PHARMACARE NO CURE-ALL

For decades, liberal-minded politicians in Canada have struggled to introduce universal drug coverage. Having decided that state-funded health care was the best way to ensure general prosperity, they’ve long wanted taxpayers to fund prescribed medicines too. Problem: Pharmacare is very, very expensive.

But Ontario’s government has found a clever way to kick-start it: Make pharmacare available to the segment of the population least likely to need it. The provincial budget released Thursday proposes universal drug coverage for all Ontarians under 25 years old. There’s no means testing; all young people will be covered, at an estimated cost to the treasury of $465 million in year one. Apparently this will fund access to 4,400 drugs.

The plan is skilful politics (we’ll get to what sort of policy it is momentarily). Premier Kathleen Wynne, facing an election next year in which she is not exactly viewed as the frontrunner, can now outflank the NDP on the left. Its leader, Andrea Horwath, recently proposed a pharmacare program for all, priced at $475 million but funding only 125 medications.

The budget pitch also speaks to a slice of the population that doesn’t always vote, but which might remember the favours the Liberals are larding on it (the government is also introducing more measures to help pay for post-secondary education, for instance).

Third, it feels like a compassionate and affordable step: It doesn’t cost billions, yet it helps our children. Who among us does not want to help our children?

Thus, no future government is likely to rescind this measure. Which is the cleverest point of all: Pharmacare gets a toehold in Ontario that even Patrick Brown’s Progressive Conservatives are unlikely to undo. It can only expand in future.

Good, say those on the left. But we worry: Even the existing public health-care system is stretched, underfunded at every turn. Wynne’s government acknowledged that Thursday with its “booster shot” funding of $7 billion to help deal with the grim overcrowding in hospitals, the shortage of long-term-care beds and the difficulty of obtaining affordable home care. Hospitals had hoped for a funding increase of 4.9 per cent; they’ll get three per cent. Ontario’s doctors don’t yet have a contract, and nurses and other levels of care worker aren’t always paid what they deserve. Does piling on another program help Ontarians in the long run?

Ah, but the budget is balanced, you say. Well yes, but spending is still at record levels, and Ontario’s debt is expected to hit $312 billion in 2017-18. Our debt-to-GDP ratio is far from admirable.

Pharmacare is good medicine for the Liberals. For the long-term sustainability of health care? Maybe not.