Social Policy in Ontario

To hydro and housing, add healthcare. The Ontario government’s budget for the coming year makes clear where Premier Kathleen Wynne’s Liberals believe their narrow path to re-election lies.

The most dramatic and welcome new element is a plan to more than double at a stroke the number of Ontarians eligible for free prescription drugs. The so-called “OHIP+” plan will make prescriptions free for children and young people – anyone who’s 24 or younger – beginning next Jan. 1.

This is a big step in the right direction. It’s a push towards universal pharmacare, the most glaring gap in Canada’s medicare system. Far too many Canadians aren’t covered by drug plans and can’t afford to fill their prescriptions. The Ontario plan will go further than any other in Canada towards extending drug coverage to all. Something like it is long overdue.

It’s also a wily political move, especially coming right on the heels of the Ontario NDP’s bold proposal to bring in partial but universal drug coverage by 2020. The NDP’s plan, unveiled just over the weekend by party leader Andrea Horwath, would include all Ontarians but would start by covering only 125 of the most commonly prescribed medications. It has a lot of appeal.

The Liberals are taking a different approach by focusing on children and youth, which has the big advantage of extending coverage to a lot of people at relatively small cost. The reality is that people under 25 are mostly pretty healthy so they generally aren’t big consumers of prescription drugs. And if their parents are fortunate enough to have a decent private drug plan (something increasingly rare these days), they’re likely to be covered already.

That’s why the government estimates the cost of covering drugs for 4 million young people at just $465 million a year, a fraction of 1 per cent of Ontario’s overall budget. By comparison, the province’s existing drug benefit (which covers 3.9 million seniors and people on social assistance) costs way more, about $4 billion a year. So the new plan comes with a lot of political bang for not a lot of budget bucks.

It’s far from clear which approach is better – the Liberals’ or the New Democrats’. Both are partial steps: the Liberals would leave many people still uncovered, but the NDP’s plan would include only some drugs.

Horwath believes Wynne is cutting her grass on this issue, as Liberals often do with attractive NDP ideas. But the fact is both leaders deserve major credit for putting Ontario’s considerable weight behind the cause of pharmacare.

As we wrote earlier this week, a national plan would be cheaper and more efficient than province-by-province solutions. But if Ottawa won’t take the lead, it’s good to see Ontario stepping up.

Too many politicians have been making concerned noises on this issue, but have failed to act while the need for proper drug coverage becomes more and more pressing. Finance Minister Charles Sousa made it clear that Ontario intends its program to be a model for Ottawa and the other provinces. If the Wynne government can get this plan off the ground successfully, it can and should serve as a starting point for more ambitious national action.

There’s a lot more in this budget for health care – $7 billion more over three years, including additional money for hospitals struggling with over-crowded wards. The province has squeezed the health sector hard over the past few years and it’s past time to inject substantial new money into the system.

All this comes as Sousa has managed to fulfill his promise to balance Ontario’s budget for the first time in a decade, since the global financial crisis blew a hole in the government’s finances. With the monkey of the deficit off their back and Ontario’s economy expanding at a robust pace, the Liberals have rediscovered their inner progressive. They’re earmarking extra money for a range of needs – from making post-secondary education more accessible, to a break on transit costs for seniors, to much-needed funding for thousands more childcare spaces.

Add all that to their plan to reduce electricity bills by 25 per cent and a set of measures to calm the Toronto region’s overheated housing market, and the elements of the Liberals’ case for re-election 13 and a half a months from now come into focus.

Judging by the polls at this point, it still looks like a long shot. After 14 years in power the Liberals own everything that’s gone wrong in the province – both the things they deserve and the ones they don’t. But even with all that, their rivals will have to step up their game.

That’s especially true of the Progressive Conservatives, whose reaction to Sousa’s effort was both confused and confusing.

They argue the Liberals are “cooking the books” and the government is really running an operational deficit of $5 billion – yet the PCs won’t say what they plan to cut to fix that if they get into power. Instead, party leader Patrick Brown fell back on old bromides about rooting out “waste and mismanagement” in government.

At the same time, Brown both appeared to support some kind of pharmacare program while complaining that the Liberal plan would let millionaires’ kids get free drugs. By that logic Brown should oppose letting wealthy people use the public medicare system. What part of “universal coverage” doesn’t he understand?

Judging by this budget, the campaign leading up to Ontario’s 2018 election is already well underway. That gives voters just over a year to pass judgment on the Liberals’ long record – and to compare them with the real-life alternatives.

This plan to kick-start a national debate on pharmacare shows that even after a decade and a half the Liberals still have a few tricks up their sleeves.