Politics·Analysis

Impeccable timing turns the fall election into a referendum on pharmacare

Eric Hoskins says the time is right for Canada to create a universal pharmacare system. The timing of his report calling on the federal government to finally do that might not be so bad, either.

The Liberals knew when Eric Hoskins' report would land - and could guess at what it was likely to say

Dr. Eric Hoskins, chair of the Advisory Council on the Implementation of National Pharmacare, arrives at a press conference at the National Press Theatre in Ottawa on Wednesday, June 12, 2019. (Sean Kilpatrick/Canadian Press)

Eric Hoskins says the time is right for Canada to create a universal pharmacare system.

The timing of his report calling on the federal government to finally do that might not be so bad, either.

"We know (pharmacare) is going to be part of the fall election campaign," the former Ontario health minister said in an interview Wednesday on the podcast edition of The House.

"So for me, there is no better time to have this discussion than with all Canadians in the context of politicians asking for their support. This is such a profound and important part of our conversation that it deserves that attention."

The Liberals appointed Hoskins last year to lead an advisory council tasked with coming up with a plan to implement a national pharmacare system, knowing his report would land now.

What they didn't know (but probably guessed) is that the report would come back as it did — with a recommendation to establish a universal, single-payer public system that would mirror medicare.

Canada's costly drugs

Canada is the only country with a universal health care system that doesn't also cover prescription drugs. Hoskins said that's one of the reasons Canadians pay the third-highest per capita drug costs among developed countries, trailing only the United States and Switzerland. It's also one of the reasons, he said, that one Canadian in five doesn't take their medicine as prescribed.

Moving to a national pharmacare plan would not be cheap. The report estimates the annual price tag for a pharmacare program, which it says could be fully implemented by 2027, would be $15 billion.

Conservative leader Andrew Scheer says he does not trust the Liberals to implement a new universal pharmacare plan proposed by a government advisory council. 0:45

Conservative Leader Andrew Scheer picked up on that number.

"I don't believe anybody thinks that when Liberals announce multi-billion dollar spending programs, that they're going to save money," he told reporters. "The fact of the matter is, they've been making this promise since 1997 and in the dying days of a scandal-plagued government, they're trying to bring this forward."

What Scheer didn't mention is what a pharmacare program would save individual taxpayers. Hoskins estimates the annual saving for the average family would be around $350, and $750 annually per employee for corporations that offer drug plans to their staff. He said another $5 billion could be saved through a reduction in hospital admissions and visits to emergency wards due to people taking the medication they need when they need it.

NDP got there first

The NDP pegged the savings to families at $550 when the party announced its own universal, single-payer pharmacare plan as a major plank in its 2019 platform.

NDP Leader Jagmeet Singh was quick to point out that the Liberals haven't come close to committing to the NDP vision of pharmacare, or to the one set out in Hoskins' report.

"This isn't the Liberals' plan," he told reporters. "The report supports our plan. Our plan is out there."

NDP Leader Jagmeet Singh welcomes the report by Dr. Hoskins but says that the PM has yet to say that he supports the call for universal pharmacare. 1:30

The Liberals' plan, meanwhile, remains a work in progress. Finance Minister Bill Morneau promised in his spring budget to create a national drug agency that would develop a list of medicines to be covered, and then work with the provinces to help drive down costs through bulk purchases.

But he was (as politicians like to say) 'perfectly clear' that the best approach to pharmacare might not be pharmacare as such, but rather some plan to fill in the gaps in existing coverage — for the self-employed, for example, who don't have insurance, or for small companies that can't afford to provide drug plans to their employees.

On Wednesday, the Liberals said they were committed to introducing a national pharmacare plan — although they didn't quite commit to the specifics in Hoskins' report. Prime Minister Justin Trudeau said he accepted the report, calling it a "foundation" for a national pharmacare program.

His health minister, Ginette Petitpas-Taylor, said she hadn't read the report when she tabled it in the Commons. She promised to carefully review the recommendations and work with the provinces and others in the health care field to consider next steps.

Realistically, those next steps can't happen until after the election. The current prime minister, or the next one, would have to meet with the premiers to work out a plan.

Could the premiers be convinced?

Liberals insist Trudeau is well-positioned to do that, despite his recent confrontations with Conservative and conservative-minded premiers over energy policy and the federal carbon price.

Still, health-care costs are the single largest budget item for every province. Hammering out a deal to reduce prescription costs might be enough of a priority for the premiers to convince them to cooperate with Trudeau — even the ones who see him as an opponent rather than a teammate.

Hoskins insisted that further delay is not an option. There's been plenty of that already; he pointed out that every report done on Canada's health care system in the last half-century recommended a national pharmacare plan.

The current arrangement, Hoskins said, is putting too many Canadians in a terrible bind. The cancer patients who need specialized drugs that are covered in every province but the one they live in. The families forced to move to a new province to ensure that a drug their child needs to stay alive is covered.

Drug costs are continuing to rise. An election is coming.

Eric Hoskins thinks the time is right. The timing of his report might even be better.


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About the Author

Chris Hall

National Affairs Editor

Chris Hall is the CBC's National Affairs Editor and host of The House on CBC Radio, based in the Parliamentary Bureau in Ottawa. He began his reporting career with the Ottawa Citizen, before moving to CBC Radio in 1992, where he worked as a national radio reporter in Toronto, Halifax and St. John's. He returned to Ottawa and the Hill in 1998.

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