Day: May 24, 2019

Liberals want to build their campaign around pharmacare, but ignore where drugs would end up

Fred Roeder is a health economist and the managing director of the Consumer Choice Center. David Clement is the North American-affairs manager for the Consumer Choice Center.

Internal documents from within the Liberal Party recently showed that Ontario Liberal MPs want 2019’s election campaign to be built on a national pharmacare plan.

Specifically, the proposed plan would seek to centralize and consolidate the 46 drug-procurement programs that exist in Canada. The goal would be to give Canada as a whole more bargaining power in the drug-procurement process, which would potentially lower the prices Canadians pay for their medicine. Although pharmacare could lower drug prices in the short run, it could also run the risk of exacerbating Canada’s existing drug shortage, and significantly limit patient access in the long run.

If a national pharmacare plan were to work, as advertised, it would help Canadian patients by lowering the price they pay for medicine. Unfortunately, the Liberals are largely ignoring the issue of where much of these low-priced drugs would end up, which is the United States. It is one thing to lower drug prices for Canadians, but that benefit isn’t realized if Canadian patients never actually have access to those cheaper drugs.

Pharmacare would be an attempt to further control the price of drugs. The problem is that Canada already has price-control mechanisms for prescription drugs at the federal and provincial level. Those price controls lead to much lower drug prices compared with the prices paid south of the border. That said, because Canadian drugs are cheaper than in the United States, several U.S. states have begun looking at importing pharmaceutical products from Canada in an attempt to undercut U.S. prices. For example, the Republican Governor of Florida has recently pushed for federal approval for drug importation from Canada, and U.S. President Donald Trump has already signalled his support of this measure.

And while importation from Canada to the United States could mean lower drug prices for patients in Florida, Canadian patients could suffer as a result of worsening access. U.S. Health Secretary Alex Azar has publicly stated that Canada doesn’t have the appropriate supply to meet patient demand, and that large pharmaceutical companies are unlikely to increase their supply for the Canadian market. Worsening drug shortages are the most likely outcome for Canadians if the federal government adds in more price controls while having large-scale drug exports to the United States. We know that this is the probable outcome because Canada already suffers from a lack of supply, and another measure to intervene on pricing will simply increase the incentive for American states to import from Canada.

Supply is one problem for Canadian patients, but it isn’t the only issue they face, and it isn’t the only issue that could get worse as a result of pharmacare. In addition to poor supply, Canada is significantly lagging in terms of access to potentially life-saving and innovative medicines. Countries such as Germany, Japan and the United States all introduce, and reimburse for, innovative drugs quicker than in Canada. Here, it takes more than 450 days for a new drug to be reimbursable, while that number is only 180 days in the United States. It can be expected that a pharmacare plan would make this innovation problem worse. It is unlikely that the manufacturers of these drugs will want to roll out innovative medicines in Canada, under various forms of price control, if those drugs can then be resold into other markets, undercutting prices abroad.

For cost, it is important to remember that Canadians have lower drug prices than Americans. At the same time, it is important to be aware that because of price controls, Canada is not a significant market for drug manufacturers, especially when compared with the United States, which accounts for more than 50 per cent of the industry’s global profits. If Canada goes too bullish against drug prices, while at the same time allowing American states to import prescription drugs from Canada, we might run the risk of drug companies leaving entirely, or massively delaying the introduction of new drugs in Canada.

Companies leaving the domestic market entirely might sound like a far-fetched concept, but it is something the Canadian marketplace has seen in other industries. Take Google and the recent issue of political advertising in Canada. Ottawa significantly changed its election advertising regulations, and rather than comply, Google decided that it would leave the political advertising market altogether. Thus, we have a large multinational entity cutting itself out of the political advertising market because conditions aren’t ideal, and because Canada’s market is minuscule in comparison to others.

Everyone wants more competitive and better pricing for patients. Unfortunately, the elephant in the room is where these price-controlled drugs end up, and how industry will respond. Our concern, as a consumer group, is that the pharmacare plan, without addressing export, could exacerbate the already serious issue of drug availability in Canada.

If a provider of vital pharmaceuticals were to pull out of the Canadian market as a result of price fixing and undercutting, it would be Canadian patients who pay the ultimate price. Drug access – especially to new innovative treatments – lags in Canada, and without the foresight to correct some of these blind spots, access could either get significantly worse, or be eliminated altogether under a national pharmacare plan. That scenario should concern all Canadians.

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Opinion: Facebook trustbusters motivated by partisan politics, not consumer protection

Channeling the spirit of Theodore Roosevelt and nostalgia for the early 20th century Progressive Era, the latest bad idea being circulated in elite circles is to use the trust-busting power of the federal government to break up the social network Facebook.

The idea has been promoted by such Democratic politicians as Sens. Elizabeth Warren and Amy Klobuchar, and Republicans like Sen. Ted Cruz. Even Chris Hughes, a Facebook co-founder, has hitched his wagon to the idea, as expressed in his now infamous New York Times op-ed.

But let’s not kid ourselves. We’re not dealing with a corporate monopoly akin to Standard Oil, U.S. Steel or even Microsoft. We’re talking about social media websites and services available on the open web.

No one is forced to use these platforms, and are very free and cheaply able to create their own. This is not a monopoly in the literal sense, or even a figurative one.

There are already plenty of competing social networks that people use for a host of services. Whether it’s Snapchat, Reddit, Pinterest or Twitter, there are plenty of services where people connect with friends and share information. Facebook just happens to have “clued in” to the needs of the greatest numbers of consumers. Does that warrant government intervention? No.

Let’s be clear: The internet is the ultimate playground for consumer choice. Government attempts to intervene and regulate based on political considerations, however, will only restrict consumer choice and deprive us of what we’ve thus far enjoyed.

No doubt, some actions by the company have been egregious and they’ll be rightfully punished. The Federal Trade Commission’s expected $5 billion fine on Facebook because of its mishandling of data and consumer privacy is a good first step.

But the movement calling on federal regulators to use their power to break up the company reeks of partisan politics.

Democrats are incensed that users on the platform may have been persuaded to vote for Donald Trump in the 2016 election due to an impressive outreach effort by the Trump campaign (not to mention alleged Russian front groups). Republicans, on the other hand, decry Facebook’s liberal-heavy moderation that has specifically targeted conservative pages and posts. Its censoring of a post citing the Declaration of Independence because it was considered “hate speech” is just one example.

But from what we’ve learned from Twitter CEO Jack Dorsey and other tech elites, banning individuals or pages are highly complex decisions made by thousands of moderators who follow an internal set of guidelines, whether at YouTube, Twitter or Facebook. The investigative article published on the Verge about Facebook moderators’ workload and stress while removing bad content from the platform speaks to that.

Despite these follies, the overwhelming majority of users are happy with their profiles. They’re able to connect with friends and family around the world, and share images and posts that spark conversations. Millions of small businesses, artists, and even news websites are dependent on these platforms to make their living.

Using the force of government to break apart businesses because of particular stances or actions they’ve taken, all legal under current law, is highly vindictive and will restrict the ability for ordinary people like myself or millions of other consumers to enjoy the platforms for which we voluntarily signed up.

We should hold these platforms accountable when they make mistakes, but not tip our hand to invite the federal government to determine which sites or platforms we can click on.

The government’s role is not to pick winners and losers. It’s to ensure our rights to life, liberty and pursuit of happiness, as the Declaration of Independence states. Let’s not use temporary partisan politics to determine the fate of online services and platforms from which we all enjoy and benefit.

Yaël Ossowski is a consumer advocate and deputy director of the Consumer Choice Center. He wrote this for InsideSources.com.

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Les jeunes manifestants pour le climat seront les gilets jaunes de demain

Depuis des mois, les jeunes marcheurs pour le climat s’emparent de l’Europe. Leurs récentes déclarations nous montrent ce qu’ils veulent vraiment – et c’est exactement ce qu’on pensait.

Ces derniers temps, difficile d’ignorer dans la presse les nombreuses images de grandes manifestations en faveur de “l’action pour le climat”. On y trouve notamment les signes les plus drôles que tiennent de jeunes lycéens, incitant les politiciens à adopter des actions inspirantes.

Jusqu’à présent, ce que les marcheurs du climat espéraient réellement réaliser n’était pas tout à fait clair.

Pour la plupart, les activistes déplorent simplement que les politiciens et les riches restent les bras croisés alors que la planète tend vers son inévitable effondrement, prévu pour dans 12 ans.

Leur symbole : Greta Thunberg, élève de secondaire de 16 ans, qui a initié le mouvement avec sa “grève scolaire” pour le climat.

Mais à l’approche de ses 18 ans, âge officiellement requis pour se présenter aux élections législatives en Suède, son pays d’origine, il lui est désormais crucial d’avoir un programme politique clair. La question est : que faire exactement contre la catastrophe climatique ?

Ces jeunes gens voudront commencer “doucement”, en exigeant simplement que toutes les émissions de carbone cessent immédiatement. Un exemple ? Annuler l’expansion vitale de l’aéroport de Copenhague, dont la jeune fille suédoise parle dans un tweet.

tweet de Greta Thunberg

“L’erreur la plus dangereuse que l’on puisse faire quant à la crise climatique est peut-être de penser que nous devons ‘réduire’ nos émissions. Parce que c’est loin de suffire. Nos émissions doivent cesser si nous voulons rester sous les 1,5/2° de réchauffement. Cela exclut la plupart des politiques actuelles. Y compris l’extension d’un aéroport.”

Une combinaison parfaite

La fin du monde approche et les jeunes nous rappellent que nous devons agir. C’est la combinaison parfaite pour l’activisme : comme vous n’êtes pas soumis aux normes politiques des adultes, vous avez une sympathie instantanée, et le facteur médiatique est énorme.

Tout le monde peut se sentir vertueux en applaudissant la foule de jeunes marcheurs pour le climat… jusqu’à découvrir ce que cela signifie dans la pratique.

Le nombre de pays participant aux manifestations “Fridays For Future/vendredis pour l’avenir” n’est pas négligeable, mais ce sont des militants allemands qui ont été parmi les premiers à publier une liste complète de revendications qui fait écho aux sentiments des gens de la rue.

Le document exige le respect des objectifs de l’Accord de Paris sur le climat de 2015 pour ne pas dépasser la barre des 1,5°C d’augmentation de la température.

Pour ce faire, l’Allemagne (un pays qui dépend fortement de la production industrielle et du commerce international) devrait atteindre l’objectif de zéro émissions nettes d’ici 2035, d’une élimination complète de l’énergie au charbon d’ici 2030 et d’une utilisation totale des sources d’énergie renouvelables d’ici 2035.

Rappelons que l’Allemagne a commencé à éliminer progressivement l’énergie nucléaire après l’incident de Fukushima, au Japon, en 2011, et s’appuie davantage sur le charbon et le gaz pour maintenir la stabilité énergétique. Cette Energiewende (transition énergétique) a entraîné une augmentation des prix de l’électricité.

Le retour de la taxe carbone

Au-delà d’un simple changement dans la politique énergétique du pays, les marcheurs réclament une taxe carbone lourde, qu’ils fixent à 180€ par tonne de CO2. Même l’économiste Joseph Stiglitz, qu’on peut difficilement qualifier de défenseur de l’économie de marché, estime que ce montant ne sera que de 40$ à 80$ l’année prochaine et ne représentera que la moitié de cette estimation en 2030.

Le magazine allemand Der Spiegel a calculé ce qu’un prix de 180€ par tonne de CO2 signifierait en pratique pour les consommateurs. En voici quelques exemples :

1 litre d’essence : émissions de CO2 de 2,37 kg. Frais supplémentaires : 0,43 €

1 litre de diesel : émissions de CO2 de 2,65 kg. Frais supplémentaires : 0,47 €

1 an d’électricité, ménage moyen de trois personnes dans une maison individuelle sans production d’eau chaude sanitaire, mix électrique 2017 : émissions de CO2 de 1 760 kg. Frais supplémentaires : 317 €

1 kilogramme de bœuf (aliments congelés) : émissions de CO2 de 14,34 kg. Frais supplémentaires : 2,58 €

1 litre de lait : émissions de CO2 de 0,92 kg. Frais supplémentaires : 0,17 €

iPhone X (2017) : émissions de CO2 de 79 kg. Frais supplémentaires : 14,20 €

Vol direct Düsseldorf-New York et retour, classe économique : émissions de CO2 de 3,65 tonnes. Frais supplémentaires : 657 €

Vol Francfort-Auckland via Dubaï, aller-retour, classe économique : émissions de CO2 de 11,71 tonnes. Frais supplémentaires : 2 107 €

L’augmentation du prix du carburant devrait particulièrement attirer l’attention. Y a-t-il eu pareille tentative de taxe de la part des politiciens récemment ? Oui… et même eux n’ont pas tenté une politique fiscale aussi radicale.


L’estimation la plus élevée possible des coûts potentiels d’une tonne de CO2, l’explosion des prix à la consommation qui en résulte, montrent le véritable visage de l’écologie : des personnes sans connaissances financières qui ne cherchent pas à trouver des solutions innovantes, mais plutôt à réduire la consommation tout court.

Si vous êtes de la classe moyenne supérieure, 17 centimes de plus par litre de lait ne sera pas la fin du monde. Mais comme ces coûts s’additionnent, les ménages à faible revenu ne pourront bientôt plus se permettre certains produits.

C’est là le véritable objectif final : surtaxer les pauvres pour qu’ils arrêtent de consommer. Que cela vienne d’une génération de nantis qui résident en Allemagne et dans de nombreux pays scandinaves est d’autant plus stupéfiant.

L’avion consomme de moins en moins de carburant et les gens sont de plus en plus conscients que polluer est un problème à la fois esthétique et environnemental. Il n’est pas possible de s’attendre à des changements considérables immédiatement suite à l’indignation des jeunes et, surtout, cela nuira aux ménages à faible revenu qui ont déjà du mal à joindre les deux bouts.

Le jour où ils auront réalisé ce qu’impliquent leurs prescriptions politiques, ces marcheurs du climat mettront leur gilet jaune.

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