Too soon to cheer pharmacare plan
The New Democrats say they’ve brought pharmacare to Canada. They brag that they have forced the governing Liberals to come around to their way of thinking on the issue of a national drug program. They exaggerate.
The program that the Liberals came up with last week is at best a summary of good intentions. The Liberals say their new program will ensure that those who need contraception or who are suffering from diabetes will receive necessary drugs free of charge.
Just why these two conditions are targeted is never clearly explained. Nor is it made clear how — or even if — that list will be expanded in the future.
The Liberal plan assumes that the provinces, who are in charge of drug plans and who have in most cases their own pharmacare schemes, will be brought on side. But it doesn’t say how or what it would cost.
The Liberals do propose the creation of a Canadian drug agency to “work toward” the development of a national formulary of pharmaceuticals that would be covered. But it is not clear who would be in charge of this agency.
The NDP brags that it has persuaded the Liberals to create a scheme that is universal, that is open to all regardless of income.
Yet this not exactly what the Liberals say. Health Minister Mark Holland told CBC that he’s open to the idea of creating a pharmacare program that fills in the gaps, geared only to those not already covered by existing plans.
The question of universality is ultimately one of cost. So-called single-pay systems offer economies of scale that reduce costs.
Indeed, studies show that in the long run a single-pay public pharmacare scheme would, in total, cost Canadians less than they are paying now through the combination of available private and public insurance plans.
The political problem is, however, that such universal public systems — even when they save money overall — cost governments more.
In the case of pharmacare, governments could end up paying $40 billion more according to the parliamentary budget officer. These costs would be more than compensated for by savings associated with a healthier population. But they still make governments wary of adopting universal pharmacare.
The Liberal government is particularly wary. Which is why the NDP jubilation over the newest Liberal plan for pharmacare may be premature. The plan, known as Bill C64, commits the Liberals to setting up a Canadian Drug Agency that would build a national formulary for drugs to be covered and create a national “strategy” for bulk purchases.
But it leaves open the biggest question: Will the proposed pharmacare scheme be universal? Or will it limit coverage to only those who, for reasons of poverty, have no other choice?
For its own political purposes, Jagmeet Singh’s NDP needs a victory here. It needs to be able to show that its support of the Liberals in this minority Parliament has produced demonstrable results — particularly in the area of universal pharmacare. But have such results been produced? The answer to that question is no, not yet.