Two rival parties get their act together

Liberals and NDP poliricians both agree on the need for pharmacare

The biggest scandal of Canadian medicare is the absence of pharmacare, a half-century after universal health care came into our lives.

Not just because saving lives is worth the money, but because a universal prescription plan saves so much money.

Now, Ontario is finally taking the first step by covering young people up until age 25. Yes, it still leaves a gaping hole for everyone else, who must depend on workplace benefits until 65 (the age of eligibility for a seniors’ drug program).

It’s a start. Yet instead of celebration, recrimination is on the rise.

New Democrats believe the Liberal government stole their pharmacare idea, announced by party leader Andrea Horwath mere days before the spring budget. Liberals counter that someone might have leaked their budget plan, allowing the NDP to pre-empt them.

Never mind the partisan skirmish. While it seems unseemly for politicians to clamour for credit (it’s in their DNA), isn’t competition for good ideas a good thing — especially if we all benefit, as we are bound to, from pharmacare?

Horwath was first out of the gate this spring, announcing a plan to cover 125 of the most commonly prescribed drugs. Sources say she had first raised the idea in late 2014 with her chief of staff Michael Balagus, and his deputy, Dan O’Brien, putting it at the top of her priorities list.

“Hey could you start looking into how a provincial pharmacare program would look? It’s something that both Andrea and Balagus would like to wrap our heads around,” O’Brien emailed a party researcher back then.

That request culminated with Horwath unveiling a detailed proposal at an April 24 news conference with UBC health economist Steve Morgan, who strongly endorsed it.

Three days later, the Liberals revealed their own closely held secret in the spring budget: a new pharmacare program, dubbed OHIP+, which also won plaudits.

So did the Liberals cut and paste a back-of-the-envelope version of the NDP plan into their budget at the last minute, as some have suggested? In fact, the two plans attack the same problem from different directions.

Instead of making only the top 125 drugs free for all, OHIP+ will make all 4,400 drugs in the provincial formulary available to everyone under 25. The Liberal plan avoids limitations on the formulary, and the risk of distortions from substitutions. It also minimizes the political peril for any government of leaving people uncovered for drugs dealing with cancer or rare diseases further down the list of eligible medicines.

Despite the speculation and accusations, the Liberal plan clearly didn’t materialize out of thin air — or emanate from an NDP convention 72 hours earlier. Health Minister Eric Hoskins, who is also a physician, had campaigned publicly for a national pharmacare program ever since taking over the portfolio in 2014, giving speeches, writing articles and lobbying his federal-provincial counterparts at a pharmacare roundtable in Toronto.

With the budget balanced for the first time in a decade, sources say the government wanted to pivot from austerity to opportunity. In late February, Hoskins made an unscheduled visit to Kathleen Wynne’s office — the premier had just started holding open office hours after Liberal caucus meetings — to plead his case.

“He asked for some time,” Wynne recalled in an interview last week. “It was something that had been floating around, but he and I had not had a conversation about it. And that was very compelling to me.”

The $465-million expense was baked into the health budget by March. When the NDP announced their own proposal in late April ($475 million), Hoskins had to hold his tongue until budget day.

Some in the finance ministry suspected a leak, possibly from one of the outside experts consulted by the government. What neither side seemed to know — or give the other side credit for — was that both Liberals and New Democrats had come to realize that pharmacare could no longer be put off.

Medicare without medicine is not truly universal, and private drug plans are a mere Band-aid in an era of precarious employment and continuing cutbacks. In a 2014 election column, I mused about the issues all parties “forgot — or more precisely, are too scared to touch: A pharmacare program to ensure everyone gets the medicine they need, not just those who have workplace drug plans or welfare.”

With the 2018 election looming, time is passing. Neither party’s plan is perfect, let alone comprehensive.

But at least they both have plans. Unlike the Progressive Conservatives, whose only promise so far is not to repeal the Liberal plan — yet that too is progress.

Pharmacare provides life-saving medicines, permits money-saving bulk purchases and avoids costly duplication by competing insurers. But that was never reason enough to act.

Only now, after 50 years of unconscionable delay, are rival politicians rushing to get pharmacare out the door — in time for the next election. Still, that’s no reason to be churlish, nor cynical.

Purity of motive is rarely a prescription for action. Politics is the ultimate tonic.