Last week, the Liberal government, aided by the Conservatives and the BQ, voted down Bill C-213 — legislation that would have helped ensure all Canadians could afford the medicines that they need. Titled the Canada Pharmacare Act and brought forth by NDP MP Peter Julian, the bill sought to establish “criteria and conditions” that each province and territory had to meet before qualifying for a “cash contribution” from the federal government.
The NDP argued that this bill reflected the recommendations made in the 2019 report by the Advisory Council on the Implementation of National Pharmacare, commissioned by Prime Minister Trudeau and chaired by Dr. Eric Hoskins, the former Ontario Liberal Minister of Health and Long Term Care.
Nonetheless, Bill C-213 was overwhelmingly defeated by a vote of 295-32, with only two Liberal MPs voting for the proposed legislation.
It would appear that our elected MPs are out of step with the opinion of Canadians when it comes to universal prescription drug coverage. A recent study found nearly nine-in-ten Canadians supported the idea, including three quarters of Conservative supporters. Furthermore, 77 per cent stated that this should be a high-priority issue for the federal government.
The same study found no significant improvement in affordable access to medications compared to 2015, when it was discovered that more than one in five Canadians struggled to keep up with the costs of their prescription drugs. This was corroborated in the 2019 report from Dr. Hoskins, which also found that nearly one million Canadians cut back on food expenses in order to pay for their medications.
The COVID-19 pandemic has only exacerbated these concerns. Many workers have seen their income dry up or have lost their job altogether, subsequently losing their prescription drug benefits. Access to health care providers and medical treatment in general has also been affected by the increased restrictions. All of these factors together make necessary medications more important, but unfortunately, more unaffordable.
Pharmacare not only makes sense from a health care perspective — it also makes financial sense. Currently, we rely on a convoluted patchwork of more than 100 public prescription drug plans and 100,000 private plans that is one of the most expensive in the world. Universal public drug coverage would reduce total expenditure on prescription drugs in Canada by between $4.2 to 9.4 billion and save the private sector between $6.6 to 9.6 billion. These findings were replicated in the study conducted by the Parliamentary Budget Officer in 2018.
Before the last election, the Liberal government created the Advisory Council on the Implementation of National Pharmacare to look into the need for a national drug coverage program in Canada. This was the fifth national commission on this topic in the past 60 years and like its predecessors, it recommended the urgent implementation of such a program.
In their 2018 federal budget, and during their 2019 election campaign, the Liberals committed to providing fair and affordable drug coverage for all Canadians. However, they have yet to offer details on what that program might look like, how it would be implemented, or any timeline on when they hope to establish a national pharmacare program.
Nearly all Liberal MPs rejected Bill C-213, including current Minister of Health Patty Hajdu, whose mandate letter from the prime minister included pharmacare. Their main arguments against supporting this bill relate to the delineation of provincial/territorial and federal powers, and the need to bring provincial leaders together before enacting national legislation.
Provincial and territorial governments have oversight over the direct delivery of medical services. Nonetheless, the federal government has a long history of exerting influence on Canadian health care through its control of the public purse. The Canada Health Act is one such example of how the federal government set national standards for health care but continued to allow the provinces and territories to individually decide how to best deliver care in their own jurisdictions.
The argument that the federal government does not have the power to exert influence on shaping health care is not rooted in the Constitution, but is instead an abdication of responsibility to the millions of Canadians that struggle to afford their medications.
Canadians have waited for decades for universal pharmacare. With the onset of the COVID-19 pandemic, they cannot wait any longer.
The 2021 federal budget is just around the corner. If the government’s rejection of C-213 was because it was written on the terms of an opposition party and not their own, this may be one of the last opportunities for the prime minister to make good on his public support for universal, public pharmacare. To quote Dr. Hoskins, “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.”
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