Ottawa needs to fix medicare

By Stan Rice
The StarPhoenix 
January 13, 2012

Rice is a retired pharmacist and health-care administrator, who has experience in developing a drug formulary for the Saskatoon Community Clinic.

Prime Minister Stephen Harper stated in a year-end interview that it's up to the provinces to fix the problems with medicare.

Yet lack of federal coordination and guardianship means that more and more Canadians lack access to comparable services in primary health care, prescriptions drugs, home care, rehabilitation and long-term care. Harper's unilateral action on future federal funding indicates that Ottawa no longer will take any responsibility for ensuring that all Canadians receive universal quality health care.

He went on to say that the provinces must do something, because the current system is unsustainable.

This is a curious statement that shows the PM either isn't aware of, or chooses to ignore, the true cost of health care in Canada.

From 1975 to 2009, medicare spending - on hospitals and doctors' services - has remained stable at between four per cent and five per cent of GDP. At the same time, the cost of services not included under the Canada Health Act have risen to seven per cent from three per cent, led by the cost of private drug plans at an average of 15 per cent annually.

The biggest impediment to progress in implementing the 2004 Health Accord has been the withdrawal of the federal government from the essential role of national co-ordination in health-care policy.

The Harper government never misses an opportunity to note that health care is a provincial responsibility and to avoid accountability for its important roles in health care, including use of federal spending power to achieve health objectives for the good of all Canadians, aboriginal health, food and drug safety, and the enforcement of the Canada Health Act.

It is unfortunate that Harper cares so little for our public health-care system that he ignores the feelings of most Canadians. A recent Nanos poll indicates that support for the public health system has risen to 94 per cent in October of 2011 from a high of 90 per cent year earlier.

Canadians expect our federal government to take a leadership role. The one area where the leadership vacuum is most damaging is in pharmaceutical management. Federal policies that govern the approval, pricing and marketing of prescription drugs are a failure. As a consequence, millions of Canadians are not receiving safe, effective, appropriate and affordable medication.

When the 2004 health accord was negotiated, pharmaceutical costs were the fastest-growing segment of health-care budgets. It is not surprising, then, that pharmaceuticals management was such a major focus of the agreement.

What is surprising is the decision of the Harper government to walk away from national pharmaceutical management. The Health minister denied in front of a Commons committee that an agreement on pharmaceuticals was ever in the accord.

For the record, the National Pharmaceutical Strategy in the 2004 Health Accord, found on Health Canada's website, promised action on catastrophic drug coverage, establishing a national drug formulary, strengthening the evaluation of drug safety and effectiveness, improving prescribing habits, and international parity on drug prices.

It is difficult to overstate the damage to people and to medicare caused by Ottawa walking away from a key element of the accord - namely nationwide solutions to concerns about safety, accessibility and affordability of prescription medicines. Some of the resulting consequences are deaths from inappropriate use of pharmaceuticals; millions of Canadians lacking affordable access to pharmaceuticals; and drug costs being 30 per cent above the international average.

In addition, the Harper government is working in the opposite direction by negotiating a trade agreement with the European Union, which could increase the cost of prescriptions by $2.8 billion a year and introduce draft legislation that weakens drug safety.

It is perverse for the Conservative government to encourage excessive growth of pharmaceutical costs and abusive marketing practices, and then pass on the bulk of the cost and damage to provinces, territories, employers and individuals. You can't claim to be concerned about rising health-care expenditures, claim that it's a provincial responsibility and then forget about your responsibility to control the fastest growing component in health costs.

A groundbreaking research study for the Canadian Centre for Policy Alternatives concluded that a universal public drug plan would save Canadians up to $10.7 billion a year. The dramatic savings are achieved by various measures that include eliminating some subsidies, using competitive purchasing, assessing new drugs more rigorously, improving prescribing practices; and revising industrial policies related to drug prices - something that's entirely within federal jurisdiction.

Politicians no longer can hide behind the excuse that universal public drug coverage is too expensive. We can save lives, cover everyone and save money. Canadians cannot afford not to have universal pharmacare.