Social Policy in Ontario

The latest tiny step forward came this week when Finance Minister Bill Morneau released his latest federal budget in which he announced some “foundational” measures on the path to national pharmacare.

The moves include setting up a national drug agency to allow bulk buying of drugs by the provinces and pledging to spend $500 million a year, starting in 2022, to lower the high cost of drugs for rare diseases.

Unfortunately, though, the federal government wasted a glorious opportunity in the budget to launch a true universal pharmacare program.

Instead it has opted for a “go-slow” approach to resolving a major health policy issue and continue Canada’s sorry status of being the only country in the world with universal health care but without a national drug coverage.

Importantly, the big reason there’s been so little movement on pharmacare is that no one in the Trudeau government’s cabinet has stepped up to champion it.

It’s a tough job to gain full federal-provincial co-operation on what will be a program that may cost up to $22 billion a year. And it’s especially hard when both Ontario and Quebec, the two biggest provinces, aren’t too keen on the idea under their current governments.

It’s even more difficult when you have to deal with opposition from rich drug companies and skepticism by some Canadians who already pay for private drug insurance.

So who in cabinet will step forward?

Clearly it’s not Bill Morneau, who favours a go-slow approach that seems to be going nowhere, especially given that the Liberals may be out of power after the Oct. 21 election.

And it’s not Health Minister Ginette Petitpas Taylor, who in the 19 months that she has held the post has shown she doesn’t feel empowered to take on such a role on an issue that will cause huge, albeit positive, upheaval in the health-care system.

One possibility was Jane Philpott, who was health minister in the early days of the Trudeau government, but resigned from cabinet last month.

The only other big champion of pharmacare in Trudeau’s inner circles was Gerald Butts, who quit last month as Trudeau’s principal secretary in the fallout from the SNC-Lavalin affair.

Today, political leaders can learn much from the past about what it takes to be a champion of health care in Canada.

In 1957, National Health Minister Paul Martin Sr. was the driving force behind the passage of the Hospital Insurance Act, the forerunner of today’s medicare that set standards for hospital care and provincially run hospital insurance.

Just as today, the Liberal government of Louis St. Laurent faced a hostile political landscape with opposition from the Ontario and Quebec governments and a lukewarm reception by the middle class. Martin is now considered one of the fathers of medicare in Canada.

In 1966, Health Minister Allan MacEachen was the cabinet champion who fought through lengthy cabinet and House of Commons debate to win passage of the Medical Care Act that established national medicare.

In 1984, Health Minister Monique Begin was alone for a long time in the Liberal cabinet of Pierre Trudeau in championing the Canada Health Act, which strengthened the medicare system.

Canadians may see some more steps in the right direction in late May or early June when former Ontario Liberal health minister Eric Hoskins releases an in-depth report by a National Advisory Council on pharmacare, which he was appointed last year by Ottawa to lead.

But Hoskins is not a cabinet minister and his council’s report will be impossible to implement without a champion in cabinet.

That’s because bold plans like pharmacare require the use of political capital, and only a strong champion with serious cabinet clout can make things happen.

Is there anyone in Trudeau’s cabinet ready to step forward and be the real champion for pharmacare? If so, the time for action is now.

Bob Hepburn is a politics columnist and based in Toronto.

https://www.thestar.com/opinion/star-columnists/2019/03/20/where-is-the-champion-for-pharmacare.html