Pharmacare: the final frontier for Canada’s Medicare system
It’s not just a political right, it’s a human right
Canada is the only developed country with a universal Medicare system in place that does not include drug coverage. Our public health insurance ends when a patient is handed a prescription.
Last year Canadians spent a whopping $30 billion on their medications. Almost as shocking, Canadians pay among the highest prescription costs in the developed world, second only to Americans.
The undesirable consequence is that one out of five Canadians can’t afford to fill their prescriptions. Many skip doses, split pills or otherwise try to spread their medications over a longer period of time after visiting a doctor.
Some pharmacists in Cape Breton believe that thousands of residents are among those 7.5 million Canadians who don’t get the medicine they need when they need it.
Such high rates of local poverty coupled with a large and growing senior population means that many get a diagnosis they can’t afford to treat medically. They risk aggravating their conditions and illnesses, perhaps even dying.
A local physician, Dr. Monica Dutt, calls the lack of drug coverage in our country “a serious flaw.” She is right, in spite of U.S. Senator Bernie Sanders’s glowing endorsement of the Medicare side of Canadian medicine. Lack of universal drug coverage exacerbates the very purpose of our reputable but beleaguered Medicare system.
Tommy Douglas, the father of Canadian Medicare, never intended to launch a system with such a glaring gap in healthcare coverage. He envisioned comprehensive drug coverage operating along with hospital and physician services. Douglas led the debates about a universal medical system in the 1940s and 50s.
By the 1960s Canadians were ready to implement a ‘national system.’ In 1964, two years before Medicare was legislated by Ottawa, the Hall Commission recommended universal Pharmacare as an integral part of our Medicare system. In the end, Canada’s Medicare Act 1966 was passed without national drug coverage.
This blatant policy omission speaks to the power of national and multinational pharmaceutical companies lobbying in Ottawa and the provinces ¬ then and now. That power has sustained itself even though a recent Angus Reid poll finds that 92 per cent of Canadians strongly support Pharmacare.
Canada’s Medicare system is chronically decentralized, facing serious problems of doctor shortages, retention and surgical wait-times ¬ problems that go beyond the lack of Pharmacare. All governments need to better fund and strengthen the Medicare side of pure heal are system while merging a comprehensive national Pharmacare program.
We are left with a hodgepodge of private drug insurance plans in the provinces and territories and millions of out-of-pocket payers with no supports. What’s worse, most provinces are antsy about embracing Pharmacare. Many have already scaled back on their senior drug plans.
Ontario is the only province that has recently pledged universal Pharmacare for everyone under 25 within its borders in 2018. Not surprisingly Quebec, the most generous province for those without drug coverage wants to eventually implement its own universal “systeme nationale” outside of Ottawa’s control and scrutiny. Nova Scotia has limited prescribed drug coverage for those on income assistance, people with disabilities and children under child welfare. Not much chance the McNeil government will embrace a comprehensive drug system within the diminishing resources of Nova Scotia’s economy.
The Trudeau government is predictably avoiding the issue, focusing instead on reducing drug prices and not actively seeking to negotiate with the provinces for a national program. Medicare has been a source of pride for Canadians, while affordable access to prescribed medicines has been a national embarrassment.
We have to move away from our basic sentiment that Pharmacare is a political right to that of Pharmacare being a human right.
“What’s worse, most provinces are antsy about embracing Pharmacare.”