Canada Needs the Full-dose of Pharmacare

Every day, someone in Canada dies because they can’t afford medication. A 2018 report commissioned by the Canadian Federation of Nurses Unions (CFNU) found hundreds of people in Canada die prematurely every year because they lack sufficient prescription drug coverage. It is a sobering fact, and it demands action.

It has been more than four years since the federal government’s Advisory Council on the Implementation of National Pharmacare released its final report recommending Canada adopt a universal, public pharmacare program. They recommended a single-payer model with provincial and federal governments as the sole payer and no private companies involved.

The program would cover prescribed pharmaceuticals in a similar way to how hospitals and physicians’ services are covered under the Canada Health Act. People could simply show their health card and prescription at the pharmacy counter and public insurance would foot the bill. This method would ensure pharmaceuticals are accessible for everyone based on need, not ability to pay.

“Among the lessons the COVID-19 pandemic taught us, is that prescription medication coverage should not hinge on employment status,” says BCNU President Adriane Gear. “So many Canadians lost their jobs and saw their drug coverage disappear overnight, meaning they could no longer afford their necessary medications. That’s one reason why an overwhelming majority of people in this country support a comprehensive public pharmacare program.”

A 2015 Angus Reid survey showed that one in four households in Canada can’t afford their prescriptions. The result is a much higher chance their health issues remain or worsen, and they end up in acute care or, in the worst cases, they die.

The advisory council’s single-payer recommendation was a major blow to corporate interests in the pharmaceutical and health insurance industries. These corporations continue to lobby for a multi-payer model that would preserve their ability to make profits off revenues that would otherwise go toward improving the health of Canadians.

It raises an important question that can be asked on so many public policy issues today; what is the government’s priority, people or profits?

 

The profit motive versus the public interest

The pharmaceutical and health insurance industries are pushing for a program that would preserve the status quo for those who already have extended health coverage and cover only those currently without it. Those Canadians with existing medical coverage receive it from more than 100,000 private and over 100 public drug plans. This patchwork approach still requires people to pay out-of-pocket for medically necessary medications, which means many Canadians don’t take the drugs they are prescribed or take a lower dose because they struggle to afford it.

A 2015 Angus Reid survey showed that one in four households in Canada can’t afford their prescriptions. The result is a much higher chance their health issues remain or worsen, and they end up in acute care or, in the worst cases, they die.

“Nurses see firsthand the struggles of sick patients who end up in the hospital because they can’t afford to fill their prescriptions,” added Gear. “Not only is it bad for the health of our patients, but it also puts extra pressure on our health care system at a time when we’re already stretched thin.”

A single-payer program would replace the current patchwork insurance model but would have a negative impact on the private sector. The insurance industry would lose much of its role and the profits earned from selling drug coverage to employers and individuals. The pharmaceutical industry currently sells its drugs in Canada at some of the highest prices in the world – it’s an industry worth more than $30 billion per year. So, while the health of Canadians will certainly benefit, these corporations stand to lose significant profits.

“Let us be clear; every dollar that goes to corporate profit is a dollar not spent on the health of Canadians.”

- BCNU President Adriane Gear

A single-payer system would allow Canada to bulk buy drugs as a single purchaser and bargain for much lower prices. Many other countries, such as Norway and New Zealand, have done this for years. According to the Canadian Centre for Policy Alternatives, it could collectively save Canadians over $11 billion per year—another major loss to corporate interests resulting in; massive savings for everyday people.

 

New legislation imminent

The NDP staked out ground well in advance of the government by introducing a private member’s bill in February 2020 for a single-payer model. The CFNU called the bill historic in a letter endorsing it, though it was voted down one year later with the votes splitting largely along party lines.

In 2022, the federal Liberal government signed the Delivering for Canadians Now agreement with the NDP. The first priority of the agreement is a better healthcare system, which includes a commitment to pass a Canada Pharmacare Act by the end of 2023. The deal had no details of the pharmacare plan, leaving it open to negotiation.

Gear is hopeful the outcome of negotiations includes a single-payer model, as it is of the utmost importance.

“It’s a matter of political will whether the federal government gives us the full dose of pharmacare we need to address high drug costs and bring Canadians full and fair coverage, or if they will cave to corporate pressure with a half measure.”

“Nurses see firsthand the struggles of sick patients who end up in the hospital because they can’t afford to fill their prescriptions. Not only is it bad for the health of our patients, but it also puts extra pressure on our health care system at a time when we’re already stretched thin.”

- BCNU President Adriane Gear

The government is now on the verge of introducing its own bill, though it has already hit one bump in the road. A first draft of the bill, which was not released to the public, was rejected by the NDP on grounds that it failed to meet the criteria of being a single-payer model. The party has said it will withdraw from its deal with the Liberals if that shortcoming remains when the legislation is introduced in Parliament. They also vowed to make it a focus of their next federal election campaign should the government plan fall short.

Full-dose pharmacare needed

Canadian nurses’ unions, through the CFNU, have been advocating for a public, universal pharmacare plan for more than two decades. But the government’s imminent legislation doesn’t have them declaring victory yet with the details of the plan still up in the air.

“The interests of Canadians and the interests of big business are at odds,” says Gear. “We need a pharmacare system that chooses people’s health over the big money interests that have been lobbying hard for a weaker plan to protect their profits. Let us be clear; every dollar that goes to corporate profit is a dollar not spent on the health of Canadians.”

It is a hard pill to swallow that so many people die prematurely because they can only afford half doses or less of their medication. According to CFNU, Canada is the only country in the world with a universal health care system that does not include universal coverage for prescribed medicine.

The government must follow the advice of its own advisors and lean into the idea of universal coverage for prescribed medications instead of putting the wellbeing of corporate interests first.

Nurses know that half doses of medications are a risk to people’s health, and so is a half dose approach to pharmacare. The full dose—a universal, comprehensive and public program—is what Canada needs to save money and, more importantly, to save lives.

UPDATE (Summer/Fall 2023)

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