Social Policy in Ontario

Canada is the only country with universal health care that doesn’t include universal drug coverage. Little wonder, since the lack of one undermines the other.

It’s long past time for Ottawa to replace the patchwork of public, employer and private plans that leaves as many as 20 per cent of Canadians uninsured or woefully underinsured with a true public drug plan that covers everyone, regardless of their age and where they live and work.

But if the federal Liberals intend to make pharmacare an election issue — and their early comments suggest they do — they need to be crystal clear on exactly where they stand.

It’s not enough to say, as Prime Minister Justin Trudeau did on Wednesday, that “we accept the report” and “we’re committed to national pharmacare.”

Health Minister Ginette Petitpas Taylor’s statement that the council’s final report “marks an important step on the path toward national pharmacare” also doesn’t cover it.

“Committed” to a pharmacare plan covers a lot of ground.

There’s true pharmacare, as laid out by the advisory council chaired by Ontario’s former health minister, Eric Hoskins.

Then there’s a paler version that seeks only to fill in the gaps by providing coverage for those who currently have none. Troublingly, that’s the version that Trudeau’s finance minister, Bill Morneau, has already stated he thinks is best.

“We need a strategy … that deals with the gaps, that doesn’t throw out the system that we currently have,” Morneau said last year.

What Hoskins’ report is calling for and what Morneau has spoken about are two very different things. Indeed, Morneau and Conservative Leader Andrew Scheer seem to be on pretty much the same page.

“It’s about the gap,” Scheer told reporters on Wednesday. “So that would be where our focus would go.”

While it’s easy to see the political appeal of a cheaper fill-the-gaps strategy, it’s ultimately doomed to fail.

The gap is growing and will only continue to do so as employment patterns change, leaving ever more workers without benefits and affordable drug coverage. Already, some households are forced to skimp on essentials like food to pay for medications; others aren’t filling prescriptions at all because they can’t afford the cost.

And the rising price of drugs is a problem for everyone — including those who currently have good coverage. Canadians already pay more for drugs than they do for doctors’ services and, the report says, drug costs are rising at an unsustainable 6.5 per cent per year. That has a big impact on both workplace plans and government drug benefits for seniors and the poor.

That’s why a key component of pharmacare must be, as Hoskins’ report states, a strong national drug agency that can buy medicines in bulk and reduce and Canada’s unnecessarily high drug prices.

Hoskins does an admirable job of laying out why a robust national pharmacare plan is the best way to improve health outcomes for millions of Canadians and reduce overall drug costs. But he’s certainly not the first to do so.

There have been plenty of other reports, all now sitting on a shelf collecting dust. Turning this one into reality won’t be any easier, but Trudeau’s Liberals should take it on because it’s well worth the effort.

It will require difficult negotiations with the provinces, admittedly a particularly challenging prospect right now.

And coping with insurance industry push-back, which has already started with dire warnings that millions will lose access to drugs under a national plan.

With universal pharmacare, the report says, the average household will save $350 a year and business owners who provide drug coverage will save about $750 annually per employee.

But it would do that by transferring $4 billion, rising to over $15 billion once fully implemented in 2027, to the public purse.

To make pharmacare a winning election issue the Liberals must be prepared to explain those costs and benefits to Canadians and why this is the right thing to do.

Hoskins’ report has started them off well in that regard.

The system we have, he says, is “near the breaking point” and “we can fulfil that original promise of universal care, of being there for one another, and create a future where no Canadian goes without the medicine they need.”

We’ve long know that Canada’s medicare system is less costly and delivers better health than the U.S. public-private mix. It’s time we see pharmacare in the same light.

https://www.thestar.com/opinion/editorials/2019/06/13/new-report-provides-the-trudeau-liberals-with-a-blueprint-for-pharmacare.html