The Minister of Health’s remarks at the Economic Club of Canada

Transcript

Transcript - The Minister of Health’s remarks at the Economic Club of Canada

It is my privilege to introduce you to our federal Minister of Health, the Honourable Jean-Yves Duclos.

Bonjour tout le monde.

Good afternoon everyone, and thank you, Natasha, for the warm welcome. Thank you, Ranya, for the very thoughtful remarks
that I listened to attentively.

And despite these thoughtful remarks, there might be some people in the room asking why the Economic Club of Canada
might be inviting Canada's Minister of Health for a luncheon. What does health have to do with the economy, growth and prosperity?

Well, many will know that there has been a minister responsible for health in Canada since 1944 and while I am a health minister, I'm also an economist, and you never stop being an economist despite being a politician, and even a health minister. My background as an economist and, even worse, as an academic economist, also means that I love information and I love data. And I would say that data informs every action and every decision that I make and that we need to make when it comes to health in our country.

So, I'm very, very grateful to be in your company today, both as a lifelong economist and as a Minister of Health, to dig into the facts about health in our economy. I think that, ultimately, we will find that a healthy society and a healthy economy do indeed go hand in hand. I'm going to spend my time, my limited time today with you illustrating the integral link between the health of a population and its prosperity and how health can be a driver of economic growth.

Now, there is no clearer illustration of this than the COVID-19 pandemic. We are only now beginning to understand the pandemic's long-term social and economic impacts. We know, for example, that some groups have suffered disproportionately, including women, already vulnerable and marginalized people, Indigenous and racialized communities and seniors.

We are also coming to grips with the deep and complex toll of post-COVID condition, which is more commonly known
as Long COVID, which, by some estimates, could be affecting
as many as 1.4 million Canadians with, therefore, a profound
effect on the labour force.

The US economist David Cutler has estimated that the American economic burden of 10 million people with three or more symptoms of Long COVID could be 3.7 trillion dollars
because of the lost quality of life, lost earnings and higher health care costs. This being said, we know, as you said, that COVID 19 could have been much, much worse. In Canada, the leadership of Canadians and the partnership of all governments not only helped save thousands and, most likely hundreds of thousands of lives, but it also helped steward the economy through its roughest period since the Great Depression.

A study by the C.D. Howe Institute found that each day of delay in Canadas vaccination would have cost the Canadian economy an additional $1 billion. That's $1 billion per day. This being said, COVID-19 tested Canada's institutions and its economy, and it will take time to repair the damage that was done. The pandemic put enormous strain on health systems that were already stretched to their limits. It caused delays and backlogs of people, we almost all of us know such people, waiting for care, especially for diagnosis and surgeries.

According to research by the Canadian Institute of Health Information, close to one million fewer surgeries were performed during the first 31 months of the pandemic, a decline of 14%. And as we rebuild, we must be mindful that this is far from the last storm the health care system will need to weather.

In the years to come, there will be other challenges,
including the aging of our population, the impacts of climate change, and yes, likely more pandemics to come our way. We need to be prepared and to do so, we need to invest wisely now because financial and human resources are scarce.

Economists estimate that about one third of economic growth in advanced economies over the last century can be attributed to improvements in the health of our populations.

Better health promotes economic growth by expanding the labour force and by boosting productivity. Healthy people live longer. They have fewer health conditions to treat. They are happier and enjoy a better quality of life. Some will choose to stay in the labour force longer. A healthy population can also help grow our economy in the longer term. To ensure that happens, we have to act now, and promoting public health will be key. This means quickly addressing future health emergencies through measures like vaccination campaigns. It means preventing chronic disease by addressing the social determinants of health and by supporting healthy lifestyles. And it means promoting good health through progressive social policies on poverty, community care, housing and the environment.

That is because 80%, 8 - 0, 80% of health outcomes have little to do with health care factors and everything to do with living standards, healthy living and eating, community safety and the quality of the environment. It also means strengthening the health care system to ensure it has the capacity to support Canadians as they age.

One of the clear vulnerabilities is a resilience of the health workforce. According to RBC, Canada will be short of 44,000 doctors by 2028, about 70% of those will be family doctors
who are usually the first to provide care, treat and diagnose Canadians. And that is a problem because primary care and access to family health teams is the cornerstone of a properly functioning health care system.

An analysis conducted in 2018 also anticipated a shortage of more than 100,000 nurses by the year 2030. And that was before the pandemic. Strengthening the health workforce is therefore essential. It's the only way we will meet today's demands on the health care system while also preparing for tomorrow's pressures.

So, how do we do that? Budget 2023 delivers, as we heard, a 10-year additional investment of close to $200 billion in the health care system. This funding will support provinces and territories in advancing five key areas of shared priorities.

First, expanding access to family health services, especially in rural and remote areas. Second, supporting health workers and reducing surgical backlogs. Third, increasing support for mental health and substance use, especially for younger Canadians. Fourth, better use of and access to health data. And fifth, helping Canadians age with dignity. First, we need to expand access
to family health services.

Approximately 4.5 million Canadians do not have regular access to a primary care provider. Some recent estimates put that number even higher. In 2020, approximately 38% of Canadians
surveyed by the Commonwealth Fund reported that their last visit
to the emergency room was for a condition that could have been better addressed by a primary care provider. Expanding access to timely family health services will also prevent small, easily treated problems from becoming complex and much more expensive health conditions. That is particularly important for children for whom prevention is important to prevent long-term
health consequences.

L'èlargissement de l'accès à des services de mèdecine familiale permettra d'èviter que des problèmes faciles à traiter se transforment en problems plus coûteux et plus complexes. Et comme je l'ai dit en anglais, ceci est particulièrement important pour les enfants.

Et, j'ajouterais que les soinspèdiatriques sont malheureusement un endroit d'investissement, à la fois en santè publique et en soins de santè, qui est prèsentement nègligè.

Les ressources humaines que l'on retrouve partout au pays, et mes collègues ministre de la Santè en sont très conscient, sont malheureusement trop peu allouèes en fonction de, des besoins et des consèquences de ne pas traiter ces besoins pour les enfants au pays.

Deuxièmement, nous devons appuyer les professionnels de la santè et rèduire les retards en travaillant ensemble pour, un, retenir les professionnels dèjà en place, ce qui est l'objectif le plus important, deux, recruter et former de nouveaux travailleurs, ettrois, reconnaitre plus rapidement et plus facilement les qualificationsdes professionnels de la santè qui ont ètè formès ailleursau pays ou ailleurs à l'ètranger.

Second, we need to support health workers and reduce backlogs by working together to, most importantly, retain and support existing workers, then recruit and train new ones, and also recognize faster and more easily the credentials of health workers who were trained elsewhere in Canada and abroad.

Third, we are working with provinces and territories to improve access to mental health, substance use and addictions services and to ensure that mental health is integrated into all of our shared priorities, and in primary care in particular, especially for youth and younger Canadians. Next, because data saves lives, we need to modernize significantly the way health data is collected, shared across providers and patients, and used, putting that information back into the hands of patients and the professionals who care for them.

Besides empowering patients to then take better care of their health, better access to health information is essential for health workers to provide high-quality and timely health care in team-based environments. Let's imagine, that happens every day, let's imagine an emergency department nurse or doctor taking care of an unconscious patient who needs immediate care and not being able to know what medication that person takes, what allergies that person may have, or what the medical antecedents of that person may be.

For that reason, we are implementing the first-ever pan-Canadian interoperability roadmap to ensure that health information is shared efficiently, data blocking is prohibited and secure, and health information is therefore securely shared between health providers and patients in part to avoid duplicative tests and procedures.

Finally, we're also focused on helping Canadians age with dignity close and closer to home. Work is already underway with provinces and territories to access, to support access to home care and long-term care through a joint investment of $6 billion over five years. We're also making transformative investments in oral health care, which is an essential part of overall health. Good oral health is an important factor in preventing cancer, diabetes and cardiovascular and brain diseases.

Delaying dental care can have wide-reaching impacts, including costlier treatments, worsening health outcomes, problems with sleep and time away from school and work, especially for lower-income Canadians. The first phase of our approach started last December when we launched the Canada Dental Benefit. Thus far, more than 300,000 children have already benefitted from the Canada Dental Benefit.

The second phase of our plan is to expand access and implement the new Canadian Dental Care Plan, which will provide dental coverage for uninsured Canadians with annual family income of less than $90,000, helping up to nine million uninsured Canadians get the dental care they need.

With all of these forward-looking investments, we can therefore keep repairing the damage caused by COVID-19 while also preparing the foundation for a healthier, more just, more inclusive and certainly more productive society.

I'm using the word investments intentionally because that is exactly what they are. Historically, health care and public health investments have saved millions of lives through immunization and have been, in particular, and have been a powerful catalyst for economic growth. In addition, although the COVID-19 pandemic has been costly in every sense of the word, it has also ushered in a new period of health innovation from the widespread adoption of virtual care to new product developments like vaccines and treatments.

After a 40-year decline, Canada's domestic biomanufacturing industry is being rebuilt. Our Biomanufacturing in Life Sciences Strategy is investing $2.2 billion over seven years to establish a robust life sciences ecosystem, one that is drawing investment and helping us prepare for future pandemics. It is already attracting major investments from leading global companies, including Moderna, GSK, AstraZeneca and Sanofi.

We're also seeing exciting innovations in nanotechnology in artificial intelligence. Canada is becoming a global leader in targeted nanoparticle delivery technology with companies like Vancouver's Precision NanoSystems, which is developing lipid nanoparticle genomic medicines. The use of artificial intelligence is also accelerating exponentially target drug discovery.

A Canadian firm, AbCellera, accomplished that with monoclonal antibody treatments for COVID-19. With all of those novel treatments being developed every day, there is also new hope for people suffering from rare diseases. Alexion AstraZeneca, for example, has recently brought several rare disease drugs to market in Canada. But the availability of these drugs is only one part of the story. We must also ensure that these treatments, which are often expensive, are accessible
to those who need them most.

And that's why the government of Canada is investing $1.5 billion over three years in a national strategy for drugs for rare diseases. This investment will increase access to new and effective diagnostics and drugs for rare diseases. Health Canada is also creating new and more agile regulations that will streamline and facilitate the approval process for clinical trials and new drugs while ensuring quality, efficacy and safety.

Investing in these opportunities and policies like these will position us for a healthier and therefore more prosperous future. And that is crucial because there are key challenges ahead. We need to be ready with a strong resilient economy, and that needs to be supported by a strong resilient health care system.

As time goes by, pressure on the health care system will only increase as further demographics, social health and environmental changes occur.

As mentioned above, our population is aging rapidly and our population of health workers is also aging rapidly, bringing with it a cascade of health and economic impacts. The longer we can support Canadians to stay engaged in our communities, in our economy and aging at home, the better the outcomes we will see. Among other things, this means addressing the chronic diseases that tend to develop as we live longer by investing in both prevention, early diagnostics and treatment.

And because, again, most health outcomes are determined by socioeconomic lifestyle and environmental conditions, it is in our best interest to address existing health and social inequalities so that everyone has an opportunity to reach their full potential and contribute to the economy.

That is why the government of Canada is investing broadly to support healthy and productive lives for all Canadians. This includes investments such as the Canada Child Benefit, which reduces child poverty every month by 40% and $10 a day childcare, which supports women's labour force participation, reduces poverty and increases gender equality, as well as investments in housing through the $80 billion National Housing Strategy. It also includes promoting physical activity, healthy eating and community participation. The economy, the environment and geopolitical security are increasingly all interrelated. Climate change and pollution are having increasingly negative consequences, both on the planet and on the health and wellbeing of people all around the world, including in Canada, as we are seeing and smelling today in Toronto.

In recent years, we have witnessed the consequences of pollution and climate change on our health system and institutions, which are pushed to their limits during climate-related disasters like floods, storms and wildfires. Take, for example, the horrifying wildfires we are currently seeing in Alberta, Nova Scotia, Quebec and Ontario. The Alberta fires themselves have burned more than 1.2 million hectares, which is three times the size of Montreal, and forced nearly 35,000 people from their homes. I visited the citizens of Baie-Saint-Paul, a small city in Charlevoix close to where I live and where my family is from, just a few weeks ago, after they were hit by tragic spring flooding. I had heartbreaking discussions with residents who were worried about their future, the future of their families and the future of our planet. These tragic natural disasters have a devastating impact on the health and mental health of our neighbours. Each year, 15,000 Canadians die prematurely due to air pollution. In addition to the heavy emotional burden of these premature deaths, we estimate the economic cost of these deaths solely due to bad air quality to be 6% of Canada's real gross domestic product. Fires, floods, air pollution are debilitating not only to the economy, but also, therefore, to our health. We must therefore act together to limit he consequences of pollution and climate change and to adapt in order to protect public health. That is why we have recently announced Canada's first National Adaptation Strategy, which invests nearly $50 million over the next five years in programs to help the health sector adapt to a changing climate and protect the health of Canadians.

Finally, Canada needs to be prepared for what the WHO calls the silent pandemic of antimicrobial resistance. Antibiotics are the foundation of modern health care. But what if these drugs stopped working? It's estimated that life expectancy would drop by a third if effective antibiotics did not exist or stopped to exist or stopped to work. That is a sobering thought. The fact is that antibiotics are becoming less effective as drug resistance spreads globally. Antimicrobial resistance has significant impacts on our health and the economy, from prolonged hospital stays to loss productivity to death.

In 2018, close to 6,000 deaths, or 15 deaths per day, in Canada were attributable to antimicrobial resistance, and the cost to the Canadian health care system is estimated to be about $1.4 billion. Now, Canada is standing up to be part of the solution. In June, in collaboration with provinces and territories, Canada released a first-ever pan-Canadian Action Plan on Antimicrobial Resistance. The action plan is a shared 5-year roadmap for concerted action on antimicrobial resistance across five pillars: research and innovation; monitoring; stewardship, infection prevention and control; and leadership. The action plan is a key milestone in Canada's collective preparedness and response to antimicrobial resistance. Now, really, in conclusion, if the pandemic has taught us anything, it is that health, safety, society and the economy are all interconnected, and so are we. When people are healthy and get the care they need, they can be at their best and give their best. They can work, start businesses and invest in our communities. This demands a strong and effective social safety net that reduces poverty and exclusion, including a strong public health care system.

La collaboration en matière d'innovation dans le domaine de la santè est essentielle our prèserver et amèliorer la santè, prèvenir les maladies, amèliorer la prestation de santè, de soins de santè par l'ètat à nos communautès, et prèvenir les futures pandèmies et les urgences sanitaires à venir si prèparer et pouvoir y rèpondre.

Collaboration in health innovation is also critical to maintain and improve health, to prevent diseases, to improve how publicly funded health care is delivered to our communities, and to prevent, prepare for and respond to future pandemics and health emergencies. With those strong partnerships, we can therefore more quickly develop vaccines, treatments and diagnostics to prevent and treat diseases when they occur. We can more easily advance innovative models of health care, such as integrated youth services for mental health, community models
for healthy aging and dementia, and team-based family medicine
and primary care. We can develop and utilize better
virtual care and digital technologies to deliver patient-centred
care across all of our communities. And finally, we can better
address key health risk, including antimicrobial resistance. That is why a better health, and a stronger workforce leads to better prosperity.

Thank you. Merci.