Remarks By Dalton McGuinty, Premier Of Ontario To The Annual General Meeting Of The Canadian Medical Association
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It's a real pleasure to be here.
And it's an honour to speak to people who do so much to serve Canadians.
Our families turn to you, often at the most critical times in their lives.
Yours is an important responsibility, and I want to thank you for the work you do and for the professionalism and compassion with which you do it.
On behalf of the people I'm privileged to serve, I also want to welcome many of you to Ontario.
I hope you find time to enjoy this great city and this great province.
My friends in the NDP like to point to Tommy Douglas as the man who brought medicare to Saskatchewan.
We Liberals like to point out that our party introduced medicare on a national level.
The fact that political parties quarrel over ownership of medicare is proof it's popular.
And it's popular because it works.
It's one of our greatest competitive advantages.
Employers tell us that the high cost of purchasing private health insurance for their workers south of the border is often a factor in their decision to invest here in Canada.
Most importantly, though, medicare is essential to who we are as Canadians, to our basic notions about right and wrong.
We believe that health care should be available on the basis of how sick you are -- not how rich you are.
As Canadians, we look out for one another, we care for one another -- you are living proof of those principles.
But while medicare is the perfect expression of our values, it is far from perfect.
Our population is growing and aging.
Technologies and treatments are advancing.
And the cost of health care is going ever higher.
Here in Ontario, health care costs are growing by eight per cent each year.
Hospital costs, by 10 per cent. Drug costs, by 14 per cent.
And catastrophic drug costs at an even higher rate.
When I first came to the Legislature 14 years ago, health care accounted for one-third of the budget.
Now, just under half of program spending goes to health care.
Sitting in Cabinet, crunching the numbers, I sometimes think that if we don't act, we will soon have to rename our government the Ontario Ministry of Health, because there will be no money for anything else.
But there's good news, too.
We have a road map for reform.
We need to improve primary care, illness prevention and health promotion.
We need to reduce our reliance on hospitals as the only model of care so we can deliver the right level of care -- be it community care, home care or long-term care.
We need to tackle the shortage of doctors and nurses that threatens the well-being of patients, particularly in many under-serviced parts of Ontario.
We need to do these things so we can improve waiting times for important procedures and tests for cancer care, cardiac care, joint replacements and cataracts, MRI and CT scans.
We know what to do.
The even better news is we have a historic opportunity to actually get the job done.
We have a prime minister who has identified shorter medicare wait times as his priority.
We have a federal government in surplus, with the resources to work with the provinces.
And I can tell you, having chaired the recent meeting of premiers and territorial leaders on this issue, there is a great deal of political will amongst the provinces to deliver the results Canadians want.
We understand Canadians want results.
Today, I want to focus my remarks on one result that will really benefit Canadians.
One idea that will make a real difference.
A national pharmacare plan, with the federal government assuming full responsibility for public drug plans across the country.
It's a proposal we put forward as premiers and territorial leaders following our meeting here in Ontario earlier this summer.
The fact that we agreed stunned the pundits.
They suggested we were as likely to speak with one voice as Rich Little on a Las Vegas stage.
You see, whatever our political differences, we can all see that the time has come for a national pharmacare plan.
Before I explain why we believe such a plan is needed now, let me be clear about one very important fact.
We do not propose that we establish a national pharmacare plan INSTEAD of tackling other priorities such as shorter wait times and more doctors and nurses.
We want to establish this plan because it is one approach that will ENABLE us to tackle those priorities.
A national pharmacare plan, established by the federal government, will ensure Canadians get improved access to prescription drugs, on a consistent basis across the country, as part of a continuum of care.
And since it would also be funded by the federal government, it would help ensure that Ontario and other provinces can use more of its healthcare resources to deliver the other results -- the shorter wait times, more doctors and nurses -- that our people want and deserve.
I don't need to tell physicians that back when medicare was in its infancy, drug therapy wasn't nearly what it is today.
Now, prescription drugs are an important part of everyday life for many Canadians.
They provide relief from many of our regular aches and pains.
They protect children from illness, treat diseases that were once considered fatal, and improve the quality of life for people coping with chronic conditions.
According to the Canadian Institute for Health Information, since 1997, spending on drugs has represented the second largest category of health expenditures in Canada, second only to hospital services.
Canadians now spend $16 billion each year on prescription drugs -- with the provinces picking up $7.55 billion of that bill.
In his report, Roy Romanow pointed out that 300 million prescriptions are filled in Canada each year.
That's about 10 prescriptions for each man, woman and child.
He said that "a strong case can be made that prescription drugs are just as medically necessary as hospital or physician services."
But instead of medicare keeping up with the expanding role of prescription drugs in an integrated way, across the nation, we have a patchwork of programs across Canada.
Here in Ontario, the Trillium Drug Program covers catastrophic drugs costs for some families without any -- or adequate -- private insurance.
But the public drug plans in some provinces offer no relief to people under the age of 65, unless they're on social assistance.
Here in Ontario, our Drug Benefit Plan covers the cost of prescription drugs for all seniors.
But some provincial drug plans exempt some seniors on the basis of income.
And, with costs escalating the way they are, it's no secret that there has been pressure on our province and others to do the same.
Pressure we managed to resist in our last budget, but not without making some very difficult decisions.
As premiers, we feel strongly that a national pharmacare plan would be a win-win-win situation.
Most importantly, patients would win.
Access would be improved for thousands of Canadians, and that access would be equitable across the provinces.
We could do away with each province having its own administration, so more money could be dedicated to drug therapy.
And the giant-scale purchasing of drugs at the national level could result in savings that would help bring down costs, freeing up money for health care for patients.
The federal government wins.
Ottawa wants to do more than send the provinces a cheque.
It wants a strong role in ensuring accountability in health care.
Well, by assuming the responsibility for a comprehensive drug plan for all Canadians, Ottawa would also be accountable for its outcomes.
And the provinces -- now hard-pressed to deliver the health care people deserve -- also win.
When patients have access to appropriately prescribed drugs, the entire health care system is more effective and more efficient.
Illnesses are prevented.
Hospital admissions are reduced.
And ultimately, waiting times are shorter.
And if the federal government took responsibility for drug programs, that would free up resources for the provinces to invest in other urgent health care priorities.
To train more doctors, hire more nurses, provide more cardiac surgeries and joint replacements and deliver more CT scans and MRIs.
Let me make this clear: we are not talking about an expensive new add-on to our current system.
Prescription drugs are not an add-on.
They are a vital component of health care that taxpayers and patients are paying for now.
We're talking about a new partnership with the federal government.
We're talking about a partnership that will reduce duplication and bureaucracy.
We're talking about a partnership that will bring all provinces up to the same drug plan standard.
We're talking about a partnership that improves access to prescription drugs for Canadians who need them.
We have a tremendous opportunity here:
- For patients to get equitable, improved access, right across the country
- For the federal government to lead in a critically important and growing sector of health care
- And for the provinces to be given the flexibility we need to deliver the shorter waiting times the prime minister and we have been talking about -- and that Canadians and Ontarians are demanding.
The idea is sound, and so are the principles that guide us in putting it forward.
A national pharmacare plan, to be funded by the federal government, must not come at the expense of other federal funding commitments and obligations -- including the federal government's obligation to fund 25 per cent of provincial health care costs.
A national pharmacare plan must result in better use of taxpayers' dollars through less duplication, better service and reduced costs.
A national pharmacare plan must remove barriers that prevent Canadians from enjoying a continuity of care across their country.
And, most importantly, a national pharmacare plan must ensure no Canadian suffers undue financial hardship in accessing medically necessary drug treatment.
I want to conclude by asking you, leaders in health care delivery across this great nation of ours, for your help and your support.
I'm asking you to back this proposal, to urge MPs, the federal cabinet and the prime minister, to take the time to consider it fully, so they can embrace it completely.
I'm asking you for this help on behalf of Ontarians, but also on behalf of the patients we are both privileged to serve -- me, as their elected representative, and you, as their chosen, trusted caregiver.
Our meeting this September with Prime Minister Martin may or may not make for riveting television viewing.
But what I do know is it will mark a critical juncture in the future of medicare.
It will be a key indication of whether we are truly ready, willing and able sustain it and improve it.
Because we will face a choice.
We can choose to continue to squabble, to focus on where we disagree -- a choice that leads to paralysis, or worse, an ever more tattered patchwork across Canada, with some private here and public there; with one place well cared for and the next barely cared for.
Or we can choose an issue on which we agree.
We can choose to work with Ottawa to put in place a national pharmacare plan.
We can help Ottawa lead on health care.
We can help the provinces manage their health care budgets.
And we can ensure Canadians get the health care they want, the health care they need, the health care they deserve.
Health care that's second to none.