Debate over universal pharmacare in Canada goes around in circles

Prescription drugs.
Prescription drugs. Stock photo from iStock/Getty Images.

Since 1964, when the Royal Commission on Health Services recommended it, there has been talk of universal pharmacare in Canada.

Over thirty years later, the National Health Forum recommended adopting a universal pharmacare plan for Canadians. Well, we didn’t get universal pharmacare.

Then the 2003 Health Care Renewal Accord recommended at least catastrophic drug coverage for all Canadians. The way catastrophic drug coverage was explained in the accord, it would cover the upper limit of what someone could pay for a drug. After the upper limit was reached, if it would be a financial hardship to pay for the drug, only then would the government cover it.

Why do we need universal pharmacare in Canada? It has to do with equity. The Canadian Institute for Health Information published a report in 2002 that found that those in the highest income group had the highest access to drug insurance versus those in the lowest income bracket, with the lowest access to drug insurance.

So, there is obviously a problem here. The poorest in Canada have the least access to drugs. While there is now a minimum catastrophic coverage in place, it doesn’t help address the need that is out there.

Until 2006 that is, when Health Canada released a progress report on the plan for a National Pharmaceutical Strategy. The task force on which the report was based was composed of the federal Minister of Health, then Tony Clement, and most of the provincial/territorial health ministers.

It, too, found that universal coverage was needed, because “First Ministers agree that no Canadians should suffer undue financial hardship in accessing needed drug therapies.”  However, this report went nowhere.

Then there was a blip on the radar once again in 2009, when the Social Affairs Division of the federal government released another report entitled Catastrophic Drug Coverage in Canada.

It noted the important fact that Canada is one of the only countries which is a member of the Organisation for Economic Co-operation and Development, which doesn’t have a national universal prescription drug coverage plan. “Instead”, the report says, “a ‘patchwork’ of public and private drug insurance plans exists.”

So, once again, there was a call for universal pharmacare in Canada, and once again it went – you guessed it – nowhere.

Now, that we’ve have a major government change in Canada, cries for a universal pharmacare plan have arisen once again.

Just one question: how is this universal pharmacare plan going to be financed?

Cut to the federal election campaign of 2015, in which NDP leader Thomas Mulcair promised a universal pharmacare plan. Mulcair raised the issue of universal pharmacare to appeal to older Canadians.

Let’s face it, Canada’s population is aging and it’s aging rapidly. Statistics Canada released population estimates for 2014 and found that:

“By the year 2016, the number of seniors aged 65 and older would be greater than the number of children under the age of 15.”

That is not all though. The population estimate also found that by the year 2063, seniors would likely account for between 24% to 28% of the population of Canada.

That would mean one quarter of the Canadian population would be seniors and in need of robust pharmacare.

Again, how would this be financed? Mulcair, on his part, pledged $2.6 billion over four years for universal pharmacare.

Here is the problem: The Economic Case for Universal Pharmacare report was released back in 2010, which stated that in 2008 Canada spent $25.1 billion on prescription medication. That is in one year alone. So the $2.6 billion pledge divided over four years falls far short of what prescription drugs actually costs Canadians. Maybe it would be more sufficient for catastrophic coverage only, but definitely not for universal pharmacare.

Let’s put this in perspective. Outgoing Prime Minster Stephen Harper slashed $36 billion for health care transfer payments to the provinces/territories, which will happen over a period of 10 years.

Once, again, where will the money be found for pharmacare if the healthcare system itself is found to be too expensive and there are continuous cuts in federal transfer payments? Especially considering an aging population which is often reliant on pharmaceuticals.

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