My bet for 2019 is that Premier Doug Ford is going to define the next federal election. But it won’t be by smoking the carbon tax. Rather, his government is likely to gut the Ontario Drug Benefit seniors’ program. How the federal Liberals and NDP respond to this challenge will define their parties’ visions for the country and determine the election results.
The Ontario Drug Benefit plan includes a variety of programs for different recipients and for certain drugs. But seniors use more than half the ODB’s $6 billion budget. Low income seniors and residents of long-term care institutions pay nothing for their drugs except $2 or less per prescription. The other 90 per cent of seniors pay as little as their deductible of $100 per year and a few dollars for each prescription.
The ODB seniors’ program isn’t perfect but it’s universal and cheap to run. Canadian public drug programs’ overhead costs are one-tenth of what they are for private plans. And the ODB has an ability to negotiate lower prices for drugs than we can as individuals.
Some other provinces used to have generous drug programs, but they have been eviscerated by decades of cutbacks. Now provinces make people use private plans, if they have them. Otherwise coverage is income dependent. Quebec’s drug plan nominally covers the whole population through mandatory public insurance for those without private insurance. But even seniors with $25,000 incomes have to pay more than $1,000 per year in premiums.
The ODB seniors’ program is vulnerable. Ford inherited a $6-plus billion deficit and he’s blown that up with tax reductions and lost law suits. He has made hurtful cuts — changing the ODSP disability definition, axing the universal basic income pilot and the new ODB program for children, etc. But none of these amount to serious money. Cutting the ODB seniors’ program and implementing a Quebec or Manitoba-style plan could save $2 billion in one fell swoop.
Seniors would complain. They lobbied to death a 2016 Liberal proposal to increase the deductible and co-pay rates. And a lot of poor and working-class seniors voted for Ford. But the government will overwhelm vulnerable Ontarians with cuts in many areas. If the Ford government opts to slash the ODB, it will be done in a massive omnibus budget bill that they will ram through this spring.
Then things get interesting. Up to two million Ontario seniors would face less accessible drugs at the same time that Dr. Eric Hoskins’s federal pharmacare task force reports. Will the task force recommend a public universal pharmacare program like the ODB or Quebec-style privatization? What will the Liberals decide to do?
They could take the ODB cuts as a gift, tack left, and support a universal pharmacare program. Running against Doug Ford’s Blue Meanies and wrapping themselves in the medicare flag could be the winning play for Ontario’s 121 seats and many ridings outside the province.
But business Liberals have always hated medicare. In 1966, finance minister Mitchell Sharpe tried to sabotage medicare while Prime Minister Pearson was out of the country. Twenty-four hours after Hoskin was appointed, current finance minister Bill Morneau claimed that Canada’s pharmaceutical coverage only needed minor tweaks — code for a Quebec-style program.
If the Liberals waffle, pharmacare could resuscitate the comatose NDP. The New Democrats are the Party of Medicare and have consistently supported a universal pharmacare plan. It would differentiate them from the Liberals and strike an attractive left-wing populist note.
Ford’s ODB cuts would be toxic to the federal Conservatives. They would be caught between Canadians desire for better drug coverage, their own anti-deficit rhetoric, and Mad Max’s faux libertarianism.
But Doug Ford doesn’t seem to much care what happens to his federal cousins and he enjoys stirring the pot. Will he define the next federal election by slashing the Ontario Drug Benefit plan?
Dr. Michael Rachlis is a public health physician and an adjunct professor at the University of Toronto Dalla Lana School of Public Health
https://www.thestar.com/opinion/contributors/2019/01/10/fate-of-ontario-drug-benefit-could-define-federal-election.html
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