Health
Pharmacare won’t help Canadians with rare disorders
From the MacDonald Laurier Institute
By Nigel Rawson and John Adams
Canadians with rare disorders will be even worse off if NDP’s parliamentary blackmail works
Last month the federal NDP convention in Hamilton voted unanimously to force the Liberals to introduce a single-payer universal pharmacare program or see the current “confidence-and-supply” deal canceled. Will universal government-run pharmacare benefit Canadians with rare disorders? We fear not.
Canadians with such disorders are already disadvantaged compared with sufferers in other countries. Fewer specialized drugs are launched in Canada than in the United States and Europe. Those that are get approval for marketing about a year, on average, after they do there.
That’s not because Health Canada takes longer to review new medicines. The process takes about the same time in the three places. Rather, delayed approval is likely due to manufacturers submitting later to Health Canada because federal, provincial and territorial hostility towards the industry has made our biopharmaceutical market less attractive.
Approval doesn’t mean government drug plans will pay for a drug, however. Further government-created barriers impact all Canadians, but particularly those with rare disorders who want access to novel drugs for their unmet or poorly met health needs. As a consequence, what gets listed in government drug plans varies widely, leading to a postal code lottery.
In a set of articles published over the summer by the Macdonald-Laurier Institute, we discuss the several obstacles patients and their families face as they try to gain access to new or expensive innovative therapies. They include: the lack of federal incentives for developers to submit new medicines to Health Canada; health technology assessment that is neither accountable, independent nor transparent and makes recommendations about which drugs to cover in public drug plans to governments; and price negotiations between government drug plans and manufacturers.
Even when drug developers clear these government-created barriers, public drug plans are under no obligation to add the approved medicines to their benefit lists. Too often governments focus only on drug costs and ignore the broader benefits effective drugs can bring, not only to the health and well-being of patients and their families, but also to other parts of the health system, to the economy and to society at large. If a new drug reduces doctor or emergency visits or hospitalizations or helps a person get back to work, those benefits typically are ignored by our drug assessment system.
The federal government made matters worse over the past six years by planning to drastically reduce drug prices by regulatory order, not negotiation. This caused considerable uncertainty among developers, resulting in even fewer new drugs being submitted for marketing approval here than in the U.S. and EU.
Proponents plainly want a lowest-common-denominator government-run public plan that would crowd out private plans, which over two-thirds of Canadians currently rely on for drug access.
Despite the federal government committing $1.5 billion over three years to “increase access to, and affordability of, effective drugs for rare diseases to improve the health of patients across Canada,” its initiative is not comprehensive. So far, Canada has neither a government-endorsed national rare disorder strategy nor an Orphan Drug Act providing incentives to developers to launch orphan medicines in Canada. Most other developed countries have both.
Patients’ organizations have stepped in where governments have failed to act and proposed a Canadian strategy that would include incentives and funding to encourage developers to launch drugs in this country and cut through the barriers we have described to provide timely access to the many innovative treatments on the research horizon. For example, access to breakthrough drugs could be allowed as soon as Health Canada says they are safe and effective, even as other administrative boxes are checked and prices negotiated. Other countries use this approach.
Canadians afflicted with any of the 11,000 or so known rare disorders have significant unmet needs. Fewer than five per cent have any treatment beyond symptom relief or palliative care. The last thing these people need is for governments to ration innovative drugs even more than they already do or to force even deeper price cuts from drug developers in order to pay for universal pharmacare that covers only basic medicines.
Canadians with rare disorders almost certainly will be even worse off if the NDP’s parliamentary blackmail works.
Nigel Rawson is an affiliate scholar with the Canadian Health Policy Institute and a senior fellow with the Macdonald-Laurier Institute, as is John Adams, co-founder and CEO of Canadian PKU and Allied Disorders Inc.
Mental Health
Headline that reads ‘Ontario must pay for surgery to give trans resident both penis and vagina: appeal court’ a sign of the times in Canada
From LifeSiteNews
Gender ideology so entrenched, surgical mutilation is no longer considered fringe
If you’d like a glimpse of what 10 years of progressive rule has done to Canada in a single sentence, I submit to you this April 24 headline: “Ontario must pay for surgery to give trans resident both penis and vagina: appeal court.”
Imagine reading a headline like that in, say, 2010. You’d wonder what country you were living in — that is, if you weren’t trying to figure out what you just read. But in Canada in 2025, this stuff isn’t fringe. It’s establishment.
The Ontario Court of Appeal, the province’s top court, issued a ruling this week stating that the province must pay for a “penile-sparing vaginoplasty” for a resident who identifies as transgender but does not identify “exclusively” as either male or female and thus would like to possess both a penis and a vagina.
According to the Post, “a three-judge panel of the Ontario Court of Appeal confirmed a lower court’s ruling that the novel phallus-preserving surgery qualifies as an insured service under the Ontario Health Insurance Plan.” In case you’re tempted to write this off as an aberration at the hands of a handful of activist judges, this ruling is the third unanimous decision in favor of the “patient,” identified in court records as “K.S.”
“K.S. is pleased with the Court of Appeal’s decision, which is now the third unanimous ruling confirming that her gender affirming surgery is covered under Ontario’s Health Insurance Act and its regulation,” K.S.’s lawyer, John McIntyre, told the Post. K.S., as it turns out, identifies as neither male nor female … but uses female pronouns:
The legal battle between K.S., whose sex at birth was male, dates to 2022, when the Ontario Health Insurance Plan (OHIP) refused her request to pay for the cost of surgery at a Texas clinic to construct a vagina while sparing the penis, a procedure this is not available in Ontario, or anywhere else in Canada. K.S. uses female pronouns but does not identify as either fully female or fully male.
Previously, saner generations would have no idea how to interpret the preceding paragraph, but gender ideology has made fools of us all. OHIP attempted to argue that “because the vaginoplasty would not be accompanied by a penectomy, the procedure isn’t one specifically listed in OHIP’s Schedule of Benefits and therefore shouldn’t be publicly funded” and also that the surgery is “experimental” in Ontario and thus can’t be covered.
But K.S., who has a male member but would also like a neo-vagina, appealed to the Health Services Appeal and Review Board, which overturned OHIP’s decision. OHIP appealed to the Divisional Court but lost; the latest appeal, heard November 26, was also rejected because a “penectomy,” the removal of the penis, was “neither recommended by K.S.’s health professionals nor desired by K.S.,” according to the court’s decision.
I wonder if the judges thought that they’d be ruling on whether a man who identifies as neither a man or a woman was entitled to obtain a vagina while retaining his penis when they were going to law school.
The court stated that K.S., who is in his early 30s, “has experienced significant gender dysphoria since her teenage years, as well as physical, mental and economic hardships to transition her gender expression to align with her gender identity.” Of course, K.S. isn’t “transgender,” per se — because he doesn’t identify as the opposite sex, even though he uses the pronouns of the opposite sex. He wants to be … both, somehow. And he wants the taxpayer to pay for it.
As the Post reported:
K.S.’s doctor submitted a request to OHIP for prior funding approval for the surgical creation of a vaginal cavity and external vulva. The request made it clear that K.S. wasn’t seeking a penectomy. In a letter accompanying the request, her doctor said that because K.S. is “not completely on the ‘feminine’ end of the spectrum” it was important for her to have a vagina while maintaining her penis, adding that the Crane Center for Transgender Surgery in Austin, Tx.,” has an excellent reputation” for gender-affirming surgery, “and especially with these more complicated procedures.”
The surgeries, depending on which are performed, range in cost “from US $10,000 to $70,000.” The court also ordered Ontario to pay K.S. $23,250 after dismissing OHIP’s appeal; the province has until June 23 to seek leave to the Supreme Court of Canada.
Quick Hit:
Authorities have identified the driver responsible for the devastating attack at Vancouver’s Lapu Lapu Day festival that killed at least 11 and injured dozens more. The suspect, Kai-Ji Adam Lo, 30, had a well-documented history of mental illness, and his family sought help just hours before the tragic event.
Key Details:
- Kai-Ji Adam Lo, 30, was identified as the driver who plowed into a crowd, killing 11 and injuring dozens more.
- Lo’s family sought psychiatric help for him hours before the attack; he was already known to law enforcement.
- Police believe the attack was not terror-related, citing Lo’s extensive mental health struggles.
At least 9 dead in mass casualty event after driver crashes into crowd at Vancouver street festival.
The 30 year old driver was taken into custody by festival goers then arrested.
According to law enforcement “the suspect was known to police for certain circumstances”. pic.twitter.com/slG7LsZNFG
— Kevin Dalton (@TheKevinDalton) April 27, 2025
Diving Deeper:
The city of Vancouver is grappling with unspeakable tragedy following the deadly assault that unfolded during the Lapu Lapu Day festival, a vibrant celebration honoring the Filipino community. Authorities have identified the man behind the wheel as 30-year-old Kai-Ji Adam Lo, who was apprehended at the scene Saturday night.
Lo, whose troubled history with mental illness was well known to local authorities and mental health professionals, faces eight counts of second-degree murder, with additional charges expected as the investigation continues. According to reports, Lo’s family had reached out to a hospital psychiatric ward just hours before the incident, desperately seeking help for him amid his escalating paranoia and delusions. It remains unclear whether any intervention was made in response to the family’s call.
Vancouver Police Chief Steve Rai confirmed that Lo had no interactions with law enforcement immediately prior to the event, but acknowledged that the city is reeling from its “darkest day.” Investigators emphasized that, because of Lo’s mental state, they do not believe the attack was terror-related.
Adding to the complex portrait of the suspect, Lo was mourning profound personal loss. His brother, Alexander Lo, was murdered in January 2024. Following the death, Lo had penned heartbreaking posts online, sharing how his brother’s death and his mother’s subsequent suicide attempt shattered their family.
Tragically, among the 11 killed during Saturday’s carnage was a 5-year-old child. Dozens more were wounded when Lo drove his SUV into the densely packed crowd gathered for the festivities. Lo has since appeared in court and will remain in custody as prosecutors prepare to bring additional charges.
The horror that unfolded in Vancouver serves as a stark reminder of the broader systemic failures surrounding mental health interventions. While Canadian authorities attempt to grapple with the aftermath, this tragedy sadly echoes similar stories in other nations where warnings about individuals in crisis have gone unheeded—with catastrophic results.
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