Rivers: Universal pharma-care a no brainer - will save the country $8 billion as well.

 

Rivers 100x100By Ray Rivers

February 11th, 2019

BURLINGTON, ON

 

We’ve seen the numbers. Canadians spend almost $30 billion a year on some 600 million prescriptions. And we know we could save as much as $8 billion by transitioning to a universal nation-wide single-payer system. It’s a no-brainer, right?

Tommy Douglas

Tommy Douglas – advocating for universal health care.

What would a universal program look like? It could be modeled on Canada’s universal health care system. In fact that would make it the perfect complement – administered by the provinces and funded jointly by both levels of government. The provinces already have a seniors’ drug program in place, and Ontario even had an OHIP+, covering those youth without a private health plan.

But to go that route, the provinces would have to agree among themselves on the universality and portability aspects. And they’d have to agree with the federal government on their joint responsibilities and cost sharing. That kind of deal might have been do-able back when the feds and most of the provinces shared a common political stripe, but with national partisan bickering increasing in the lead-up to the 2019 federal election, it won’t likely happen this year.

Ford at joseph-brant-hospital-doug-ford

Doug Ford at the Joseph Brant Hospital

For starters, Ontario, which is preoccupied with cutting or ending former Liberal programs has little interest in adding anything resembling a new or expanded social program, especially one which might lead to increased taxes. And cost-sharing discussions with a federal government currently being sued over carbon taxes is definitely a non-starter.

On the other hand there are good reasons for the federal government to implement a cross Canada program all on its own, given federal jurisdiction in the management of pharmaceuticals in this country.

One might expect the provinces to welcome a comprehensive program, funded at the federal level, saving them the costs of current provincial drug programs. But provinces are always wary about federal intrusion in what they see as their areas of responsibility, particularly in Quebec, so it’s not that easy.

How can we afford it? Well folks we are already paying the costs…and more. The existing patchwork of federal and provincial government subsidized programs is being funded through your tax dollars. On top of that, there is the cash we dole out at the pharmacy, the subscriptions to private drug plans, and the lower earnings accompanying a work place drug benefit. And that doesn’t count the costs to both the health system and work places for people who can’t afford to fill their prescriptions and end up just getting sicker.

It’s what we learned after moving to single-payer universal health care. We can’t afford not to have Pharma care. The four to eight billion dollar savings estimates may be speculative but it’s clear the savings won’t be zero. Efficiencies will be gained as competing pharmaceutical programs are reduced. Lower prices should be expected by negotiating for larger orders and buying in bulk. And then, of course, there is all that drug and drug insurance company profit.

Big pharma

Profits for the pharmaceutical industry are among the highest in the world.

Besides partisan politics at the provincial level, the other obstacle to implementation comes from lobbying by the Canadian patent drug industry and its international parents. They have become wary of efforts like Pharma care to compromise their profits in the nation with the highest drug prices on earth, after the USA. So they have offered to voluntarily hold the line on drug price increases over the next decade.

Their offer, which they estimate at $26 billion has been spurned by the federal government and for good reason. One has only to look at countries like New Zealand for inspiration. They manage to keep drug prices as low as one tenth of those here.

Pharma care was an integral part of Tommy Douglas’ vision for the nation’s first medicare program which he enacted In Saskatchewan. It was also a component of the original plan for universal national health coverage which the Pearson government introduced in 1964. The federal Liberals, in 1997, campaigned on a pledge to develop a plan for the implementation of universal Pharma care but failed to deliver.

Layton_Quebec

Jack Layton won almost everything in Quebec in the 2011 election. That let Stephen Harper form a government with the NDP serving at the Opposition.

Only in 2004 had Paul Martin finally secured landmark inter-jurisdictional agreements for a number of social programs, including universal Pharma care. But dithering and being caught up managing fallout from the Liberal Sponsorship scandal took its toll. In 2006 Martin’s minority government fell thanks to Jack Layton’s NDP, and with it so did our hopes for universal Pharma care.

Stephen Harper wasted no time giving any more time to universal Pharma care. Tommy Douglas must have shuddered in his grave knowing that his own party had helped deprive Canadians of Pharma care for the next decade and a half. It was only last year that the Liberals announced setting up an advisory committee to plan for a national drug plan.

scheer mute

Scheer hasn’t had much to say on a universal health care plan.

And Trudeau’s own finance minister mused that it might require means testing for income, thus ending dreams of universality. He clearly needs a primer on what the term Pharma care really means. And so does opposition leader Scheer, who, like Harper before him, has been mute on the idea, except for partisan attacks on the person leading the advisory committee.

And if Scheer wins the next election… there may well be somebody else writing this column in fifteen years and she’ll be asking … It’s a no-brainer, right?

Rivers hand to faceRay Rivers writes weekly on both federal and provincial politics, applying his more than 25 years as a federal bureaucrat to his thinking.  Rivers was a candidate for provincial office in Burlington where he ran against Cam Jackson in 1995, the year Mike Harris and the Common Sense Revolution swept the province. He developed the current policy process for the Ontario Liberal Party.

 

Background links:
Global Pharmacare –     Pharmacare –    National Program

Drug Prices Deal –     Advisory Committee –     Scheer

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