“Old age is not for sissies,” said Bette Davis. Indeed, it is not, but the images from our childhood of what it meant to be “old” have changed dramatically. Of course, as I enter my 60th year, my perspective on what it means to be “old,” of necessity, shifts. As another popular aphorism, puts it “the hardest thing to decide is when middle age begins.” Thanks to advances in health care and a focus on healthy living, Canadians are living longer. And today’s senior has different issues and challenges than in our grandparents’ day. I see it every day, as my riding of Saanich-Gulf Islands is one of those with the highest proportion of older citizens. While so much in the mass media sees only the negatives of this aging demographic, there is much to celebrate.

The group Moses Znaimer calls “zoomers” are not abandoning their love of tennis or skiing. The aging population is increasingly embracing the benefits of staying involved, especially as they give back to community through the donations of thousands of hours of volunteer work.

That is, of course, not to deny the challenges. Today’s seniors want to know that pension and retirement savings are adequate to maintain an active lifestyle. The Green Party supports expansion of the Canada Pension Plan. CPP is sustainable and reliable. It is time to review whether RRSP is working as a vehicle. Evidence suggests its uptake is very limited, it has a large impact on government revenues and yet it seems to benefit primarily those Canadians who least need it.

Staying active is challenging in a car dominated culture. An aging population increases the need for convenient, accessible, mass transit. As it becomes less safe to drive at night, seniors want access to public transit.

The most extreme challenges of aging are experienced by seniors living in poverty, a disproportionate proportion of whom are women. While the percentage of seniors living in poverty dropped dramatically from a high of approximately 30 per cent in 1976, to a low of 4.7 per cent in 2007, the poverty rates for seniors have begun to move up once again5.8 per cent in 2008. We cannot be complacent about the economic struggles of our seniors.

Meanwhile, the widely-repeated claim that the growth in aging Canadians as a proportion of our population will drive up health-care costs is not supported by the evidence. Empirical evidence suggests that the aging population is not a major cause of increased costs. According to the Canadian Institute of Health Information: “Analyses of the drivers of increases in public sector health expenditures over the last decade showed that the contribution of aging has been relatively modest. To date, system-level cost drivers such as inflation and increased utilization have played bigger roles in health spending increases,” according to Health Care Cost Drivers: the facts, CIHI, November 2011.

The largest single driver for increased health-care costs is the rising cost of pharmaceutical drugs. We are all too often seeing evidence of over-prescription of drugs, and registration of drugs that actually will harm more people than they help. While seniors are wrongly seen as the reason for increasing health-care costs, the reality is that seniors are particularly vulnerable to the excess use of prescription drugs.

That is not to say that our health-care system is ready for an increase in the diseases of aging, particularly dementia and Alzheimer’s. We need to significantly improve supports for family members. So often a senior becomes the full-time caregiver for their spouse. Particularly, seniors of limited means lose any potential for enjoying life as they sacrifice for their partner. Better respite programs, better supports for home care, as well as more beds in long-term senior care facilities are needed, with supports from both federal and provincial governments.

We also need to have a conversation about the loss of basic rights experienced by seniors in care. One of the most shocking trends that I have uncovered since becoming an MP is the loss of basic human rights for seniors in residential care. Shockingly, I have heard dozens of stories of seniors being denied access to family members, being placed on drugs they do not want, and even being denied the right to go home to family members who would welcome them.

And lastly, we need to grasp the nettle of the thorny ethical problem of assisted suicide and the right to die with dignity. The solutions will not be simple because the problems are complex. Nevertheless, Canadians are demanding better answers. We need to engage in a respectful, informed discussion starting with a review of the various legal regimes in use around the world. We need to ensure that discussion is grounded in bioethics and premised on an acute awareness of the slippery slope of creating the impression that some human lives are worth more than others. What we must not do is to continue to ignore the suffering of well-informed, adult Canadians who wish to make a choice to die with dignity in their own country.

Originally printed in the Hill Times.

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It is in this sense that “life sciences” has become a hot commodity. While the Harper Conservatives seem allergic to any kind of science to monitor and expand our knowledge of life on earth—whether fresh water ecosystems (through the killing of federal support for the world-renowned Experimental Lakes Area), the nature of polar atmospheric chemistry in terms of ozone and greenhouse gases (through the closing of the Polar Environmental Atmospheric Research Laboratory), the build up of toxic chemicals in marine mammals (shutting down the DFO marine contaminants program), to name a few, pressing for the commercial advantage of the global pharmaceutical industry is a “life science” Mr. Harper likes.

When contemplating the proposed, and now fast-tracked, Canada-European Union Comprehensive Economic Trade Agreement (CETA), many Canadians are concerned with the reality that the agreement will assist the pharmaceutical industry in retaining patent protection longer, undercutting generic drugs and driving up prices for critical medicines.

Trade agreements still masquerade as though they were about trade. Little wonder. They still get away with being described as “trade agreements.”   The term “trade agreement” should be reserved for agreements, like the 1947 General Agreement on Tariffs and Trade (GATT); one of the last agreements actually about trade in goods. Ever since the Uruguay Round of the GATT, leading to the creation of the World Trade Organization, agreements have shifted from the focus on elimination of tariffs and other barriers to trade in goods, to the greater economic integration of national economies in the interest of corporate profits. And the shifting of balance away from national policies designed to improve the health of a domestic economy to assisting transnational corporations in deriving ever-higher profits is well demonstrated in the CETA provisions to aid Big Pharma.

While Canadians bemoan the “health-care crisis,” the single fastest rising component of health care is the cost of pharmaceutical drugs. The costs are “justified” by claims that the pharmaceutical industry invests an enormous amount in research that can only be captured through drug prices that far exceed the actual cost of production of the drugs in question. That allegation is false. Recent studies from around the world have debunked this claim. (Light, et al., “Will lower drug prices jeopardize drug research: a policy fact sheet,” American Journal of Bioethics, 2004.)

Meanwhile, the regulation of pharmaceutical products is failing Canadians. The excellent work by the Therapeutics Initiative at University of British Columbia is well worth replicating across Canada (www.ti.ubc.ca). Using an objective, evidence-based approach, the Therapeutics Initiative (TI) has saved lives and dollars by advising the B.C. government of drugs, approved by Health Canada, which, in their assessment, posed more risks than benefits. Due to the TI assessment, British Columbia did not approve Vioxx or cholinesterase inhibitors for Alzheimer’s patients. In fact, the TI approach was so successful that it was targeted by Big Pharma and pressure was brought to bear on the B.C. government to cease its funding.

This is not the time to abandon scientific rigour when it comes to pharmaceuticals. It is one of the largest corporate profit-centres on the planet, and its ethics are not squeaky clean. GlaxoSmithKline agreed in July to plead guilty to fraud and to pay $3-billion in the United States for illegal promotion of Paxil in what is the largest settlement ever with Big Pharma.

Giving the pharmaceutical industry more power to drive up drug costs faster is not in the public interest—not in Canada and not in Europe. The fact that we are in the midst of negotiations operating on the assumption that this is a worthy policy goal is evidence of just how unhinged the public good has become from public policy.

While discussing life sciences, we need to bring to bear actual evidence-based science in the interest of protecting life. What a novel approach.

Elizabeth May is the Leader of the Green Party of Canada and Member of Parliament for Saanich-Gulf Islands.
Originally printed in the Hill Times.

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