Canada’s public health care system is based on the values of Canadians and those are very clear when it comes to health care: need regardless of the ability to pay. Trade agreements, on the other hand, are in blunt opposition to these values. The principles which regulate the market support the ability to profit. Health care and international trade should not mix in Canada and that is why we recommend a strong general carve out for all areas of health care in every trade agreement.
The issue in detail
Health care in Canada is legislated as a public good – not a commercial commodity. Our public system is based on the Canada Health Act, where health care is delivered solely on the criterion of the need of patients, without regard for their ability to pay or their socio-economic status. The central objective of international trade agreements is trade liberalization through the reduction of barriers to trade.
Trade agreements assume a clear demarcation between public and private. But the mix of public and private interests on the delivery side of the health care system makes it difficult to draw a sharp line between what is public and what is private, causing problems when applying Canada’s reservations and exemptions.
We have seen an increase in the scope of trade agreements. The Trans-Pacific Partnership (TPP) signed by Canada in 2015 (but yet ratified) is known as the largest free trade initiative in history. The TPP will impact public health care at home and abroad, decreasing internal controls over Canadians’ access to medications as well as increasing barriers to medication access in developing countries. It will negatively impact the health of Canadians by keeping drug prices inflated, adding new external influences into drug safety monitoring and marketing, creating challenges for the development of a National Public Drug Plan, and truly hurt the world’s most vulnerable with delayed market entry for generic drugs. This is not in keeping with Canadian values to expand public health care for all and assist vulnerable countries and their people. New trade agreements like the TPP may allow for foreign governments and lobby groups to intervene in the regulation of Canada’s drug marketing and the monitoring of drug safety.
The CHC is calling for:
- The Government of Canada to negotiate exemptions on any trade agreements that clarify these agreements shall not be construed to apply to measures adopted or maintained by a party with respect to health care, health services or health insurance as was suggested by the Romanow Commission (2002).
- The Government of Canada to remove all matters related to pharmaceutical patents from the current and future trade and investment negotiations. Instead, Canada needs to impose conditions on the pharmaceutical industry that benefit the public interest and protect the common good from private monopoly.
The Trans-Pacific Partnership and its impact on Health Care (Canadian Health Coalition, 2016)
TPP and Health Care: a Powerpoint presentation (Canadian Health Coalition, 2016)
Statement on CETA (Canadian Health Coalition, 2016)
NAFTA Chapter 11 Investor State Disputes to January 1, 2015. (CCPA, 2015)
CETA Threats to Public Health Care in Canada (Canadian Health Coalition, 2014)
CETA and Pharmaceuticals: Impact of the trade agreement between Europe and Canada on the costs of patented drugs (CCPA, 2013)
The CETA and Health Care Reservations: A briefing note for the Canadian Health Coalition (CCPA, 2011)