Time to Deliver on Tommy Douglas’ Vision for Pharmacare

At the end of last week, Canadians received news that a deal had been reached between the government and New Democrats that would finally establish a framework for a Canadian pharmacare system. This is an historic step toward a universal, public pharmacare program that will deliver concrete measures to help Canadians who are struggling with the costs of prescription medication. Continuing progress towards a universal national pharmacare program was one of the foundations of the Supply and Confidence Agreement between both parties. As the only nation that has a universal health care system without a universal pharmacare program, this is a huge deal.

This legislation is something that will have a real, measurable impact on people across the country. It establishes a plan for a universal, single-payer, public pharmacare model that has been called for in the Advisory Council on the Implementation of National Pharmacare, chaired by Dr. Eric Hoskins. The plan will establish the framework and allow the Federal government to negotiate the finer details of a pharmacare plan with the provinces and territories moving forward.

So what does that framework look like? It includes a commitment from the government to follow the recommendations of the Hoskins Report, ensures that they are required to consider the Canada Health principles in their negotiations with the provinces and territories, and establishes an implementation council tasked with clarifying the details on the operations of the program. In essence, it sets up everything we need to work out the finer details on a pharmacare plan with our provincial and territorial counterparts.

The Hoskins’ Report demonstrated that approximately one-fifth of Canadians are falling through the cracks, and have either inadequate drug coverage, or worse, no coverage at all. When the report was published in 2019, one-fifth of Canadians had not taken medication they were prescribed because of the cost. Three million Canadians had stated they couldn’t afford one or more of their prescriptions, and of those, 38 percent had private insurance coverage, and 21 per cent had public coverage, but through copayments and lack of coverage, couldn’t afford the entirety of their prescriptions. Nobody should do without the prescribed medication they need because they either lack coverage, or their insurance is inadequate.

While the legislation is important to establish how we achieve a single payer, public pharmacare system, people are expecting results now. This is why New Democrats followed the advice in the Hoskins Report and pushed to deliver single-payer prescriptions for contraceptives and diabetes medications as a first step towards universal, single-payer pharmacare.

For contraceptives, the coverage will include prescription birth control, IUDs, hormonal implants, contraceptive injections and emergency contraceptives. Most diabetes medications will be covered by this plan, including insulin, Metformin and inhibitors. Additionally, there will be a fund that will allow the Federal government to negotiate with the provinces and territories to cover the costs of diabetes supplies such as glucose monitors, test strips, and pumps. These measures will help millions of Canadians in the shorter term while we continue to push for universal, single-payer pharmacare.

While there will no doubt be people who bemoan the costs of a universal pharmacare program, studies have shown it can actually reduce our overall health care expenditures. JAMA (The Journal of the American Medical Association) Health Forum recently published an article tracking health spending of 747 Ontario patients who reported the high cost of drugs left them leaving prescriptions unfilled or stretched out. JAMA covered the drug costs of roughly half of those patients for three years. For those whose drugs were covered, they actually saved the health care system an average of $1,488 per patient per year, mostly through reduced hospital and emergency room visits.

Tommy Douglas once stated, “I came to believe that health services ought not to have a price tag on them, and that people should be able to get whatever health services they required irrespective of their individual capacity to pay." We are now one step closer to realizing his vision.