Two reports during his time in government have laid out the foundational principles of a national plan: universal, portable and comprehensive.
Published Oct 25, 2023 • Last updated 4 hours ago • 3 minute read
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Prime Minister Justin Trudeau has a unique opportunity to add a historic legacy to the Canadian social fabric. NDP Leader Jagmeet Singh has conditioned support for the minority government on delivering a bold, universal pharmacare program.
We’ve talked for decades about pharmacare. It has been part of Canada’s public conversation about health care as far back as the 1940s. From the outset, it was understood that universal coverage of prescription drugs was essential to universal health care. Yet we’re the only country with universal health care that does not have universal drug coverage. It doesn’t make sense and it’s time to complete what was started when we embraced medicare in 1984.
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The Stephen Harper government rejected the idea of pharmacare or any expansion of Canadians’ access to public health care. Trudeau ran on a promise to establish a pharmacare program. His minority government has ended up back at a crucial decision point. It is time to deliver.
In 2016, the Liberal-led Standing Committee on Health undertook an exhaustive two-year study of our system of drug coverage. In its 2018 report, the committee recommended establishing a universal single-payer public prescription drug coverage program. Not so fast, said then-health minister Ginette Petitpas Taylor. An advisory council led by Ontario’s former minister of health, Dr. Eric Hoskins, was struck that same year. It was to examine all options.
Hoskins and the advisory council brought back the same option. They were crystal clear. The commitment we made as a country so many years ago was to be there for each other when we’re sick. The absence of universal drug coverage contradicts that commitment; it means that only some Canadians can afford, and look forward to, a healthier future. In the absence of the bargaining power that comes from a national, single-payer plan, Canadians pay among the highest prescription drug costs in the world.
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Under our current fragmented system, one in five Canadians has no drug coverage. This means that millions are unable to afford prescription drugs — or must choose between the drugs prescribed and other necessities such as food, heat and shelter. The pain is not distributed evenly: vulnerable, racialized and marginalized communities are the ones who suffer the most.
Hoskins’ interim report laid out the foundational principles of a national pharmacare plan: universal, portable, comprehensive. The council’s final report in 2019 set out a reasonable roadmap for the implementation of a plan that anticipated, by 2027, annual savings of: $5 billion on system-wide spending on prescription drugs; $6.4 billion on families’ out of pocket drug costs; and $16.6 billion on business and employee drug costs. Hoskins’ report also pointed to another $1.2 billion in savings to the health system that would flow from universal pharmacare as there would be 220,000 fewer visits to emergency rooms and 90,000 fewer hospitalizations. Such relief on health budgets and health human resources, in particular, would have been welcome then — and it’s vital today.
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Now, we arrive at this place, with the NDP’s continued support for Trudeau turning on one of the prime minister’s yet unfilled promises: pharmacare legislation by the end of 2023.
The prime minister’s reluctance to implement his own, widely endorsed promise makes nurses nervous. We know why pharmacare has eluded Canadians for many years: those profiting from the current privatized system have influenced politicians to stop it. This must stop; Canadians’ health must come before the profits of the global pharmaceutical industry and deeply entrenched insurance companies. The lobbyists of enormously wealthy and mostly foreign-controlled companies should not dictate Canadian policy. It is those interests that stand in the way of this prime minister’s promise to Canadians.
We must be alert when the new pharmacare program is announced. Large business interests, should they fail to stop a new public program, will try to dilute it instead, shaping it to their own ends. These are the companies now heavily lobbying the government to enact a “fill-in-the-gaps” drug coverage program that would be a disservice to Canadians, and a huge bonus for corporate profits. This is not what the health committee nor the Hoskins report recommended. Nurses call on politicians: do not fail Canadians. They are your constituency, not Big Pharma.
Canadians made a promise to future Canadians when embracing universal health care decades ago. We promised to fill a major gap, which is the absence of a comprehensive, universal drug coverage. It is time for Trudeau, supported by the NDP, to deliver universal drug coverage for all Canadians.
Doris Grinspun, RN, is the CEO of the Registered Nurses’ Association of Ontario.
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