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Reality Check

Pharmacare: the dog that didn�t bark By Robert Sheppard, CBC.ca Reality Check Team | Dec. 30, 2005 | More Reality Check

In what has been a Santa Claus campaign stuffed with almost daily promises of tax cuts and electoral goodies, it feels a bit Grinch-like to parse the partisan pledges and make a list of what�s been left out. But a quick look at the last election � it was just 18 months ago, remember � suggests that while much has been accomplished during this last, raucous, minority Parliament, there are still some unfulfilled ideas that are just, well, no longer talked about much. The big unspoken one is for some kind of national drug plan.


For the Liberals, the electoral checklist includes:

  • A new 10-year medicare deal with the provinces.
  • Massive new investments in cities and aboriginal communities.
  • Continued debt reduction and now $30-billion in tax cuts over the next five years.

What Paul Martin doesn�t expound on much these days are his once high-profile pledges:

  • To tackle the country�s so-called democratic deficit, through electoral and institutional reform.
  • To increase, pro-Bono, Canada�s foreign aid budget, to .7 per cent of GDP by 2015 (Martin says it�s the timetable he can�t commit to).
  • And to create cozier relations with the U.S.
Off the table

For the Conservatives, the list of what�s off the table is a little more prosaic.

  • Tanks and fighter jets are the big items. Promised in 2004, they aren�t in the party platform this election. The new list calls for three new armed icebreakers, heavy-lift aircraft, a reconstituted airborne battalion and a couple of Arctic ports which, most analysts say, should more than take up the $5.3 billion in additional defence spending the Tories are committed to over the next five years.
  • Also going unpromised is the 2004 pledge to change Canadian patent laws to allow for the sale of generic anti-viral drugs in Africa, an idea that has become bogged down in the politics of international trade.
  • Another to fall by the wayside is the idea to allow investors to shelter $5,000 a year in a Registered Lifetime Savings Plan. Contributions wouldn�t generate a tax reduction, but withdrawals wouldn�t be taxed, either.
The big dog

The mega-issue missing from almost every agenda this time is a national pharmacare program or even its more stripped-down version, a catastrophic drug plan, to help shield Canadians from the growing cost of prescription medications.

In the last election, all parties were promoting at least some version of such a plan. This time, only the NDP is explicitly putting a national drug plan forward. But given everything else the party is advocating � its campaign pledges exceed $67 billion over five years, Reality Check has calculated � one has to ask how realistic such a promise is.

The history

Prescription drugs are the fastest-growing component of Canada�s health-care system and provincial plans are a hodgepodge of half-measures.

The Canadian Diabetes Association, for example, just reported that nearly half its members pay between $50 and $200 a month for their medications out of their own pockets, and they are just one element of the pharmaceutically dependent. Experts have suggested a national drug plan will cost between $7 billion and $12 billion a year, based on the British model, and depending on how generous the benefits might be. At least half that cost would come from Ottawa.

A so-called catastrophic drug plan, in which Ottawa would top up provincial plans or contribute directly to individuals who spend more than, say, $1,500 a year of their own money on medication, would cost less. This is what the Conservatives promised in 2004.

The reality check

Given that the major parties have already put forward huge tax cuts and spending plans � $80 billion for the Conservatives, $67.5 billion for the NDP and $56.5 billion for the Liberals (all over five years) � one has to wonder how this next Parliament will come up with new money for pharmacare.

When he met with the premiers following the last election, a drug plan was high on Paul Martin�s wish list. But in the end, because many provinces were wary of taking on new spending commitments, it was put off for another day.

A task force of federal and provincial ministers is currently studying the idea and is to report in June on some kind of formal proposal. That means pharmacare will be back on the national agenda shortly. So perhaps now is the time to ask the mainstream parties whether a national program is still on their radar and just how do they intend to pay for it, amidst all their other commitments.

With the many election promises outstripping projected federal surpluses over the next five years, that how-do-we-afford-it question may be a good one to ask in any event.

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