It's becoming clearer and clear that the various players in the health-care system have to contribute solutions in order to ensure its future. We have to overhaul how doctors are paid, review the organization of work, in particular to make better use of nurses, and revisit our drug insurance plan! This is the third of the four solutions that we are putting on the table to better control health-care costs. When the financial health of the health-care system, the prescription drug insurance plan and the pharmaceutical industry are compared, there is one obvious winner and two big losers. I won't ask you to guess who wins; give you the answer: the pharmaceutical industry.
Economics 101 teaches that there is a maximum price that a consumer is ready to pay for a good or service. Beyond that maximum, the consumer simply does without. But all the Economics 101 textbooks add that there are certain exceptions to the rule. The one they cite is the price of a drug that puts an end to a persistent illness or saves lives. In such a case, there's no maximum price. We are ready to pay whatever it takes, with the only limit being what we can afford.
Pharmaceutical companies are very aware of this exception to the rule. A number of community, labour, political and other organizations are calling for stricter control of this industry - take, for example, the campaign launched by the Union des consommateurs.
Why stricter control?
There are various interesting examples of what tackling drug costs can involve, but let's take an extreme case. For years now in Africa, there has been a social and medical crisis called AIDS. We have known for almost20 years that there is a treatment that allows HIV-positive people to live more normal lives. If it were not for the relentless work done by Doctors Without Borders, this treatment would still be totally out of the question for the vast majority of Africans. It is certainly not the pharmaceutical companies that would have solved the situation.
Drug companies exist for one reason only: to make maximum profits. It's part of their DNA. Between maximum profits and the value of a human life, the drug companies choose maximum profits. Providing drugs to Africans at prices the latter could afford would affect the prices of drugs here in America and especially in Europe, and thus have a major impact on profits. So it's an easy choice for them: profits.
This is why capitalist rules can't apply to this. Between the value of profit and the value of human life, the choice is easy to make: we choose life.
Two years ago, the CSN took a position on prescription drugs in Québec, proposing various cost-control measures:
• optimal use of drugs;
• stricter regulation of the pharmaceutical industry's promotion and marketing practices;
• longer periods for prescription refills;
• abolition of the "15 year rule";
• establishment of a rigorous drug assessment process;
• review of the choice of comparator countries used by the Patented Medicine Prices Review Board (PMPRB) so that the group is not composed of countries with the highest prices for medicines.
The CSN also suggested the creation of an entirely public drug insurance plan, noting the following advantage:
• in terms of efficiency and effectiveness, a universal public plan makes it easier to control costs and implement ways of optimizing the use of medicines. Furthermore, in the past the administration costs of public insurance plans have been lower than private insurers' costs.
Finally, there is an important debate to have on the creation of a public agency that would take charge of procuring prescription drugs. At the present time, there are hidden costs that government pays for. In Québec, we spend more on medicines than the average for OECD countries or the rest of Canada.
According to Québec solidaire's proposal to create Pharma Québec:
Keep in mind that prescription drugs account for 19.6 per cent of health-care spending in Québec, compared to a Canadian average of 16.2 per cent. The annual cost is $1,027 in Québec, $701 in British Columbia and an average of $912 in the rest of Canada.
In the past five years, Québec has invested more than $3.4 billion in the pharmaceutical industry in Québec. During the same period, 3,000 jobs disappeared.
To ensure the future of the public health and social services system, it is time for the government to screw up the courage to conduct this debate; it's an urgent necessity if we want to achieve better funding of the health and social services system.
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