A pharmacare placebo for no real problem

Ensuring that no Canadian lacks access to the medicines they need is a laudable goal. If the federal government is to move forward with a national pharmacare program, it should focus on what needs fixing: providing coverage to the 10 per cent of Canadians that are currently uninsured or underinsured.

There is no rhyme or reason to throwing out an entire system that is working for most Canadians for a costly alternative. Any national program must be designed in a way that is fiscally sustainable, ensures continued access to innovative medicines, and does not crowd out the comprehensive coverage options that most Canadians already enjoy.

How do we know that the current regime is working? Canadians said so. A recent study by Abacus Data shows that the vast majority of Canadians are covered under an existing private/ group plan and satisfied with the coverage and affordability provided. Eightysix per cent of Canadians are satisfied that their private/group insurance is making medicine affordable and 82 per cent are satisfied with the range of medicines covered. Overall, 77 per cent of Canadians say that the medicines they need are affordable or “affordable enough.” Among those Canadians who received a prescription in the preceding six months, less than one per cent indicated that they did not take their medication as prescribed because of cost.

National pharmacare should not reduce the coverage enjoyed by most Canadians under the existing system or result in coverage falling to the lowest common denominator. A full 90 per cent of Canadians believe that a national pharmacare policy should in no way put group benefits at risk of cancellation. There is no guarantee that a single-payer system will have the same formulary or access to the most innovative medicines as Canadians’ existing group plans.

It is also not fiscally prudent to increase public sector debt to pay for a costly single-payer system when the existing system is working for most Canadians. Seventy-five per cent of Canadians believe it is quite or very important that “government shouldn’t spend on those who already have prescription drug coverage.” The Parliamentary Budget private/ Officer estimates a net annual cost of $19.3 billion to the federal government for a single-payer national pharmacare program. To put that in perspective, this cost is comparable to the entire federal government deficit in the 2018–19 financial year.

A single-payer plan will likely result in increased deficits and taxes, both of which are not in the interest of average Canadians. The cost of a single-payer system represents money that could be better used on other aspects of our health care system — such as reducing wait times — or necessary investments in education and infrastructure.

What makes the most sense is a program that focuses on filling in the gaps in the existing system that Canadians say works for them, emphasized instead on improving health outcomes.

National pharmacare will provide the greatest value to Canadians by focusing on those who do not have coverage and those who are under-insured. It should provide the most appropriate coverage to those who need it. The proposals for a costly single-payer national pharmacare system is a placebo for no particular ailment.

THERE IS NO RHYME OR REASON TO THROWING OUT A SYSTEM THAT WORKS FOR MOST CANADIANS.