Liberal-NDP deal promises nothing more than a pharmacare pantomime

NDP Leader Jagmeet Singh stepped over broken promises about pharmacare walking down the aisle to join Prime Minister Justin Trudeau in a confidence and supply agreement. The “marriage” vows included a new promise—not to implement pharmacare, but about “continuing progress” toward a national program by passing legislation next year and making a plan to bulk purchase essential medicines. The announcement appeard under the banner Delivering for Canadians Now. This urgent language mirrors a parliamentary committee report called Pharmacare Now that has been collecting dust since 2018. Pharamcare was a key plank of the Liberal platform during the 2019 election, but the prime minister dropped it before joining the campaign trail again in 2021. The breathless language was fitting as pharmacare’s absence literally leaves people gasping for air. Untreated asthma can lead to collapse; poorly controlled high blood pressure can result in a heart attack; and uncontrolled diabetes can give way to kidney failure and strokes. Canadians brought insulin to the world a century ago, "but now only those with “extended” benefits at their job can reliably access this life-saving treatment. The price of insulin has only increased after its rights were sold for one dollar so that it would be accessible to everyone. Nav Persaud is the Canada Research Chair in health justice at the University of Toronto and a physician and researcher at St Michael’s Hospital in Unity Health Toronto. Photograph courtesy of Nav Persaud The urgency of the matter has led the NDP to challenge the Liberal government for failing to meaningfully include pharmacare in past budgets. Now the NDP is promising to support future budgets that only include a pharmacare pantomime. It does not provide people with life-saving medicines, like treatments for HIV-AIDS, which can stop people from getting the infection. Work towards a list of medicines that would be funded for everyone in Canada was underway long before this most recent announcement, and there is already a mechanism for jointly negotiating drug prices. The studies have been done and we already know that providing people with essential medicines works as expected and will save billions. Last year, my colleagues and I recommended implementing pharmacare as one of 13 measures to promote health equity or fairness during the pandemic recovery period. Pharmacare motions have come and gone. So, it is not clear what is new in this announcement. Pharmacare remains just beyond the next election horizon. What we need now is to shift purchasing spending away from private insurance companies—which push up drug prices to increase the size of their cut of each claim—and toward our publicly-funded health system. The infrastructure to do this is already in place and recipients of social assistance, like welfare and disability, already have their health card swiped at the pharmacy. But instead, the federal government is continuing to subsidize the unfair private insurance system that sees higher income individuals access insurance plans for drugs while people working in factories, fast food restaurants, and coffee shops are on their own. This is one of two ways we will be able to see if the NDP-Liberal “marriage” will really yield pharmacare. The public subsidy for private insurance plans should be rolled back or cancelled. Back in 2017, the Trudeau government indicated it would re-examine that regressive subsidy that was estimated to be worth $2.9-billion at the time. That’s right, although some naively ask how we can afford pharmacare, the current private insurance system for medicines receives a public subsidy worth well over $3-billion today. The other test of this commitment to including medicines in our publicly funded system will be by reforming regulations patented drug pricing. Bulk purchasing will not necessarily lower the prices of patented medicines, so price ceilings need to be set and enforced with fines. Currently price ceilings in Canada are set using comparator countries like the United States that pay high prices. Plans to adopt prices paid in countries that do a better job of reigning in drug pricing were postponed in 2018 due to pressure from the pharmaceutical industry and private insurance companies. How can we tell if industry lobbying is succeeding? Our elected leaders will wave around pharmacare blueprints but never put their work boots on. The status quo will persist and we will keep paying the price. The Liberals and NDP have separately gotten a lot of political mileage out of pharmacare announcements in the past, but from opposing sides. Last week they got positive coverage making a vague announcement together. Since there is now no opposition party challenging the government’s unwillingness to make pharmacare a reality, the 86 per cent of Canadians who support pharmacare need to demand immediate action and not recycled pledges dressed up for pomp and ceremony. You can raise a child without being married. Nav Persaud is the Canada Research Chair in Health Justice at the University of Toronto who has studied access to medicines. Persaud is also a researcher at the MAP Centre for Urban Health Solutions at St Michael’s Hospital in Unity Health Toronto and a family physician. The Hill Times

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Liberal-NDP deal promises nothing more than a pharmacare pantomime

It is not clear what is new in this announcement. Pharmacare remains just beyond the next election horizon.

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