With the Liberal Party of Canada (“Liberal Party”) winning Monday’s federal election with 157 of 338 seats in the House of Commons, campaign promises will need broader support in order to be realized. This bulletin summarizes the positions of the top five parties, the Liberal Party,[1] Conservative Party of Canada (“Conservative Party”),[2]Bloc Québécois,[3] New Democratic Party of Canada (“NDP”)[4] and Green Party of Canada (“Green Party”),[5] on health care topics including pharmacare, medicare other than pharmacare (such as dental care), primary care, mental health and addiction services, Indigenous health care and medical assistance in dying.
Pharmacare
Three of the five leading parties committed to expanding the public health care system to include prescription medication. The federal government’s 2018 budget announced the creation of the Advisory Council on the Implementation of National Pharmacare (the “Council”). The Council released a final report on June 12, 2019. The Council’s report is summarized in our earlier bulletin: Universal, Single-Payer Public Pharmacare in Canada: An Overview of the Proposed Model and its recommendations are reflected in the party platforms.
| Liberal Party | • In the 2019 federal budget, the Liberal government committed foundational funding, including for the creation of the Canadian Drug Agency, the Canadian Drug Agency Transition Office, and a strategy for high-cost drugs for rare diseases.
• Promised to take the next steps, including by negotiating with the provinces and territories, establishing the Canada Drug Agency, and implementing a national formulary. The Liberal Party committed to using the Council’s recommendations to guide its approach. • Promised to bring down the price of drugs through a Rare Disease Drug Strategy. • Committed $6 billion over the next four years to its public health commitments as a whole (including pharmacare and primary care). |
| Conservative Party | • The Conservative Party stated that its focus is on those individuals not covered provincially or at work, rather than on a national pharmacare strategy.
• Promised to ensure access to drugs for Canadians with rare diseases by working with provinces and territories, the Canadian Organization for Rare Disorders, and other rare disease groups to encourage drug development and research, inform early detection and offer evidence-informed care. • Offered support for the $500 million commitment to rare diseases, promised in the 2019 budget by the Liberal government. |
| Bloc Québécois | • Promised to change how drug prices are determined. Currently, the drug prices are determined by comparing the prices with other countries. The Bloc Québécois would remove the United States from the comparison in order to recalculate the prices of all drugs.
• Quebec currently has a pharmacare program that covers uninsured and some other individuals. |
| NDP | • Proposed to implement universal pharmacare by late-2020, costed at approximately $10 billion annually.
• The NDP plan proposed prescription medicine available for free at the point of care to everyone, without co-payments. Co-payments may exist for brand name options and could be paid with private insurance. • Proposed new legislation modelled on the Canada Health Act with an annual pharmacare transfer to provinces and territories.[6]Provinces and territories would be required to commit to universal coverage of a comprehensive selection of medicines. The NDP acknowledges Quebec’s existing prescription drug insurance program and committed to full compensation towards a comparable system for Quebec if the province opts out of the federal program. • A national formulary would be determined by an arms-length agency. |
| Green Party | • Promised to extend the model of the Canada Health Act to other aspects of health care, including prescription drugs dispensed outside of a hospital.
• Would create a bulk drug purchasing agency and reduce drug patent protection periods. • Costed platform commits $26.7 billion in the program’s first year. |
Further Expanding Medicare
In addition to pharmacare, the NDP and Green Party promised to expand the Canada Health Act to other areas of health care.
| NDP | • Promised to introduce publicly funded dental care for low income households without insurance.
• Promised to increase access to eye and hearing care. • Would enforce protections against privatization and user fees. |
| Green Party | • Promised to expand medicare to include dental care for low income Canadians.
• Would enforce the Canada Health Act to address growth in private clinics. |
Primary Care
The Liberal Party, NDP and Green Party promised to expand access to primary care within the provinces and territories.
| Liberal Party | • Promised to ensure that every Canadian has access to a family doctor or primary health care team. |
| NDP | • Committed to working with the provinces and territories to improve wait times and access to primary care by identifying gaps in human resources, recruitment and retention of the doctors, nurses and other health care professionals. |
| Green Party | • Promised to work to ensure that every Canadian has a family doctor and that primary care is centred around the patient, with sensitivity to issues of social justice, equity and cultural appropriateness. |
Mental Health and Addiction Services
Mental Health Services and Funding
| Liberal Party | • Promised to set clear national standards for access to mental health services, to be incorporated into the Canada Health Act. Has also committed to better mental health support for specific groups including workers, veterans, Indigenous people and LGBTQ2 people.
• In the 2019 budget, announced $25 million over five years, starting in 2019-2020, with $5 million in ongoing funding, to support a suicide prevention service, including a 24/7 crisis line with bilingual support from trained responders. |
| Conservative Party | • Promised to maintain the additional Shared Health Priorities[7]funding for mental health services in the provinces. |
| NDP | • Promised to expand the health care model to include mental health, with mental health care available at no cost to those who need it. Has also promised specific support to farmers, Indigenous people and veterans.
• Would establish a national suicide prevention action plan. |
| Green Party | • Promised to negotiate the Canada Health Accord to prioritize expansion of, among other things, mental health services. Has specifically committed to addressing mental wellness for Indigenous people, LGBTQI+ youth, veterans and workers.
• Would establish a mental health strategy and suicide prevention strategy. |
Opioid Crisis
| Liberal Party | • Committed funding to support expanded access to a safe supply of prescription opioids, protect people from risks of overdose, and provide response training and Naloxone in vulnerable communities.
• Promised to invest in community-based services, in-patient rehab beds, and programs including extending hours for safe consumption sites. |
| Conservative Party | • Promised to help more Canadians recover from addiction by revising the federal government’s substance abuse policy framework to make recovery its overarching goal.
• Committed to investing in recovery community centres and recovery high schools and treatment centres, and partnering with municipalities and school districts to help clean up used needles in public spaces. • Promised to launch a national education campaign focusing on the dangers of drug use and the benefits of staying drug free. |
| NDP | • Promised to declare a national public health emergency in connection with the opioid crisis, and provide support to overdose prevention sites and access to treatment on demand.
• Promised to work with all levels of government, experts and Canadians to end the criminalization and stigma of drug addiction, while also addressing the trafficking of illegal drugs. |
| Green Party | • Promised to address the opioid crisis as a health care issue, rather than a criminal issue.
• Committed to declaring the opioid crisis a health emergency, increase funding to community-based organizations to test drugs, and make Naloxone widely available. |
Indigenous Health Care
| Liberal Party | • Promised to co-develop Indigenous health legislation and work with First Nations communities to ensure Indigenous control over the development and delivery of services. |
| Conservative Party | • Named Indigenous communities as a partner in its planned autism strategy. |
| Bloc Québécois | • Promised to address systemic racism and increase indigenous autonomy. The Bloc Québécois is committed to working towards administrative autonomy based on the ”Peace of the Braves” agreement.[8] |
| NDP | • Promised to implement Indigenous-led, culturally-appropriate home care and long-term care. The NDP also committed to investments in infrastructure and diagnostic equipment, and to develop an action plan to prevent suicide in partnership with Indigenous communities.
• Committed to upholding Jordan’s Principle,[9] ensuring Indigenous people receive equitable health care. |
| Green Party | • Also promised to uphold Jordan’s Principle.
• Promised to fund maternal and infant care, mental health services and treatment for diabetes and tuberculosis for Indigenous communities. • Would call for the implementation of the health focused calls to action developed by the Truth and Reconciliation Commission. The calls to action include increasing representation in the health-care field, and teachings in medicine and nursing programs.[10] • Promised to support traditional knowledge, and formal inclusion of traditional healing in the health care system. |
Medical Assistance In Dying
Several parties promised to broaden medical assistance in dying laws in Canada if elected. Promises focused on this issue have been prompted in response to a Quebec Superior Court decision in September, 2019, which found parts of the federal laws to be invalid. This issue was addressed specifically in the French language debate held on October 10, 2019.
| Liberal Party | • Committed during the French language debate to relaxing assisted dying laws. |
| Conservative Party | • Committed during the French language debate to protect vulnerable people. The Conservative Party has expressed interest in appealing the court decision to seek guidance from the Supreme Court of Canada. |
| Bloc Québécois | • Committed to take the steps required by the Quebec Superior Court decision and noted that there is room for improvement in the current laws. |
| NDP | • Also committed during the French language debate to amend the laws to create more autonomy. |
| Green Party | • Amending medical assistance in dying legislation was a platform promise. The Green Party’s proposals include advance directives and a “living will” that would allow individuals to limit or refuse medical intervention or treatment. |
Other Notable Health Care Issues
Blood donation
- The Liberal Party, which points to its success reducing the blood donation ban from a lifetime to three months for gay, bisexual and other men who have sex with men, promised to work to end the ban altogether with the implementation of a behaviour-based model.
- The Green Party committed to protecting Canada’s public blood system by prohibiting for-profit blood collection services and removing barriers to blood donation that are not based on science.
- The NDP committed to preventing the sale of blood products and behaviour-based screening for blood donation.
MRI/CT machines
- The Conservative Party promised to invest $1.5 billion in its first term to purchase new medical imaging equipment for facilities across Canada, to deliver quicker access to tests.
Autism
- The Conservative Party’s platform includes $50 million over five years for a National Autism Strategy.
- The NDP also committed to developing and implementing a national strategy.
Age-related, palliative and long-term care
- The Liberal Party promised to standardize access to home care and palliative care.
- The Conservative party committed $15 million to implement the Framework on Palliative Care in Canada.
- The NDP promised to create a national seniors strategy, which would include a national strategy for dementia and a prevention plan for elder-abuse.
- The NDP also promised to develop and amend the Canada Health Act with national care standards for home care and long-term care, to address inconsistent standards across Canada such as understaffingat residential homes. The intention is to legally protect access to home care and long-term care services.
- The NDP committed to determining a core basket of home care services that would be covered by provincial insurance plans.
- The Bloc Québécois has proposed a home care expenses credit based on a calculation grid. Currently, home care expeneses are eligible for a tax credit upon presentation of receipts.
- The Bloc Québécois would like to see health transfers to Quebec increased to 6% per year and, specifically, that the ageing population be taken into account in the calculation of health transfers.
Other
- The NDP also promised stand-alone legislation to regulate natural health products
- The Liberal Party promised to deliver better health care for women, including by finding and eliminating gaps in quality of care. They committed to doing so by engaging in gender-based and diversity analyses and creating a National Institute for Women’s Health Research.
- The Green Party specifically wove the health effects of climate change throughout its platform promises.
[1] The Liberal Party’s health care promises are outlined in a health care backgrounder and their platform, in addition to public statements and the party leader debates.
[2] The Conservative Party’s platform is available online. Health care is most specifically addressed in the chapter “More Help at Home”. The Conservative Party has also released specific statements on its health care initiatives, including autism and MRI and CT machines.
[3] The Bloc Québécois’ platform is available online.
[4] The NDP platform is available online. The NDP also released a booklet on pharmacare, available online.
[5] The Green Party’s platform is available online.
[6] The Council rejected inserting pharmacare into the Canada Health Act.
[7] See A Common Statement of Principles on Shared Health Priorities for additional information.
[8] ”Peace of the Braves” or La Paix des Braves, is the short form name for the Agreement Respecting a New Relationship between the Cree Nation and the Government of Quebec, signed on February 7, 2002.
[9] “Jordan’s Principle” is a legal requirement that developed out of orders of the Canadian Human Rights Tribunal. The principle provides that any public service ordinarily available to all other children must be made available to First Nations’ children without delay or denial. More information is available from the Assembly of First Nations by clicking here.
[10] See Truth and Reconciliation Commission of Canada: Calls to Actionfor more information.
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https://www.fasken.com/knowledge/2019/10/The-Leading-Parties-Promises-on-Health-Care
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