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| Aisha Jahangir, Facebook |
The first part of our conversation illustrates two things about Aisha that I want to emphasize. First, she's really got a "fire in her belly" for health issues. That's important, because there's a lot of work involved in running for office and the odds are pretty heavily stacked against her winning. And unless you are totally committed to the cause, the effort of running for election will burn someone out very fast. Secondly, we had a hard time finding a time to talk. That's hardly surprising, because she is a mother and a healthcare professional in the middle of a pandemic. I think that this is an important point, because it shows that she has the energy and drive to survive in the political sphere. And as the saying goes "If you want something done, ask a busy woman".
Because Ms. Jahangir is so motivated by concern about the health system, I decided to "fact check" her.
First, I tried to find out the percentages of full versus part-time work for Canadian nurses, but they were hard to find. The best I could get was a 2019 study by the Canadian Institute for Health Information that included numbers in it's break down by province---but they didn't have a nation-wide number. Here's the info for Ontario:
As you can see, only 67.5% of Registered Nurses and 55.6% of Licensed Practical Nurses are full time---the rest may be working 40 or more hours a week, but that would either involve working at several institutions at the same time, or, getting more hours but still being paid with a lower rate of pay plus no benefits (ie: payment into a pension plan). And, as we learned with our Long Term Care facilities, it is a really bad idea to have people working part time at different institutions during a pandemic.
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As for the cost of drugs, comparing them across countries is really complex. Luckily I found a Rand Corporation study from 2021 that tried to do this by comparing US wholesale drug prices with those of several other nations---including Canada. Here are three graphs that show their findings.
The first thing to understand about these graphs is that the numbers for each country are a percentage of the US cost for a basket of drugs. That means if a drug costs $100 in America and the graph lists it at 200% of what the same thing costs in Canada, that means that it costs $50 here. That means, paradoxically, the higher the number is on the top of the individual country's bar, the less it costs in real terms.
The three graphs split the market into generics, patented brand names, and, the two types of drugs averaged out. In the US, copyright drugs are significantly higher priced than in any other country. But at the same time, generics seem to be cheaper there than in any other "developed" country. (I wouldn't be surprised, for example, if India produces cheaper generics.) The additional prices for patented drugs outweighs the savings on generics, though. Which means the total average drug costs in the US are more than anywhere else.
Also, please note that these numbers are based on wholesale prices, not retail. That means that there may actually be a difference based on what sort of mark-ups are done in the actual pharmacy.
Once you understand the above points, you see that our prices in Canada are higher than France, Italy, and, the UK for all three aggregated groups of drugs. Moreover, Canada also pays more on average than the entire list of 33 nations that the Rand study used to base their study on. (The average of the entire list is the last bar labelled "All Countries".) It appears that drug prices are yet another example where we look great compared to our neighbours South of the border, but not so when compared to Europe.
And, of course, we all know that Canada doesn't have a universal socialized prescribed medicine system. There are, however, several complicated "work-arounds" that exist to offer drug coverage to different segments of the population based on need. Rather than try to explain this, I'll just insert the following YouTube video produced by the Oncology Drug Access Navigators of Ontario (ODAN). This appears to me to be a non-profit that helps people with cancer navigate the complex bureaucracy which gives financial assistance to those who need it. (Of course, you have to wonder about how useful a government assistance program really is, if a non-profit comes into existence just to help people take advantage of the program. Couldn't the bureaucracy do a better job of helping people access the program?)
The above information brings together the two halves of a public health system. First, prices have to be controlled---which is where the "single-payer" side of our medical services comes into play. That is the process where the federal government tells medical providers what they are and are not allowed to charge for any given procedure. This prevents the doctors and hospitals from bankrupting OHIP. Canada is failing on that front because drug companies are charging more here than they do in other countries with single-payer prescription drug systems.
The second part is the government program that pays the costs of patients. A national drug policy would be able to bring in the cost savings of the single payer system, which would then allow the government to cover everyone through a universal system---instead of the current fragmented system where some folks have drugs covered by company benefits, others get it through a means-tested, or, age-based system, and, the folks who pay out of their own pockets. Without a government payment system, there are people who don't have either a private or government insurance program and find they cannot afford to buy the medicine that a doctor prescribes.
All of this is just to say that Ms. Jahangir's experience as a nurse seems to be pretty much spot-on with regard to nursing and drugs.
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I've gotten into this in some detail because I think it's really important to understand people's motivation when they get into politics. At one time I thought that it was important for an MP to have as wide-ranging a view of issues as possible. That's because the government of Canada has look out for the interests of everyone on every issue. That invariably means that conflicts will arise between people's particular concerns.
In my case, in the past I've been skeptical of the NDP because I suspected that when push comes to shove they were more interested in issues like healthcare than the environment---and would always trade concern over climate change off in order to get something like a national drug plan. And that's why I have a history of supporting the Green Party. (That's no secret if you know anything about me.)
But as I've gotten older, I have come to the conclusion that we all have different life experiences and it's asking too much to expect people to become dispassionate, logic-slingers like Data or Spock from Star Trek. Instead, I think it's a good thing for candidates to have their own passions and to let them out for everyone to see. Then voters will have a good idea about who they are voting for, and why. When the people who win end up in caucus and Parliament-as-a-whole, then they are going to have to "fight it out" to see what ends up being a priority.
I'm still concerned because people have a very strong bias towards what they've personally experienced in their lives. But if someone's passion is something I have lots of sympathy towards, like socialized medicine, I'll just have to hope that he or she will still have some room to support other issues too. Indeed, without broad and deep support for environmental issues, there's little sense in electing people who focus on the environment because the other parties and the general public will just sabotage all efforts at getting something done. Big issues require broad consensus to solve---.
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This article has run on and I still have lots more to write about Aisha's experiences as a candidate, so I'll save it for the next instalment. Until then, get your shot, keep your distance, and, wear a mask. The virus is still out there and you can still get it and spread it even if you are fully vaccinated (everything is a question of percentages). Take care, things can still fall apart---look at the UK and Holland, if you want to see how badly.
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