The Liberals have a chance to make headway on pharmacare. They should seize the opportunity

Posted on November 2, 2023 in Health Debates

Source: — Authors: – Opinion/Editorials
October 26, 2023.   By Star Editorial Board

If all this leads to “foundational” legislation and a road map going forward, that will be significant progress in a time of economic uncertainty.

There are rare times when the political imperative and the public good intersect. We have arrived at this point when it comes to a universal pharmacare program.

Canada is the only nation in the world with universal health care that does not provide universal drug coverage. It is also surely the only nation in the world where such a program, in one form or another, has been discussed for two generations.

For the federal Liberals and New Democrats, the political imperative is clear.Under the terms of the supply and confidence agreement between the two parties, NDP support is conditional on a pharmacare bill being tabled by the Liberals by the end of the year. Delegates to the recent NDP convention said the party should withdraw its support if the Liberals fail to commit to do “a universal, comprehensive and entirely public pharmacare program.”

If the two parties can find an alignment on the start of a program by the end of the year, the unpopular minority Liberals buy more time before having to go to the polls and the New Democrats can point to another achievement from an agreement that too often looks like a fruitless coalition of two parties trying to avoid the electorate.

The public good is also clear.

The Advisory Council on the Implementation of National Pharmacare, in its 2019 report, found that one in five Canadians had either no drug coverage or coverage inadequate to meet their needs. One in five households reported a family member who had not taken their medication over the past year because of cost, a million cut back on home heating or groceries to pay for their medications and another million borrowed to pay for their medicine. This was the state of affairs beforetoday’s financial squeeze in which shelter and food costs have left so many Canadians struggling. A larger number of self-employed or contract workers have been left more without prescription drug coverage.

Even then, more than four years ago, the council concluded that lack of access to needed medications cost the Canadian economy $1.2 billion annually in unnecessary visits to emergency rooms and hospital stays.

But the council acknowledged that the road to pharmacare would be long, with incremental steps. The council, chaired by former Ontario health minister Eric Hoskins, gave the government three years to pass proper legislation and negotiate with the provinces and territories and another five years after that to complete a national drug formulary.

This go-slow approach is the third imperative. The federal deficit for the 2023 fiscal year is expected to be $35.3 billion and the Liberal spending spigots are running dry. Conservative Leader Pierre Poilievre has maintained a singular – and effective – focus on the Liberals’ economic performance. The Liberal priority is housing, and with interest rates remaining high, the economy slowing and international spending commitments in the Middle East and Ukraine clouding the future, a national pharmacare program would likely again fall off the government shopping list if not for NDP pressure.

The PBO has estimated that the pharmacare model under discussion by the Liberals and New Democrats would cost federal and provincial governments $11.2 billion in 2024-25, rising to $13.4 billion in 2027-28. But cost savings on drug spending would hit $2.2 billion by 2027-28.

Hoskins had recommended that a universal program begin with essential medicines, which would initially cost the government $3.5 billion to $4.5 billion. The NDP insists on a single-payer universal system but acknowledges it can’t be done in one fell swoop. It has demanded that timelines for progress be enshrined in legislation.

If all this leads to a “foundational” piece of legislation and a firm road map going forward, that will be welcome and significant progress in a time of economic uncertainty.

Hoskins that the Star recently that now is not only best chance to act on this issue, it may be the only chance for the foreseeable future.

The Liberals campaigned on pharmacare in 2019, then dropped it when they went back to the polls in 2021. Putting such a plan before the voters again, having made no progress, would be perilous. Hoskins is right. The best chance of success is now, even if the reluctant Liberals are dragged to the starting gate in that rare alignment of political need and public good.

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