Social Policy in Ontario

Sometimes it takes courage to act on the evidence. It is well established, for instance, that “Ontarians need drug coverage now,” but until Andrea Horwath said it on Monday, no political leader seemed willing to confront that fact.

As the Star has written many, many times, Canada needs a national pharmacare program. We are the only country in the world with universal health care that doesn’t also offer universal drug coverage, and for this we have suffered.

Our existing hodgepodge of private drug plans and patchy public coverage puts too many Canadians at risk. At any given time, thousands face aggravated illness and needless suffering because they can’t afford the rising price of drugs; nearly a quarter of all households report having at least one member who over the last year has not filled a prescription due to cost.

Our system is ridiculously expensive not only for individuals, but also for governments. For instance, the cost of drugs is covered for those admitted to hospitals, creating a perverse incentive for people to unnecessarily draw on the most expensive care. Moreover, other countries achieve far lower drug costs by purchasing medicine through a single, national buyer. Studies have put the potential public savings of a universal and comprehensive pharmacare program at several billion dollars per year.

So compelling is the case that nearly everyone agrees. Justin Trudeau promised to develop a framework for a national pharmacare program. Ontario Health Minister Eric Hoskins has been among the most persistent and articulate defenders of the idea. Some 90 per cent of Canadians say they want this program. And yet no government has proposed a path, in large part because of political reluctance to embrace the inevitable start-up costs.

So it’s good to see Horwath showing some much-needed leadership on the issue. She announced on the weekend, that if her party is elected in next year’s provincial vote, she will not wait for Ottawa to take action on pharmacare, but will launch a universal program for Ontarians, which she expects would be in place by 2020.

As Horwath noted, some 2.2 million Ontarians are currently without any drug coverage, and as full-time, permament jobs with benefits become less and less common, the lack of an adequate public program becomes more and more urgent.

Horwath’s plan is sensible. She would begin by offering universal access to 125 essential medications, to be selected by an expert committee, and as the province begins to see savings, expand coverage until it is comprehensive. The initial cost would be $475 million, one-third of one per cent of the provincial budget.

Would a national pharamacare plan be cheaper, better and more just than an Ontario-only solution? Absolutely. But if Ottawa were going to lead on pharmacare, presumably it would have done so during the recent negotiations on a new health accord.

In asserting that Ontarians shouldn’t have to wait for federal leadership that may never come, Horwath is employing much the same logic as the Wynne government did when it prepared to pursue its own solution to another looming crisis. The proposed Ontario Pension Plan was never an ideal solution, but after years of federal inaction on the CPP, the province’s consolation plan was better than no plan at all.

Ideally, the prospect of an Ontario pharmacare program would have a similar effect on Ottawa as did the pension proposal, spurring the feds finally to act and thus to obviate the need for a provincial solution. But if not, the realization of a successful pharmacare program here might very well serve as a model for the rest of the country, as Saskatchewan’s medicare program once did, while improving the lives of many Ontarians.

Horwath’s 2014 election campaign was conspicuously empty of policy substance, and for that, arguably, she lost her party’s balance of power at Queen’s Park. By offering a bold, but workable solution to an urgent problem, she is putting her party in a much better position, and forcing this crucial issue onto the political agenda.

https://www.thestar.com/opinion/editorials/2017/04/24/andrea-horwaths-pharmacare-proposal-makes-good-sense-editorial.html