Pharmacare As A Canadian Political Pawn
Canada’s national, publicly-funded healthcare strategy began in earnest in 1984 1, when the bill known as the Canada Health Act was passed unanimously by Parliament.2 The legacy of government-funded hospital stays, doctors office and emergency visits, and lab tests left by Tommy Douglas, the Father of Canadian Medicare, was likely intended just to be a start.
Yet, for 34 years, Canadians have continued to wait—and wade—through a patchwork of government-paid, insurance-paid (if you’re lucky to have it), and out-of-pocket costs as they attempt to access the healthcare they need.
Pharmacare in Canada
The reality is though, national pharmacare in Canada—a system of drug coverage which currently also exists as a patchwork of over 100 provincial and federal government systems for those of us without insurance3—has been rallied around by politicians since at least the "1997 election, [where] the second Liberal Red Book committed the government, among other things, to working toward universal pharmacare."4
As someone with asthma who takes several thousand dollars worth of medication a year for things including asthma and ADHD, and doesn’t have access to private insurance, I’m fortunate to have a good portion of these costs covered by a provincial Pharmacare plan. A National program, though, would ensure more equal access for people like me and all others who need medications—be it once in awhile or every day.
This is election season
As I write this we are just over halfway through election season for Election 43. And it is Pharmacare Week. It’s kind of like Shark Week, well, minus the actual sharks. Metaphorical ones, well, I’ll leave that to your feelings on politics.
For those of you outside of Canada, consider this within your own contexts of healthcare change—it is likely that down the road, lessons will be learned of our divisive and fractured approach on this subject, even where Canada is often (incorrectly, in my opinion) held to a high standard as a “holy grail” of healthcare—as Steve Morgan & Jamie Daw opine in their August 2012 article, "If Canadian medicare is a source of national pride, then Canadian pharmacare should be a source of national embarrassment.”5
While the party leaders and politicians are doing what they can to sway the vote of Canadians, specifically those who are in current need of drug coverage, I’ve found myself in a few situations this week trying to share the real implications of the lack of national Canadian pharmacare with voters: that we spend more money, and people still don’t have what they need.
Engaging in activism
I participated in an interview with Global National earlier this week around pharmacare. In essence, I shared my experiences but those experiences prove why this incomplete system of pharmacare in Canada isn’t enough (You can see it here if you are so inclined, but they didn’t even use anything substantive or smart-sounding from me!).
Over the past week and a half, I’ve knocked on just shy of 150 doors in 5 evenings for my Member of Parliament and current New Democratic candidate. I also went to a debate where I asked the two candidates who showed up—the guy I’m door-knocking for, and the Liberal candidate (yes, that Liberal Party as above who’ve been promising us pharmacare for over 2 decades), what they plan to do to advocate to get us there.
This is election season. And I don’t want to see pharmacare yet get bandied around as a promise, never to be heard about again until 2023.
A primer on the Canadian political environment
In Canada, we might summarize the major parties into major-major parties and minor-major parties, and minor parties. Here’s an oversimplified primer: federal leadership has been won either by the Liberals (center to center-left) or the Conservatives (center-right to right - sometimes under a different moniker) every year since confederation in 1867, most years with the other as the Official Opposition.
The New Democratic Party (center-left to left) earned official opposition status to the Conservative Harper government from May 2011 to November 2015. Other players include the Bloc Quebecois (center-left; Quebec sovereignty focus with presence only in Quebec); the Green Party of Canada (environmentalism), and the People’s Party of Canada (the newest party, right-wing).
Where the parties stand on pharmacare in Canada
Now more than ever with drug prices steadily rising, pharmacare is an issue if immense discussion during the 2019 election.
I’ve compiled a basic stance of each party from three sources' overviews: CBC, BNN Bloomberg, and the Vancouver Sun.
Liberal Party of Canada
- Intend to take, in their words, “critical next steps” on pharmacare, with as of October 4, 2019, little in the way of substantive details6,8,9
- Coordination of prescription drug purchases (bulk purchasing)7
- Make high-cost drugs for rare diseases more affordable7
- “Discussions on national pharmacare” “kickstarted” by negotiations with the provinces, investing $6 billion in improvements to various healthcare services7
Conservative Party of Canada
- Have “dismissed pharmacare” as a whole, would “[focus] on those not covered provincially or at work”6; have “not pledged to introduce universal pharmacare”8
- Proposes “gap-filling” measures9
- “Could improve bulk-purchasing on drugs”9
New Democratic Party
- Proposed a “pharmacare for all” plan, covering all drugs approved by Health Canada. (The cost of which is less than gap-filling measures proposed by the Liberals)6
- Platform includes $10 billion a year on a comprehensive national pharmacare program by 2020.7,8
Green Party of Canada
- Expansion of universal pharmacare in Canada6
- Enact pharmacare for all by 20207
- Reduce drug patent protection periods (relevant, as these protections make drugs more expensive and prevent production of more affordable generics)8
- Reduce price of brand-name drugs “by removing the United States as a reference for determining the price of all drugs”7
- As a Quebec focused party, Global News notes that in Quebec, citizens are “already [offered] prescription drug insurance [from the province] for people who don’t have a private plan and some other individuals”9
Peoples Party of Canada
- No pharmacare proposal; will make provinces and territories 100% responsible for healthcare programs, including pharmacare and other services, and would provide tax incentives to “[allow] provinces to raise their own money”6 and a “stable source of revenue” from these tax points7
- Increased privatization6
It’s time for Canadians to make an informed decision and speak with their votes
We are currently treating pharmaceuticals like they aren’t necessary. This is leading to greater healthcare costs when people cannot afford to take the medications they need, and because of our patchwork of “plans” and payers, drugs cost more than they need to, leading to Canadians paying the second-highest pharmaceutical prices in the world.
Pharmacare in Canada is popular among voters, with 93% in support per recent polling.10 This needs to be the final federal election where national pharmacare is used against Canadians as a political pawn.
Have asthma inhalers affected your dental health?