October 31st, 2024
Canada’s Major Step Towards Pharmacare, and the Challenges Ahead
Late on the evening of October 10th, Bill C-64, the pharmacare framework legislation, passed the Senate, received Royal Assent, and became law. This was a major step in advancing public health care and stands as one of the crowning achievements the NDP managed to secure this parliament. However, there’s still a significant amount of work to do to ensure Canadians can get access to timely medications through a public, single payer universal pharmacare system.
Bill C-64 was the result of the negotiations found in the Supply and Confidence Agreement between New Democrats and the Federal government. It was actually a centerpiece of that agreement, one that was a particular sticking point over the course of its lifetime between both parties. New Democrats negotiated the passing of the Canada Pharmacare Act by the end of 2023, leading to tensions as the government played fast and loose with that time frame, and only finalized its passing through the House of Commons at the start of last June. While it took six months longer than agreed to, not counting the time it took to get through the Senate, the bill’s passage marks a monumental shift towards Canadian pharmacare.
Establishing a framework for pharmacare has been a very long time coming. Former NDP Leader and father of Canadian Medicare Tommy Douglas had always envisioned a health care system that covered all health care issues from head to toe, and New Democrats have always sought to finalize his legacy. Pharmacare had also been part of the Liberal’s platform for almost 30 years, since 1997, despite being in government for more than half that period.
Politics aside, there is a good reason for passing a bill for a framework for pharmacare. According to Statistics Canada, one-fifth of Canadians reported not having any prescription insurance to cover medication costs. Some 25 percent of seniors, who are more likely to require prescription medication, had no drug coverage. One-eighth of Canadians spent more than $500 per year on drugs and 17 percent of people reported non-adherence to a prescription because of the cost when they had no drug coverage. A recent Leger poll shows 22 percent of Canadians have reported cutting pills, skipping doses, or refusing to renew prescriptions due to cost. While drug prices are significantly cheaper here than in the U.S., they are still higher in Canada than in many OECD countries. There’s also an economic case for establishing a single-payer, universal pharmacare system, as it would reduce the cost of drugs due to bulk purchasing, and it would reduce the high administration costs and eliminate the profit margins charged by insurance companies, further reducing costs by small and medium enterprises of the financial burden of providing drug coverage for employees.
Now, to be clear, C-64 is a bill to establish the framework for pharmacare. This is the first step in a broader pharmacare regime that will require the Minister of Health to negotiate how pharmacare works within the provinces and territories. The legislation also puts the Federal government in a position to strike deals that will ensure access to free contraceptives for 9 million Canadians, as well as diabetes medications to 6 million diabetics, within the public health care system. While the Minister has stated that he intended on having deals in place with provincial and territorial governments by next spring, it will require proponents of pharmacare to hold his feet to the fire.
And it’s important to strike those deals sooner rather than later, as we have come a long way in actually getting this hard work done. Dr. Eric Hoskins, who chaired the advisory panel on pharmacare, has urged swift work on negotiating these deals, citing concerns about a potential election call that could put much of the work on pharmacare at risk. He isn’t wrong to share this concern, as the Conservative leader has said he would reject single payer pharmacare if he became Prime Minister. This, despite recent polling from Environics that shows majority support for pharmacare in Canada, with some 75 percent of Canadians polled supporting pharmacare and 80 percent supporting the current plan to provide diabetes and contraceptive medications.
Pharmacare isn’t just popular, it’s the right thing to do.