The quest for universal pharmacare
Canada’s federal government seems poised to prop up the status quo instead of going upstream
It looks like the snake oil salesman is about to gallop away with a tidy pharmaceutical profit once again.
Indications are Canada’s federal government will choose to bend to the pharmaceutical and insurance industry and continue to toil with its broken patchwork model instead of building a universal pharmacare system that’s accessible to all.
According to pharmacare expert Marc-Andre Gagnon if that decision stands, it means Canada will continue to lag behind all other countries with universal health care systems.
It means Canadians will continue to pay the second highest drug costs in the world.
It means people without money or private drug coverage will continue to struggle to afford even basic prescriptions.
Before this broke in the media, I participated in the Canadian Health Coalition’s big push for universal pharmacare on parliament hill. Our goal was to make sure that every member of parliament understood that a universal system would have better health outcomes for their constituents than a “fill the gaps approach” modelled after the Quebec drug plan—the plan Finance Minister Bill Morneau seems in favour of promoting.
I was assigned to a team of three other people: Darlene Jackson, the new president of the Manitoba Nurses Union; Brianne Goertzen, the coordinator of the Manitoba Health Coalition; and Debbie Boissoneault, president of CUPE Local 204.
On a really snowy day in late January 2019 our team trudged through the capital to meet with four members of parliament with the mission of educating members of parliament on the health, social, and economic benefits of a universal system.
Our most engaging meeting was with MP Doug Eyolfson, a former emergency room doctor and champion for universal pharmacare. He was part of the House of Commons Standing Committee on Health (HESA) which conducted a study, released in April 2018, on the idea of a national pharmacare plan. The committee’s report recommended a universal, publicly administered, single-payer system through the expansion of the Canada Health Act.
The report noted that a universal public plan could save Canadians at least $4.2 billion in annual prescription costs. The Canadian Health Coalition submits that the savings could be as high as $11 billion.
The HESA report noted that the upfront costs were going to be roughly $10.7 billion to set up the pharmacare system before the savings trickle down to Canadians. But the system would provide better care to Canadians.
The universal plan is meeting resistance from insurance companies and large pharmaceutical players who favour a “fill-the-gaps” approach modelled after Quebec. The challenge with that model is that the public system wouldn’t realize much savings because it would only get the high-risk and high-cost clients that are rejected by for-profit drug coverage.
A “fill-the-gaps” approach would benefit large corporate interests more than it would small- to medium-sized businesses who could eliminate the cost burden of a private drug coverage plan.
Unfortunately, too many Canadians don’t have adequate coverage provided through employer plans. Most importantly, we need a system without deductibles and co-pay arrangements. Only a universal public plan can provide the required level of accessibility that leaves no one behind.
The Canadian Health Coalition estimates that a universal pharmacare system could save Canadian families a total of $7.1 billion in household expenses every year.
Those MPs not in favour of universal pharmacare were concerned that a public plan would let employers off the hook for paying for their employees’ health. Others expressed concern that universal pharmacare would lead to job losses in their ridings.
Despite agreeing that too many Canadians lack sufficient coverage, they were more concerned with broader economic agendas and the interests of corporate Canada. Yet they weren’t making the link between a healthy population, healthy communities, and the positive impact that would have on the economy.
One overarching fear that was evident in these meetings is that many MPs are reluctant to raise the revenue needed to set up the program. They fear losing an election over raising taxes to pay for pharmacare. Since day one, the finance minister has been signalling that he will choose the “fiscally responsible” option.
When we complain rashly about higher taxes, we paint ourselves into a corner, rewarding politicians that won’t build a more equitable system of prescription drug coverage to ultimately save us all more money and contribute to healthier outcomes.
By refusing taxes, we refuse to invest in a lower-cost, healthier future. We remain stuck in a situation where Canadians are paying more for our drugs than we would under a universal system. Simply because we have an allergy to taxes, a cynical relationship with politicians, and a mistrust of the ability of public institutions.
As long as this tax aversion mindset remains in place, insurance companies and big pharma will cynically manipulate us into paying more out of pocket than it would cost in taxes. And we continue to lose sight of the public good.
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