Colleen Fuller: Will National Pharmacare survive the upcoming elections?
After a nationwide, multi-generational struggle that began before the Second World War, Canadians are finally taking the first steps towards a National Pharmacare program. Unless something goes sideways as a result the upcoming provincial and federal elections.
On October 10, Bill C-64 received Royal Assent, becoming the first critical step towards a comprehensive, universal, publicly funded and administered National Pharmacare program that will ensure Canadians who require medicine won’t have to choose between filling a prescription and buying food. The first items to be covered are contraceptives and drugs needed to treat people with diabetes – including insulin and supplies to manage and monitor their condition and administer their medication, which can cost over $18,000 per year. The bill’s passage means those who live in provinces and territories that agree to participate in the program will get free access to medications without co-pays or deductibles.
Even before the bill was passed, BC’s health minister, Adrian Dix, became the first to sign on to the national plan. He negotiated coverage for any British Columbian who needs diabetes medications or drugs to treat menopausal symptoms (BC already covers contraceptives). This is a significant benefit for families across the province and highlights the leadership role BC has played in discussions about how people will be covered.
Considered a model for the rest of country, BC Pharmacare has helped ensure residents pay less per capita for drugs than other Canadians, less for hospitalization and doctors’ visits and to enjoy the longest life expectancy in Canada. But there’s room for improvement. Like all provincial drug plans in Canada, access to Pharmacare benefits are income tested: those with an annual income above $30,000 must pay for their own drugs until they meet the established deductible after which, Pharmacare pays between 70% and 100% of the family prescription drug bill. But by signing the agreement to participate in the national plan, the BC government has moved the province towards full and universal coverage, beginning with those who need access to prescription drugs to treat one of the most drug-intensive of all chronic conditions. They will no longer have to pay anything out of pocket.
Will Conservatives and the insurance industry kill pharmacare?
About 60% of Canadians are covered by private health insurance, a number that fluctuates wildly depending on wear one lives and works. Low-income earners and both the young and the old are the least likely to have private health benefits. There are lots of reasons public insurance plans are superior, including that they’re managed more fairly and efficiently than those in the private sector, most of which are operated by global corporations. Most importantly, public plans can’t discriminate against people based on their individual characteristics. Private insurers, on the other hand, are allowed under provincial and federal human rights law to discriminate based on age, sex, and health status in order to limit costs. And about 70% of every dollar spent by private plans is for prescription drugs.
October 19 could decide whether residents of BC who require diabetes drugs – estimated at five percent of the population – will be relieved immediately of the heavy burden associated with treatment costs. If the Conservatives form the next government, it is uncertain whether they will honour the agreement negotiated between Ottawa and the province and whether British Columbians will continue to access the best coverage for prescription medicines in the country. That’s because Conservative leader, John Rustad, has not mentioned a single word about either the provincial Pharmacare program or the agreement reached between BC and the federal government, and the Conservative Party has not responded to any of the questions posed on 6 priority solutions from the BC Health Coalition.
This matters to people with diabetes and those who require access to treatment for severe menopausal symptoms. But it also matters to every other British Columbian who is struggling to access needed prescription medicines. Canada is the only high-income country with a universal health care system that, as Professor Steve Morgan has written, “ends as soon as a patient is handed a prescription to fill.” Last year, Canadians spent almost $37 billion on prescription medicines, and over $5 billion of that came directly out of the pockets of individuals and families already struggling to pay rent, support their children or keep their heads above water. A National Pharmacare program is way, way overdue.
There are a lot of issues people are considering as they cast their ballots in this election. For many, one of those will be Pharmacare. We need BC’s next government to move us as quickly as possible towards a full, universal and public prescription drug plan.
Colleen Fuller is a Community Co-Chair for the BC Health Coalition and a Co-founder of Independent Voices for Safe & Effective Drugs