By Steve Morgan
Ontario has just announced that they will offer a publicly funded pharmacare system for children and youth in Ontario. This is a small step in the right direction, one that is arguably most important for its symbolism in a national debate.
Why just a small step? Because Ontario is adding universal, comprehensive pharmacare coverage to the age group that uses medicines least often. Many working-age Ontarians, who are far more likely to require medicines than children, will still be uninsured.
Why symbolic? Ontario’s new pharmacare program signals that government is taking responsibility for this component of health care, integrating it with medical and hospital care. This is as it should be.
Several national commissions on Canada’s health care system have recommended adding prescription drugs to our publicly funded universal medicare system. No federal government has ever acted on those recommendations. Not yet, anyhow.
By creating ‘pharmacare-junior,’ Premier Wynne and Minister Hoskins are in essence calling on the federal government to help finish the job and create a pharmacare program for all Canadians of all ages.
Here are four reasons why Canada needs a universal, public pharmacare program — and what Canadians can do to make it happen now.
The most important reason for universal pharmacare in Canada is that access to essential medicines is actually a human right according to the World Health Organization (WHO). The WHO recommends that countries protect that right in law and with pharmaceutical policies that work in conjunction with their broader systems of universal health coverage. Consistent with this, every other high-income country with a universal health care system provides universal coverage of prescription drugs It is time Canada did the same.
Canada’s patchwork of private and public drug plans leaves millions of Canadians without coverage. As a result, Canadians are three to five times more likely to skip prescriptions because of cost than are residents of comparable countries with universal pharmacare programs. A 2012 study estimated that inequities in drug coverage for working-age Ontarians with diabetes were associated with 5,000 deaths between 2002 and 2008. Nationally, this human toll would be far greater.
Canadians spend 50 percent more per capita on pharmaceuticals than residents of the United Kingdom, Sweden, New Zealand and several other countries with universal pharmacare programs. This amounts to spending $12 billion more each year and still not having pharmacare. Why? Because the universal pharmacare programs in other countries use their purchasing power to obtain better drug prices than our fractured system. Among many examples of such price differences, a year’s supply of atorvastatin, a widely used cholesterol drug, costs about $143 in Canada but only $27 in the United Kingdom and Sweden, and under $15 in New Zealand.
The rising cost of pharmaceuticals are a growing burden on Canadian businesses. Part of the problem is that Canadian employers waste between $3 billion and $5 billion per year because employment-related private insurance is ill equipped to manage pharmaceutical costs effectively. Another part of the problem is that the number of prescription drugs costing more than $10,000 per year has grown almost ten-fold in the past decade. Because such costs can quickly render a work-related health plan unsustainable — particularly for small businesses — it is best to manage them at a province- or nation-wide basis.
It will not happen unless citizens speak up
Billions of dollars in savings to Canadian taxpayers, employers and households equals billions of dollars of lost revenues to pharmaceutical industry stakeholders. Those stakeholders will not likely make it easy for government to implement universal pharmacare, no matter the benefit to Canadians and the broader economy.
To make pharmacare a reality for Canada, citizens need to get informed and involved. If they support the idea of universal, public pharmacare, they need to let others, particularly elected officials and political candidates, know they care and that they will support a government that takes action. There is a parliamentary e-petition circulating right now in the hope of doing just that.
Without such a groundswell of public engagement, it is unlikely that the federal government will implement a universal pharmacare program any time soon.
Steve Morgan is an expert advisor
with EvidenceNetwork.ca and a
Professor in the UBC School of
Population and Public Health.
