There is no ‘pharmacare deal’
You can’t dismantle what doesn’t exist
Justin Trudeau’s backroom geniuses want you to see yet another clip of Pierre Poilievre refusing to answer a very insistent reporter’s question in Ottawa. The question, asked during a Thursday press conference was, “Will you dismantle pharmacare?” Poilievre, unable or unwilling to get a word in edgewise, simply walked away rather than answer.
“Pierre Poilievre refused to answer whether he’d cut Liberal pharmacare. Because he will,” the Liberals warned their social media followers.
The Liberals’ and NDP’S “deal on pharmacare,” as CBC News described it, was big news all week. It was a condition of the NDP maintaining its supply-and-confidence agreement with the government (or at least, party leader Jagmeet Singh said it was) so it had major political ramifications (if we assume Singh was actually serious about withdrawing support, which we certainly should not).
“Canada’s pharmacare bill has officially been introduced in Parliament,” Global News announced.
“Deal on pharmacare bill has been reached with Liberals ahead of March deadline, NDP says,” was The Canadian Press headline.
Folks, there is no pharmacare to dismantle. There isn’t even a deal on pharmacare to dismantle — or to walk away from, to abandon or to otherwise disrespect. Almost literally nothing has happened to underpin this news cycle.
What we have is Bill C-64, “An act respecting pharmacare.” Excluding preamble and title page, it is four-anda-half pages long (two-anda-quarter really, since it’s bilingual), and it most certainly does not bind the government to implementing a national pharmacare program — which it can’t do on its own anyway, health care being provincial jurisdiction and two of the country’s larger jurisdictions (Quebec, which already provides prescription drug coverage, and Alberta) having already indicated they’re not interested.
Paragraph three sets out the purpose of the bill, which is “to guide efforts to improve ... the accessibility and affordability of prescription drugs ... in collaboration with the provinces, territories, Indigenous peoples and other partners and stakeholders, with the aim of continuing to work toward the implementation of national universal pharmacare.”
To guide efforts to improve access to prescription drugs ... with the aim of continuing to work toward the implementation of national universal pharmacare.
Why don’t we pause here and marvel at how lame that is.
The bill authorizes the minister of health (not that I would have thought it necessary) to “seek advice from the Canadian Drug Agency on” matters including “the prescription drugs and related products that should be included in prescription drug coverage plans ... and the conditions of that coverage.”
Headlines have noted the government’s stated intent to cover insulin and contraception. “Ottawa unveils national pharmacare plan that covers diabetes, contraception to start,” CBC News announced.
Here’s what the bill says: “The Minister may, if the Minister has entered into an agreement with a province or territory to do so, make payments to the province or territory in order to increase any existing public pharmacare coverage ... for specific prescription drugs and related products intended for contraception or the treatment of diabetes.”
If that sounds like something less than a done deal to you, your instincts are good. Anything predicated on an agreement between Ottawa and the provinces is very much worth doubting until the moment it demonstrably, verifiably exists. And yet provinces are already under at least implicit pressure from media to declare themselves in or out. “While Ontario is not ‘writing off anything’ in national pharmacare talks,” Global News reported, “the government is taking a wait-and-see approach before deciding to opt in.”
That’s a perfectly accurate description of what’s happening. But it also implies there’s actually something to opt into, and that opting into whatever it is now might be a reasonable thing to do. There isn’t, and it wouldn’t be. One of the health minister’s assigned tasks under Bill C-64 is to have the Canadian
Drug Agency come up with “a list of essential prescription drugs and related products to inform the development of a national formulary.”
What kind of “national pharmacare plan” do you really have if you don’t yet even have a list of the drugs it would cover? I submit you have no national pharmacare plan at all — certainly not one anyone or any province would choose over the coverage the vast majority of Canadians already have without a whole lot more information.
This is the central absurdity of the whole pharmacare discussion: Its proponents frame it as a matter of simple social justice. But by the government’s own account, roughly 80 per cent of us already have what it considers “adequate” prescription-drug coverage. The Conference Board of Canada estimates more than 97 per cent of Canadians have at least some coverage.
Outside the supply-and-confidence bubble in which the Liberals and NDP (and apparently some media) live, what both parties need to sell Canadians on is trading their existing plans, however imperfect, for a new plan, designed in Ottawa, that would cover ... well, they’ll get back to you on that. Why would anyone do that? Why would any province do that on its people’s behalf? MPS and civil servants no doubt associate government with gold-standard health-care coverage; the rest of us, including the millions of Canadians who already rely on various government programs, do not.
On Tuesday, hilariously, federal Health Minister Mark Holland admonished Bloc Québécois parliamentary leader Alain Therien that it was much too early to talk about compensation for Quebec in lieu of signing up for national pharmacare. “It’s important not to criticize something that doesn’t exist,” said Holland.
Wise words, though they don’t help Holland’s case: We shouldn’t laud something that doesn’t exist either.