"This is our generation's national project: better access to the medicines we need, improved health outcomes and a fairer and more sustainable prescription medicine system. Let's complete the unfinished business of universal health care. That can be our promise and our legacy to each other and to all future generations."
— Dr. Eric Hoskins, chair of the Advisory Council on the Implementation of National Pharmacare.
I will never forget that time, years ago, when I went to the pharmacist’s counter to pick up my prescription, worrying about the cost during rent week.
The pharmacist handed over my prescription, offering a polite “thank you.”
On the bag, I looked at the receipt with astonishment: $0.00.
I didn’t have to pay a cent, thanks to my new job with benefits!!!
As I exited the Shoppers Drug Mart I resisted the temptation to look over my shoulder to see if security was tailing me for shoplifting.
I’ve had jobs that offer full benefits and I’ve had jobs that offer no benefits. Full benefits coverage is a game changer. It offers piece of mind. It’s liberating. Especially on rent week.
Too many Canadians aren’t so lucky. That’s why I’m cheering a new report by the Advisory Council on the Implementation of National Pharmacare.
The need is definitely there: 1 in 5 Canadians struggle to pay for their prescription medicine.
Canada has been kicking the tires on a national universal pharmacare plan for a long time. The report does us a favour by outlining some of the history.
1929: Progressive organizations start promoting the idea of universal public health care.
1947: Saskatchewan implements universal public hospital insurance, including coverage for drugs administered in hospital.
1957: The federal government passes the Hospital Insurance and Diagnostic Services Act, offering to share provincial and territorial costs, with conditions attached. Within four years, free access to hospital services is a reality everywhere in Canada.
1962: Saskatchewan expands public coverage to include physician services (ie, universal health care).
1964: The Royal Commission on Health Services recommends the federal and provincial governments split the bill 50-50 for a public drug benefit, making it available to all Canadians for a buck a prescription.
1966: The federal government introduces the Medical Care Act, offering to share provincial and territorial costs for physician services. By 1972, every province offers public coverage for physician services.
Are you starting to see the powerful role that federal leadership can have in taking one province’s initiative and making it go viral?
1984: The federal government implements the Canada Health Act enshrining 5 principles into law: health care should be publicly administered, accessible to all, comprehensive, universal, and portable.
That should have translated into a national universal pharmacare plan, but it hasn’t — yet.
Provinces and territories have filled some of the gaps by offering their own public drug plans, but Quebec is the only jurisdiction in Canada with universal drug coverage. It made drug coverage mandatory for all residents, requiring employers to provide prescription drug benefits that meets or exceeds the level of coverage in the provincial public plan.
2002: The Commission on the Future of Health Care in Canada recommends that governments work together to cover prescription drugs under the Canada Health Act.
2002: The Standing Senate Committee on Social Affairs, Science and Technology issues a report recommending catastrophic drug coverage, with the federal government footing 90% of the bill.
2019: The Advisory Council on the Implementation of National Pharmacare recommends that the federal government work with provincial and territorial governments to establish a universal single-payer, public system of prescription drug coverage in Canada.
(One more time for the people in the back row).
Australia does it. New Zealand does it. The UK does it. Why not Canada?
The advisory council recommends that Canadians pay no more than $5 per prescription for all drugs listed on the national formulary, with a $2 co-payment for essential medicines, and an annual maximum co-payment of $100 a household.
It also recommends a co-payment exemption for people receiving social assistance, government disability benefits, or the Guaranteed Income Supplement.
There’s lots more detail in the report, which you can read here, including the advisory council’s estimate that Canada would save $5 billion a year on drug costs by implementing its recommendations.