Pharmacare — the lost opportunity
Drug plan a collective way to promote the health of all people, not just that of a privileged minority
Mary Cowper-Smith of the P.E.I. chapter of the Council of Canadians made a powerful and persuasive case for implementing a comprehensive, universal, national pharmacare program covering prescription medications for all Canadians (Guardian, “Canada deserves pharmacare plan,” June 1, 2017).
Canada is the only major industrialized country that hasn’t incorporated pharmacare into its national medicare program, instead opting for a hodgepodge of provincial drug programs aimed at different target groups with widely varying eligibility criteria.
Dr. Danielle Martin in her recent book on medicare reform in Canada, Better Now - Six Big Ideas to Improve Health Care for All Canadians (2017), identified pharmacare as the second most important priority required to upgrade our national medical system.
All major European countries, regardless of ideology, have a national pharmacare program. Socio-economic background (class), and access to medications, are crucial determinants of good health. In general, those in higher income groups are healthier; poverty is a social disease. Failure to have a national pharmacare program effectively creates a two-tier medical system. The Canadian Medical Association since 2015 has endorsed a national pharmacare program.
In this regard, my own personal experience with a foreign and provincial pharmacare program may be of some interest. When I was studying in Britain, between 1979-81, our infant twin daughters were constantly in need of lictus (DM) and antibiotics.
The meds were covered by the British National Health Service (NHS) and cost us, as medical consumers, the magnificent sum of L 1.65 (pounds) per prescription, as co-payment, then the equivalent of a pint of beer. Any cost for a prescription above that amount was covered by the NHS. Coverage for prescription drugs was universal. Through the NHS we even had a house call on Christmas Day from two physicians (remember what a house call is?).
We returned to Canada in late 1981 and went directly out to Saskatchewan where I worked on pension reform for Alan Blakney’s NDP government. Unbeknownst to me, the Saskatchewan government had implemented a comprehensive, British-style pharmacare program.
All residents of the province were entitled to this coverage. Imagine my pleasant surprise when I filled my first Rx at our neighbourhood pharmacy and was told that I only had to pay a $5 fee (co-payment); any amount in excess of that was paid for by the provincial government.
The province of Saskatchewan, in the best CCF tradition, introduced both the first medicare and pharmacare programs in Canada. Few people are aware of this history. Subsequently, Saskatchewan’s provincial pharmacare program was terminated by Grant Devine’s newly elected Conservative government.
Contrary to American-style, dog-eat -dog Social Darwinism, a national pharmacare program for all Canadians is a collective or communitarian way in which to promote the health of all people, not just that of a privileged minority.
It is recognition of our mutual responsibility to help our neighbours. Pharmacare is a social program whose time has come. Don’t leave home without it.