Trudeau says Liberals are committed to launching a national pharmacare plan to ensure drug coverage for Canadians

Thestar.com
June 13, 2019
Bruce Campion-Smith and Alex Boutilier

Prime Minister Justin Trudeau says the Liberals are committed to instituting a national pharmacare program, setting the stage for a political battle with the Conservatives in the fall federal election.

Trudeau told the House of Commons Wednesday his government will move forward with a pharmacare program after an advisory committee’s report recommended extending prescription drug coverage to all Canadians.

“This report is an important step to lay the foundation of a national pharmacare program for us. We are going to continue to make sure that Canadians can afford their medication as we move forward,” Trudeau said during question period.

“We recognize that Canadians should never have to make the impossible choice between paying for their medications or putting food on the table,” he said.

While such a system would cost the federal government billions of dollars annually, Dr. Eric Hoskins -- the former Ontario health minister that headed the advisory committee -- warned that the current patchwork of public and private prescription drug coverage is unsustainable.

“(The costs) will be significantly less than if we do nothing,” Hoskins told reporters at a press conference in Ottawa.

“We recognize that there are incremental costs, significant incremental costs to building national pharmacare, but these costs are already being paid by Canadians. We are confident that the implementation plan we’ve put forward … fair and sustainable and accessible to Canadians.”

In its final report released Wednesday, an advisory council appointed by the federal government called on Ottawa to work with the provinces to establish a single-payer, public system of prescription drug coverage.

The system would provide coverage for a national list of prescription drugs and related products to ensure all Canadians have equal access to medicines -- a list that would start with a smaller group of “essential medicines” in 2022 and be gradually expanded.

The program would cost governments $4.1 billion in 2022, relative to what they would otherwise be spending on drugs without pharmacare. The committee estimated that, once fully implemented in 2027, the pharmacare program would cost approximately $15.3 billion per year.

Under the plan, out-of-pocket costs for products on that list would not exceed $5 per prescription and expenses capped at $100 per year, to ensure that necessary medications aren’t out of the reach of Canadians. Hoskins said pharmacare would save Canadians $350 a year.

And Hoskins underlined that the system has to be universal -- not a “fill-the-gaps” style plan to address the specific medical needs of specific groups.

“Frankly, that was the approach advocated for in the 1960s by many people. If we had filled the gaps in 1966, we would have an American-style health-care system in this country,” Hoskins said.

“Arguably, the proudest thing that binds us together as Canadians is our health-care system. And so we can’t afford to push this aside.”

Federal Health Minister Ginette Petitpas Taylor said she wanted to study the report before announcing next steps but said the Liberal government was “committed” to the creation of a national pharmacare program.

She noted that the federal government has already taken the first steps. The 2019 budget earmarked $35 million over four years to create the Canadian Drug Agency that would create a national list for medications that are covered, and use its bulk-buying power to negotiate lower prices for those drugs on behalf of coverage plans.

The success of a national pharmacare program hinges on the participation of provinces and territories and Ottawa footing the bill. That could be a point of contention in the Liberal cabinet.

In February 2018, federal Finance Minister Bill Morneau seemed to downplay the need for a universal system to ensure Canadians have access to pharmaceuticals and appeared instead to favour a system that plugs the gaps.

“We recognize that we need a strategy to deal with the fact that not everyone has access and we need to do it in a way that is responsible, that deals with the gaps, that doesn’t throw out the system that we currently have,” Morneau said at the time.

Petitpas Taylor said she agreed with the panel’s finding that the cost of doing nothing would be “astronomical” and said that Ottawa must be prepared to pay its share.

“We certainly recognize that funding is going to have to be a part of this equation as well. We certainly don’t expect provinces to foot the bill here,” she told reporters.

“If we want to put in place a national pharmacare program, the federal government has to play a leadership role. But we have to make sure we have all provinces and territories at the table,” she said.

A spokesperson for Ontario Health Minister Christine Elliott said that the provincial government “will carefully consider any recommendations and their impact on Ontarians.”

“As we do, we will measure all recommendations against their impact on the sustainability of our public health-care system while keeping in mind the lessons learned with OHIP+,” Hayley Chazan said.

That’s a reference to Ontario’s universal public drug plan for children and youth under 25. The Progressive Conservative government earlier this year ended the program for those who have private insurance.

Petitpas Taylor said more information would “come forward in our platform,” a nod to the coming election and a signal that pharmacare will be an issue in the campaign.

The NDP reiterated their long-standing support for prescription drug coverage and urged the Liberals to make it a reality, noting their 1997 election promise to, never materialized.

“Time and time again Liberals have promised to help deliver a result of lower costs to medication, but they failed to do so,” NDP Leader Jagmeet Singh said Wednesday.

But the Conservatives were less enthusiastic to the panel’s recommendations. Conservative Leader Andrew Scheer said there are other ways for the federal government to ensure all Canadians have access to necessary drugs -- and questioned the Liberals’ ability to manage such a large undertaking in a fiscally-responsible way.

“It’s about the gap. It’s about the people who don’t have access to pharmacare,” Scheer told reporters. “Studies show that is a small percentage of people who don’t have access to provincial plans, who don’t have access to employee-sponsored plans. So that would be where our focus would go.”

Advocacy groups voiced their support. The Canadian Health Coalition called pharmacare the “missing piece” of the health-care system.

“This will be a ballot-box issue in the upcoming federal election. We’ll be calling on all the political parties to make universal, public pharmacare part of their election platforms,” Melanie Benard, the organization’s national director of policy and advocacy, said in a statement.

CARP (Canadian Association for Retired Persons) applauded the council’s findings, noting that three-quarters of retirees see their drug benefits reduced or lose them entirely. The organization also highlighted the recommendation to eliminate the co-payment for low-income seniors.