Justin Trudeau is campaigning on a national pharmacare plan, but it’s important to note that the Liberal leader did not say this plan would be universal. In fact, the report by the Advisory Council Trudeau appointed clearly states that “fill the gaps” alternatives to universal pharmacare would do little to lower drug prices or create more equitable access to prescription medications.
Those in favour of a universal option have public opinion on our side. A 2019 Environics poll found 88% of respondents agree that universal pharmacare is better than targeted programs that supply piecemeal financial assistance and other benefits.
Given that targeted programs are deemed insufficient by an overwhelming number of Canadians, how realistic is the main alternative: a universal pharmacare program?
Discussions relating to the implementation of a universal pharmacare plan are often focused on how to pay for it. What many of these arguments are missing, however, is a reasonable and practical solution. It is certainly worthwhile, then, to consider the cost of the current prescription medication system and compare it to a universal pharmacare plan.
Canada is the only member country of the Organization of Economic Cooperation and Development (OECD) that has universal healthcare which excludes prescription drug coverage. As a result, prescription medications are covered by a mix of private and public payments. In Canada, drug costs are the fastest-growing health expenditure, recently even surpassing physician costs.
Considering the renegotiated NAFTA extends patent protections for biologic drugs from 8 to 10 years, this problem is only expected to worsen. A universal pharmacare plan, on the other hand, would save money and yield more benefits.
In 2015, Canadians spent $28.5 billion on prescription drugs. Of this, $24.6 billion would likely be covered under a universal pharmacare plan. The Parliamentary Budget Officer, a provider of independent, non-partisan economic analysis, found that a universal program would cost $20.4 billion, meaning $4.2 billion in savings for Canadians. This answers the question: “How can we get more medication for less money?” The answer is collective bargaining and generic drugs.
To argue that the Canadian government cannot afford such a program is simply wrong. If the money Canadians spent on medication was given to the government instead of directly to drug companies, we would save $4.2 billion per year. The costs of inaction, too, are much greater.
It is also important to remember that a universal pharmacare plan would be funded by a progressive taxation system: those that have more, pay more. This would allow us to shift a greater burden of medication costs onto the wealthy rather than the sick and vulnerable, just as we do with medicare.
Along with saving Canadians billions of dollars each year, a universal pharmacare plan would also help to ensure that everyone receives the medication they need. So why has such a plan not been implemented? For one, it puts $8,000 per minute of industry profits at risk. To be frank, this issue is about whether political parties are willing to take on the greed of the pharmaceutical and private health insurance industries.
With the federal election approaching, it is important to think strategically about how a universal pharmacare plan could be achieved. A Liberal minority government propped up by the NDP is our best chance at achieving this. This will ensure all Canadians receive the medications they need, while saving the average family of four more than $500 per year.
Drug coverage should have been included in medicare when it was founded more than half a century ago. Yet, with the two main political parties more interested in industry profits than lowering drug costs, we must empower an alternative that will put the interests of everyday Canadians first.
Brandon Doucet is a practicing dentist currently based in Newfoundland.