TTH-1

Audience Comment / Toronto Town Hall

My name is Michael McBain. I'd like to start just by thanking Dr. Turnbull and The Canadian Medical Association for calling on federal leadership in healthcare. We're gonna lose the system without federal leadership. We're not just a bunch of provinces. We're not just a bunch of regions. We're a country and the system is splintering because there's no guardianship -- there's no building for the future -- without federal leadership.

You're asking a really good question. We're not getting value for money and I think the 800 lb gorilla in the system is the pharmaceutical industry. Now it's interesting that nobody talks about that but that's the biggest cost driver. How can you say you're concerned about sustainability and rising costs and not address what the cost driver is -- the primary cost driver. Pharmaceuticals has gone up 73% in 10 years per capita inflation adjusted. Nothing comes near that. But worse than that we're spending 30% more than the international average on new drugs. We're not using them properly. Over prescribed. Drugs are dispensed based on marketing tactics not on evidence. Even with children! If we're concerned about children's health we should be concerned about physicians who are prescribing dangerous anti-psychotics to 2 year olds. That's a huge problem and that's a marketing problem. That's something the medical association needs to consider. This is a moral issue. Medicine's not about commercial marketing. And that's the biggest challenge in terms of value for money.

And I think the solution is a universal public pharmacare plan. Not a private plan, not a hybrid like Quebec has because Quebec's drug plan is out of control. It cannot control it's costs because it partnered with the private insurance industry. You have to have a public plan. So I think it's a very good question. I think we have to address the cost drivers and I think we're not getting value for money, particularly with new drugs.