits.

Health committee  The leading therapeutic categories are drugs to treat cardiovascular risks, drugs to treat anxiety and depression, drugs for diabetes management, and drugs for asthma and COPD, or airway diseases. There are a handful of therapeutic categories that dominate.

Health committee  We're already paying for it. In fact, we're already paying billions of dollars more than—

Health committee  This program will cost billions of dollars less than Canadians are already paying for prescription drugs. What we need is to find a revenue tool to move some of the money that is in the private sector—some of the money for publicly financed private drug benefits for people like me, a public employee—into the system.

Health committee  Can I quickly comment? I think this committee also heard from the CEO of the Surrey Board of Trade, a board of trade in my province that brought up to our provincial chamber of commerce a motion in favour of a universal public pharmacare plan, which was passed. One of the arguments that was made in moving that up to a formal policy or request of that organization was that a public pharmacare program makes extended health insurance more affordable to more small employers.

Health committee  The principles of the Canada Health Act, particularly as they relate to accessibility, actually forbid there being extra billing or user charges of any kind for what are called “insured services under the act”. The insured services, if you were to add pharmaceuticals, would have to be defined in relation to some sort of national formulary, which would be the minimum package of drugs available to Canadians.