Let’s finish the job and implement Pharmacare

Medicare is a good idea but incomplete without Pharmacare. Let’s finish what we started in the 1960s. The plan was always to finish our health care system but realization of that dream got lost in perennial federal-provincial squabbling.

image: Green Party

Canada is an anomaly among nations. We are the only industrialized country with a universal public health care system but no Pharmacare.

Every study of Canada’s health care has identified the lack of Pharmacare as a major gap in our system.

Medicare without drug coverage doesn’t even make sense. What good is a health care system that prescribes drugs but doesn’t cover them?

What we now have is a mess. Drug coverage in Canada consists of a patchwork of 100 public and 100,000 private insurance plans. Some working Canadians are covered by employer-funded private plans. Seniors and those on social assistance are covered by publicly-funded provincial plans. Indigenous people, military members, federal inmates are covered by federal plans. Low-income Canadians struggle. In B.C. they have to pay up to the deductible amount.

Studies show that some low-income Canadians go without prescribed drugs because they have to buy groceries and heat their houses first. Women typically suffer more than men. Nearly two million Canadians reported not being able to afford one or more drugs in the past year. Unfilled prescriptions result in an additional burden on our health care system –patients end up going back to their doctor or to the hospital.

What we have is a mess and it’s ridiculous. When I go to the hospital, prescribed drugs are covered by Medicare and dispensed from the hospital pharmacy. When I walk out the door of the hospital, I’m on some other plan if I’m lucky, no other plan if I’m not.

The model of Medicare provides a good template for Pharmacare. While Medicare is universal in that it covers everyone, it is not universal in that it covers everything. This is especially true for Pharmacare as technology offers ever more expensive remedies. Pharmaceutical companies are coming up with new, expensive, drugs. Some are only marginally better, some no better than generic drugs. Pharmacare should not cover every conceivable pharmaceutical.

Drug spending in Canada has grown significantly over the past few decades, from $2.6 billion in 1985 to $33.8 billion in 2017, and the share of GDP spent on drugs has more than tripled from 0.5% to 1.6% over this period.

Pharmacare will reduce the amount we pay for drugs. Canadians pay among the highest prices and spend more on prescription drugs than citizens of almost every other country in the world. Among Organization for Economic Co-operation and Development (OECD) member countries, only the United States and Switzerland spend more per person each year on prescription drugs and pay higher patented drug prices than Canada.

The bickering between the federal government and the provinces over Pharmacare must stop. Now’s our chance. The federal government has opened a dialogue. What do you think? You can answer the questionnaire and make a submissions until September 28.