Social Policy in Ontario

Their scheme to provide those under 25 with free prescription drugs isn’t comprehensive. Nor, in spite of Finance Minister Charles Sousa’s boast, is it exactly path-breaking.

Saskatchewan already offers a similar, albeit less generous, drug plan to children 14 and under.

But it is a start.

The plan, announced in Thursday’s budget, would allow any Ontarian age 24 and under who needs prescription drugs for medical purposes to receive them at no cost.

Unlike the province’s drug plan for seniors, there would be no co-payment and no deductible. Unlike the drug plan for welfare recipients, there would be no means test.

Rather, like medicare, it would be universally available and cover the entire cost of roughly 4,400 drugs.

Experts can argue whether the Liberal pharmacare plan is better or worse than that pitched by Andrea Horwath’s Ontario New Democrats. The NDP proposes a scheme that would cover everyone under 65 but only for 125 commonly prescribed drugs.

But the Liberals have the advantage of being in power right now. If they follow through on their promise, their truncated pharmacare plan will come into effect next January.

I suspect they will follow through because this idea is likely to be popular. And once a popular pharmacare scheme is in place, it will be politically difficult for any government to kill it.

Fiscally, the Liberal drug plan has the advantage of being cheap — largely because younger people tend to be in good health. Officials say it will cost roughly $465 million a year, a relatively small amount for a government that spends more than $140 billion annually.

Politically, the drug scheme is a classic pre-election Liberal feint to the left. After years of foundering and with an election due in 2018, Wynne has rediscovered the virtue of activist government.

Health care spending, in particular, is being boosted. The government kept the lid screwed tight. It is loosening it.

The average annual rate of growth in total health spending is rising from 1.8 to 3.3 per cent — with a big chunk of that new spending going to hospitals.

If re-elected, the Liberals may return to their tight-fisted ways. They have done so before. Their surprise decision to authorize the sale of Hydro One demonstrates that the Wynne Liberals are infinitely flexible.

But they will find it politically difficult to reverse themselves on pharmacare. It is the missing piece of medicare. Voters understand that.

Voters also understand that employee health benefit plans are in decline. Employers find them too expensive. Precarious workers rarely, if ever, qualify for them.

For these reasons, any move toward universal publicly funded pharmacare is welcome and probably irreversible. Progressive Conservative leader Patrick Brown told reporters Thursday that he would prefer a scheme that is means-tested. But Ontario already has a drug benefit program for the poor.

What is useful about this scheme is precisely what Brown doesn’t like about it: It is a step on the road to universal pharmacare.

Sousa told reporters that he hopes Ontario’s move will persuade Ottawa and other provinces to act. Perhaps it will.

But if that doesn’t happen, this budget at least commits Ontario to something. It makes no sense to exclude out-of-hospital drug therapy from public health insurance. It never has.

There is much in this budget that is unsatisfactory. Welfare rates adjusted for inflation remain flat. The problems faced by seniors trying to get long-term care are not really addressed. As NDP leader Horwath noted, even the pharmacare proposals have a haphazard air about them.

But at least the government has promised something positive. I don’t know whether this will be enough to give the Liberals a victory in the next election. I don’t know whether the Liberals deserve a victory in the next election.

However, if they manage to get this thing going in January, they do deserve, at the very least, a round of one-handed applause.

https://www.thestar.com/opinion/commentary/2017/04/27/one-handed-applause-for-youth-pharmacare-plan-walkom.html