Matthew Gaiser, Calgary-Bow

Question 1: Cancer Care and Healthcare Services

In a recent poll conducted by CBC Vote Compass, healthcare is the number two issue on the minds of Alberta voters.

If elected:

A) How will your government improve the delivery of cancer care and other healthcare services in Alberta?

B) Will your government continue to provide a publicly funded healthcare system or would it institute a private healthcare system?

C) How will your government restructure healthcare delivery in Alberta?

D) How will your government ensure that cancer patients receive the services they need, including home care, financial assistance during recovery and for long-term side effects of cancer and/or treatment?
A) Having fortunately never had cancer, and my mother having a professional and caring experience that saved her life, I cannot say that I understand the issues facing cancer care delivery in Alberta. Out of respect for those currently tackling those issues, I will refrain from commenting on this question other than saying that I would do what I could to address health care delivery issues and will defer to the advice of those on the front lines. In my own life, I have required medical care at hospitals several times and the main issue seems to be a shortage of people and of beds. Shortages of nurses, who when surveyed in two years ago described being burnt out. Shortages of specialty doctors (mind you, the shortage seems to be in recruitment/facilities, not practitioners if this article is correct http://news.nationalpost.com/news/doctor-shortages-a-myth-nearly-one-in-six-new-medical-specialists-cant-find-work-report-suggests). The shortages in beds and ambulances are obvious. The shortage of beds and ambulances requires additional capital spending to alleviate. Whether that is additional overall spending or just spending redirected from other parts of the health system Making things “more efficient” will not help the fact that so many people need an ambulance or so many people need a hospital bed. Another ambulance is going to cost money. Another bed is going to cost money. But that money needs to be spent so that Albertans can receive quality care. I do not understand the exact reasons for a shortage of nurses nor a shortage of doctors and without understanding the root of those two problems, I cannot have a solution.

B) Under a Liberal government, health care would remain publicly funded. There is no question about that.

C) I cannot say how I would restructure health care delivery in Alberta before having a chance to discuss the current problems with front line staff members. This is not my area of knowledge. Please contact another Liberal candidate, such as Dr. Swann, who would have expertise in this area.

D) When my mother was diagnosed with cancer, support such as you described was handled by generous neighbours and my great family. Some people may not be so fortunate to have all the support available just from those around them. How this would be delivered is again, something that I do not know. However, I do support it being done in some form as it was a critical factor in my mother’s recovery.

Question 2: Drug Approval

A key element of providing timely treatment for cancer patients is ensuring that they have access to the medications they need at the time they need them. Unfortunately, this is not always the case in Alberta.

On average between 2004-2010, Alberta approved for public reimbursement 17.7% of the 306 new drugs approved by Health Canada, compared to the cross-country provincial average for the same period of 23.44% (Access Delayed, Access Denied: Waiting for New Medicines in Canada, Mark Rovere and Brett J. Skinner, Studies in Health Policy, April 2012, The Fraser Institute).

If elected, will your government commit to increasing the number of new cancer and other drugs approved for public reimbursement so that all Albertans have timely access to the drugs they need, and if so, how will this be accomplished?
This brings us to the larger issue of public vs private drug funding in Alberta and in Canada overall and whether some form of Pharmacare should be implemented, either on the provincial or national level. Should it be single payer, a mix of both systems, or should drug coverage should be entirely the domain of private insurers, with subsidies for the low income (the suggested solution from the Fraser Institute)? I think that on this issue there are two key points, both of which point some form of Pharmcare as the preferable option.

1) The economics: Does it make financial sense for society to pay for these drugs, can we afford them, and what are the financial consequences of society as a whole paying instead of individually/as part of corporate benefits?

At the end of the day, the cancer drugs are needed to survive/live with a reasonable quality life. They are not optional in any way. Therefore, the dollars consumed will generally be the same no matter who pays (lets assume that the bulk discounts negate the increase in usage because certain individuals could not otherwise pay without public/charitable help). Therefore the bill will be the same assuming that administration costs do not drop. Therefore, the only question is, who gets the bill? Society as a whole decided that we should pay for health care, so why is it different for medication, which I am sure most physicians will say is an essential part of that care?

2) The duties of our society/health care accessibility:

The main point of this that point towards pharmacare are that private insurance only goes so far. I have health insurance through Queen’s University, and it would reimburse me 80% of drug costs up to $2000. Now look at this article: http://globalnews.ca/news/1656699/the-cost-of-cancer-how-much-do-cancer-drugs-cost-canadians/ . $2000 annually is little help for a drug that costs $8000 a month. If I required that drug as a student, I most certainly do not have the financial resources to absorb that cost and do not really have the assets to even borrow that much money. My parents are well off, but they do not have that kind of money on hand. Unless my parents’ health care plan covered the drug, they would have to borrow money to save my life were I resident in Ontario or Atlantic Canada. I find it to be a very bizarre interpretation of societal obligation to say that the financial burden shall be shared with regard to health expenses, but only when one is sick in a hospital. If you are sick elsewhere, you are on your own. I realize that in Alberta this is not the case for live saving medication to a certain extent, but consider drugs such as Neulasta, which at the time of my mother’s cancer were not covered by AB. My father’s employer insurance at the time covered it, but his old one would not, and most plans are not that generous and access to care should not be dependent on whether one has good employer coverage. It is now covered (http://www.drugcoverage.ca/en-ca/search-results.aspx?ID=1327) but I see what you mean by the wait times and how they harm patient care.

I think that the Fraser institute is wrong about private drug plans solving the problem. My Queen’s drug plan would not have helped much and I expect that most drug plans would not be sufficiently helpful either. Medication is an important part of health care and should to a greater extent be covered by the government. The savings by bulk buying and administration will likely pay for themselves. Yes, taxes may go up, but costs per person will go down. The only difference would be that a portion of money spent currently on private/employer insurance would instead be used to fund government insurance of some sort and that would mean lower overall costs per person.

Keep in mind that many of these are my views, and may not be official party policy. I can only speak for what I would support, not what other candidates would support. I apologize for this being so long, I have a fair bit to say on the issue.