Green Party of Canada 1. Public Administration: The public health insurance plan must be managed in a public, not-for-profit fashion. 2. Comprehensiveness: All residents must be covered for “medically necessary” health services. 3. Universality: All residents must be covered by the public insurance plan on uniform terms and conditions. 4. Portability: All residents must be covered by their public plan, wherever they are treated in Canada. 5. Accessibility: All residents must have access to insured health care services on uniform terms and conditions without direct or indirect financial charges, or discrimination based on age, health status or financial circumstances. The threat of a NAFTA challenge from the American for-profit health care industry cannot be overestimated. Allowing for-profit health care would be the “thin end of the wedge” that jeopardizes our entire health system. Based on the rules for “national treatment,” if Canada allows increasing numbers of for-profit facilities, we run the risk of losing our entire universal single payer system in a NAFTA challenge. We cannot take that risk. Fixing our health care system means protecting the core elements of universal single-payer health care. We need to ensure that every Canadian has a family doctor. We should embrace the vision of PatientCentered Primary Care as developed by the College of Family Physicians of Canada. The health care team, centered on the patient, includes a large number of trained professionals. We can do more to make efficient use of nurse-practitioners, to ensure nurses are well supported with other workers performing cleaning and other essential services. We need more health care professionals and we need more beds to reduce the wait times. We also need adequate funding to ensure that the support staff of cleaners is not compromised. The spread of infection within hospitals has worsened as janitorial staff have been privatized with lower wages and cut back. In order to keep health care spending from continuing to skyrocket we must find a way to control the cost of drugs. Currently, 20% of our health care budget is spent on pharmaceuticals – and this is the area of health care in which costs are rising most quickly. Pharmaceutical use must be more rigorously assessed on an evidence-based approach. Used as directed, it is estimated that prescription drug use leads to 150,000 deaths every year in North America. Health Canada has not performed adequately in assessing risks. Canada still lacks any requirement for mandatory reporting of side-effects from prescribed drugs. Far too often, conflict of interest in the relationship between those who advice government agencies, and even physicians who accept trips and promotions from the pharmaceutical industry can influence decisions. There are two and a half drug sales representatives for every physician in Canada. Getting a handle on the use of prescription drugs can both save lives and cut costs. The best way to accomplish both life-saving and cost-cutting goals is through a universal pharmacare program, a bulk drug purchasing agency, and make new drug patent protection times shorter. This national agency would follow the principles of the gold-standard for evidence based assessment of the risks and benefits of pharmaceuticals – the Therapeutics Initiative at University of British Columbia. It is critical that no conflict of interest corrupt the drug assessment process. Drugs showing a greater harmful than beneficial effect will not be part of a national Pharnacare programme. The Therapeutic Initiative approach identified Vioxx as such a drug, when Health Canada missed the risks. It is estimated that the TI assessment, and the willingness of the British Columbia Health Department to accept that advice,
68