Orwellian “Doublethink” on “Transparency” from Ontario’s Drug Czar

Secret, untendered contracts with the world’s most expensive consultants. Undisclosed backroom deals worth hundreds of millions of dollars. Nasty implications and innuendo planted in the news media. That’s the McGuinty government’s idea of “Transparency”.

And we are NOT even talking about the eHealth or Cancer Care Ontario scandals that have proven beyond a doubt that the McGuinty government has seriously mismanaged our healthcare dollars.

This particular outrage comes courtesy of the Transparent Drug System for Patients Act, a law so poorly thought out that even its name is steeped in hypocrisy.

In 2006, Dalton McGuinty’s government decided to “fix” pharmacy - a part of the health care system that wasn’t broken, but that actually worked, delivering excellent, cost-effective patient care. At the time, the government said they were going to improve drug system “transparency”. Let’s see how that worked out.

In August, we learned that the government was getting hundreds of millions of dollars in secret rebates from drug makers, in return for listing their medicines on the Ontario Drug Benefit formulary.

On October 23^rd, Sun Media reported that the government provided a secret sole-sourced consulting contract for $750,000 to cost-cutting specialists McKinsey and Company, to produce a report on how to cut pharmacy funding - again.

Through the spring, summer and fall, a government official repeatedly fed stories to the news media that had the effect of making pharmacists look greedy and even dangerous.

Who is behind all of these initiatives? Ontario’s Drug Czar: Helen Stevenson, the immensely powerful drug system Executive Officer. The Ministry of Health and Long-Term Care official who isn’t accountable to the Deputy Minister, isn’t even accountable to the Minister, but is accountable only to the Lieutenant Governor in Council (the Cabinet).

And what does she have to say about government transparency?

“We are compromising on transparency…”

‘Compromising’, Ms Stevenson? Here’s one definition of “compromise” I found online: A settlement of differences in which each side makes concessions.

Major concessions, including financial losses and increased bureaucracy, have been forced upon community pharmacy. What concessions has Ms. Stevenson made?

Ms Stevenson was asked to share with the public the details of the deals she cut with pharmaceutical manufacturers. Her response, according to the National Post: “…the secrecy around price arrangements is unavoidable…”.

And how about that secret, sole-sourced $750,000 report from McKinsey? Will Ms Stevenson share that with the taxpayers who paid for it? No: “…nor would she discuss the recommendations made in the McKinsey and Co. report”.

How’s that for transparent? Here’s another definition of the word “compromise”: A concession to something detrimental or pejorative: e.g. “a compromise of morality”.

What does government transparency really mean in Ontario?

Now we understand the McGuinty government’s bold use (or abuse) of language: We’ll say transparency in government is vital. We’ll title our laws using the word “Transparent”. Then we’ll create unaccountable government positions of unprecedented power, and let officials make secret deals, hand out huge secret contracts and concoct secret plans to cut health care. We’ll forget the Joint Working Group that was created to negotiate, in good faith, a new services and funding model with pharmacy. That’s just to keep the pharmacists busy talking. Patients and pharmacists will never know what hit them.

George Orwell knew what to call this kind of propaganda. In his novel 1984, he coined the term “doublethink”. Government efforts to embrace utter contradiction and hypocrisy that are so strong, the purveyors of the propaganda begin to believe it themselves. To the slogans that include, “War is Peace”, “Freedom is Slavery” and “Ignorance is Strength”, perhaps we can now add “Secrecy is Transparency”.

Another eminent thinker, a contemporary of Orwell’s, had additional insights. He said: “…truth is so precious that she should always be attended by a bodyguard of lies.”

That was Winston Churchill. But he prefaced that line with the critical qualifier “In wartime…”.

For those of us who appreciate cooperation and fairness, there is no idea more detestable than the declaration of war. But it now appears that the McGuinty government has done just that to pharmacists.

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Note: As previously noted Ms Stevenson likes to talk about needing police protection, and imply that she’s in danger from Ontario pharmacists. That’s clearly not true, but every member of the pharmacy community should make sure that our comments and communications on this situation remain truthful and polite, but firm.

Send a letter (politely but firmly) demanding that the Premier, the government and Helen Stevenson start to negotiate honestly, fully disclose their secret contracts and deals, and treat Ontario pharmacists with the respect we’ve earned and deserve.

Write to Premier McGuinty: http://www.premier.gov.on.ca/feedback/

Write to your MPP:

http://www.ontla.on.ca/web/members/members_current.do?locale=en

Write to Helen Stevenson: Helen.Stevenson@ontario.ca

Ontario government official smears pharmacies in National Post

With talk about “death threats”, “2,000%” rebates and “fat profit margins” in the National Post on October 2nd, Ontario drug system executive officer Helen Stevenson continues her smear campaign against community pharmacies. In doing so, she has revealed her apparent agenda to cut funding for the pharmacy care and services Ontarians rely on.

Every pharmacy owner, pharmacist, technician and staff member should understand what is at stake: access to and quality of patient care, the future economic viability of community pharmacies, our livelihoods and our jobs.

Ms Stevenson seems to be ignoring the fact that pharmacy is currently engaging, in good faith, in a negotiating process with the Ministry of Health and Long-Term care, to create a common plan to reform the province’s funding model. We have come to the table. Pharmacy has even taken the initiative to present the government with a workable formula that protects patient care, reduces drug system costs, and ensures fair, stable and predictable funding for pharmacies.

But while pharmacy works with the Minister and Deputy Minister to design smart solutions, Ms Stevenson continues to seed the news media with claims that malign the reputation of Ontario’s pharmacists and pharmacy community. Let’s take a closer look at her claims.

“Fat profit margins”?

Ms Stevenson’s website includes an assertion that pharmacies have higher margins than other retailers - a fairy tale she seems to like telling to the media. As data from Statistics Canada prove, that’s simply not true. Furthermore, pharmacies have a higher cost structure than many businesses, making their NET earnings even smaller. Does she even understand the difference between gross profits and net earnings? Maybe when you get paid $275,000 taxpayer dollars a year to sit in an office taking potshots at pharmacists, these things don’t matter much. But when you spend long days working intimately with patients, and trying to meet a payroll every month, these things matter a lot.

“2,000 % rebates”?

Does Ms Stevenson really expect people to believe that community pharmacies are receiving professional allowances at that rate – when they’re limited by law and regulation under the Ontario Drug Benefit Program to 20% of a drug’s list price? Furthermore, these allowances must be fully reported and accounted for in order to comply with the rules. I’m not getting 2,000 % of anything. But I can say that, under the current global funding model, without professional allowances I’m losing money on every single prescription I dispense under the ODB.


“Death threats”?

As far as I’m concerned, anyone who makes death threats is a criminal, and an idiot. So prosecute them, whoever they are. But every time Ms Stevenson talks to the media about community pharmacy funding, she talks about death threats and police protection – implying that Ontario’s pharmacists are like little Tony Sopranos putting out hits on people. We’re not a bunch of criminals, Ms Stevenson. We’re health professionals caring for patients and trying to keep our businesses’ doors open. So quit trying to smear us with this nasty implication. It’s getting a bit stale.


Tony Soprano: Not an Ontario pharmacist



Faisal Khawaja: An Ontario pharmacist


To me, it’s obvious that Ms Stevenson has a plan. She is intent on cutting health care funding to pharmacy. So in spite of the Minister and Deputy Minister’s assurances that we have a legitimate negotiating process in place, she’s spreading information in the media that can only have the effect of making pharmacists look greedy and dangerous. Perhaps the fledgling EO’s office was given too much power. Perhaps the Minister’s office and maybe even the Premier are concerned about having another liability on their squad, given the numerous recent scandals and apologies. Loose cannon or not, Ms. Stevenson’s rhetoric is not helpful, and needs to be reined in.

We need to tell Ontarians the truth. That they’re right to trust us as one of the most honest and ethical professions. That we work every day to provide our patients with expert, accessible health care advice and services. And that we won’t stand idly by while a powerful official attacks and insults the integrity of our profession.

Send a message

It’s time to send a message to the Premier that he should make his officials negotiate in good faith, and show more respect to the health professionals on the front lines who actually care for hundreds of thousands of Ontarians every single day.

Send a polite but firm email to the Premier at this address: http://www.premier.gov.on.ca/feedback/

First Post

Welcome to my blog!

I’m a community pharmacist in Milton, Ontario. Pharmacy care is changing. It’s getting better – becoming even more comprehensive, accessible and convenient for patients and customers.

But the business of pharmacy that forms the whole foundation for the health care pharmacists provide is changing, too.

These are the issues I’ll be writing about – the good and the bad – and my thoughts on both.

Thank you for reading, and I would appreciate your comments and emails.

Faisal Khawaja

Pharmacist