National Post (National Edition)
PM keeps the NDP fooled on pharmacare
Former finance minister Bill Morneau is “baffled” that the Liberal government has committed to a public dental care plan while the long-promised national pharmacare commitment remains unfulfilled.
That is probably why Morneau is an ex-minister. He was never comfortable with the concept that politics is like navigation — sometimes you sail, sometimes you use the wind; sometimes you tack and sometimes you catch the tide, in order to reach the destination of political survival. Often, you promise things that don't make sense; occasionally, you make brazen commitments on which you know you can't deliver.
In the supply and confidence deal the Liberals signed with the NDP, the big item was a new dental care program for low-income Canadians. But it also included a promise to make progress toward a national pharmacare program by passing a Pharmacare Act by the end of 2023, and then asking a newly formed National Drug Agency to develop a formulary of medicines that would be bulk purchased by the end of the agreement.
Jagmeet Singh has said the failure to pass legislation this year would be a “deal-breaker.” The Liberals, for their part, have said they remain committed to the plan.
But this week, sources say the government members of the oversight group that monitors the deal warned the New Democrats that pharmacare is unlikely to happen in the next few months — a clear sign that there will be no new spending in the budget.
Finance Minister Chrystia Freeland has already said that the government will “continue to take a fiscally prudent approach” in the coming budget, given the uncertainty in the world economy. There are already pressing demands to deliver more health, defence and green-tech spending.
Liberal chiefs of staff are said to have been told to come up with something, anything, in their area of departmental purview to keep the New Democrats onside — as long as there are no spending implications whatsoever.
The last thing the Liberals want — or can afford — is for the NDP to reach the conclusion that they are being duped and that the Trudeau government has no intention of investing upward of $15 billion in a universal, single-payer national drug formulary.
That might result in Singh calling time on the deal that keeps the Liberals in office.
But for anyone who has looked at the issue, it would be reasonable to conclude the Liberal commitment in the deal is not worth the paper it was written on.
As Morneau wrote in his new book, Where to from Here, a wholesale change to the system would be extremely expensive, and difficult to implement because it would face opposition from, among others, the half of Canadians who are quite happy with their current employer-based private insurance coverage. Even the provinces are lukewarm. They would prefer Ottawa simply hand over more money, no strings attached, in the form of an enlarged Canada Health Transfer (which may well happen after next week's health-care summit).
Morneau predicted pharmacare would swallow up an inordinate amount of the government's time, as the feds negotiated with employers, insurance companies and the provinces. Instead, he suggested a “fill the gaps” approach that covered people with no private insurance — a change he suggested could be achieved for the relatively affordable cost of $3 billion.
But Justin Trudeau is not a man satisfied by incremental gains; his initial political campaign launch theme was inspired by Johann Wolfgang von Goethe's mantra: “Dream no small dreams for they have no power to move the hearts of men.”
The Liberals have promised full payment for prescription medicines and that is what they will remain publicly committed to, even if they have no intention of actually living up to that promise.
Fortunately for Trudeau, Singh's anger at the government over the hiring of consultants from McKinsey and the introduction of what Singh calls “American-style health care” is entirely synthetic.
Government officials say their impression is that the NDP is actually quite happy with the deal so far. Quite why that might be is unclear.
The most recent public opinion polls show the NDP as becalmed as the Liberals. In the event of an election, the risks for both are on the upside.
As a result, both parties appear happy to play out the fiction that a public, single-payer drug plan — a castle in the air since the royal commission of 1964 — is still in the offing.
Unable to spend its way out of trouble, this Liberal government looks bereft. In its early years, Trudeau was on a moral crusade to transform Canada into a more egalitarian country by government fiat at the taxpayers' expense.
Now, in an era of “fiscal prudence,” his government looks faltering and feeble. It has lost too many good people, and those that remain lack conviction when it comes to concepts like innovation and economic growth.
The lack of dynamism has led to fumbles like the appointment of a special adviser on Islamophobia, who it turned out — spoiler alert — wasn't fond of Quebec's discriminatory bill banning public servants from wearing religious symbols like head scarves.
The Liberals' decision Friday to withdraw amendments from the gun control bill that established a legal definition of assault-style guns, and a list of more than 3,000 guns that would be banned, is just another example of the flailing and flopping that has been characteristic of late.
The Liberals are not dead yet. But to stay alive, they will need to stop making unforced errors; point out to voters the inevitable consequences of a protest vote; and focus on delivering on things they said they were going to do. A national pharmacare plan will not be one of those things.