The wait for pharmacare has gone on long enough

When the NDP and the Liberals signed their confidence-and-supply agreement in March, one element that generated a lot of excitement was a pharmacare plan. This is something that has been promised for more than 50 years, since the Hall Royal Commission report established medicare in the 1960s. Then came the April budget. Where was pharmacare? On page 150, $35-million to Prince Edward Island over four years was claimed as “advanc the implementation of universal national pharmacare.” On page 151, the promise of pharmacare was repeated. That was all. No commitment of money. No timetable. The money to P.E.I. is not going to implement pharmacare. P.E.I. spends far less per capita on prescription drugs than the Canadian average—$255 versus $335. The $35-million is going to help narrow the gap and allow P.E.I. to increase the number of drugs its public plan covers and to decrease user fees that patients have to pay. That’s helpful to the citizens of P.E.I., but it’s not pharmacare. Pharmacare is national coverage for evidence-based prescription drugs for all Canadian residents. Pharmacare is like medicare. We don’t pay when we visit doctors or get admitted to hospitals. We shouldn’t be paying when we get the drugs needed to keep us out of doctors’ offices and hospitals. We already have a timetable for pharmacare. It’s in the report from the Advisory Council on the Implementaton of National Pharmacare. The council, under Eric Hoskins, a former Ontario minister of health, was set up in 2018 by Prime Minister Justin Trudeau and his Liberal government. The advisory council’s mandate was not to tell the government if we needed pharmacare. That was already a given. It was to tell the government how to achieve it. And it did. When the advisory council reported in 2019, it laid out a timetable. Start on Jan. 1, 2022, with covering a “carefully chosen list of essential medicines covering most major conditions and representing about half of all prescriptions.” And no later than Jan. 1, 2027, have a “full, comprehensive national formulary.” Hoskins also said that pharmacare should be run like medicare: all residents of Canada must be covered on equal terms and conditions; the plan must be publicly funded and administered; it must cover a broad range of safe, effective, evidence-based medicines; access must be based on medical need, not ability to pay; and people should be covered when they travel or move from one province or territory to another. In the run-up to the 2019 election, the Liberals were campaigning on pharmacare. In the House of Commons, Trudeau said, “we recognize that Canadians should never have to make the impossible choice between paying for their medications or putting food on the table.” After the election, the minority Liberal government still seemed to be in favour of pharmacare. The mandate letter from the prime minister to the minister of health instructed her to “continue to implement national universal pharmacare.” But then the Liberals starting hedging their promises. The provincial premiers were not very enthusiastic. Then-Manitoba premier Brian Pallister said “don’t start with another program , get that right, start by getting that right.” Quebec Premier François Legault wanted nothing to do with a national program. Even British Columbia’s NDP Premier John Horgan downplayed pharmacare, saying “those of us who already have significant plans … get back to a more equitable distribution of resources to deliver health care broadly.” Trudeau used this opposition to back off from pharmacare. He said that his government would not create or impose pharmacare on provinces that didn’t want to co-operate with his government. In an interview with the editorial board of the Toronto Star, he was clear that he wouldn’t interfere in areas of provincial responsibility because, according to him, that’s not how the federation is supposed to work. So, we arrived at the budget, with barely a mention of pharmacare. This is why more than 1,000 experts in health care and public policy have signed a letter calling on the government to increase the pace and scope of its commitment to national pharmacare. Canadians should not have to wait for a universal and comprehensive public pharmacare program. Dr. Joel Lexchin is an emergency room physician, an associate professor with the University of Toronto’s Institute of Health Policy, Management and Evaluation, and sits on the board of the Canadian Health Coalition. The Hill Times

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The wait for pharmacare has gone on long enough

We already have a timetable for pharmacare. What’s needed now from the Liberals is commitment.

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