Drugs: “Medicare’s unfinished chapter”

Picture of prescription drugs.

Momentum is building for universal coverage for prescription drugs. (www.canstockphoto.com)

Prepare for a wave of misinformation about the costs of providing universal pharmaceutical coverage in Canada, especially now that momentum appears to be building towards the idea.

The most recent endorsement comes in the form of an editorial in the Globe and Mail Sunday which strongly supports universal access. “It makes no sense to divorce pharmaceutical treatment from the principal of universality,” the Globe states. “More and more health care is pharmaceutical care and Canada is the only developed country with universal health insurance that doesn’t provide full coverage for medications.”

The Toronto Star made its own endorsement in an editorial November 28, calling pharmacare “medicare’s unfinished chapter.”

An endorsement by the Globe is likely a stand-in for approval from Bay Street – not entirely a surprise given the obvious advantages to employers. Drugs are the largest benefit cost they face and the premiums have been escalating faster than inflation. The overall savings of a universal public plan – estimated to be as much as $10.7 billion annually – would easily offset any tax adjustments (if any) necessary to cover such a plan. Those savings represent about five per cent of all health spending – both public and private.

The Globe is endorsing the idea of universality, but has so far reserved comment on a publicly administered system suggesting more study is needed.

However, sizeable benefits would only accrue under a strong single-payer public system where government has purchasing leverage over the pharmaceutical industry. New Brunswick and Quebec already have universal plans by making pharmaceutical insurance coverage mandatory, much like car insurance is for drivers. What it doesn’t do is realize any bulk purchasing efficiencies or omit the high administrative costs behind private insurance. A C.D. Howe study estimated legal, technical administrative savings of $1 billion alone through a single-payer system.

At a recent ad hoc meeting among interested groups in Toronto it was great to see other labour groups present. This should be a priority for labour. The savings possible with a universal system will make it possible for workers to bargain other priorities – whether that’s enhanced health coverage or wage gains. For health care professionals and support staff struggling with workload issues, this will have a significant impact on the number of patients showing up at ER for reasons of non-compliance with their prescriptions — estimated to be as high as one in ten. For the labour movement as a whole, this is also an issue of social justice at a time when employment is becoming increasingly precarious and part-time. A drug benefit plan is no longer a guarantee with a union card.

In the coming months we’re bound to see a sly counter-attack by the insurance industry.

They will likely stoke fears of tax hikes and paint government as inept at managing such a plan — ignoring the fact that provinces successfully manage their own public health plans (such as OHIP) at much lower administrative costs. They will likely pitch the idea of catastrophic coverage or recommend expansion of public coverage to a few more individuals they deem to be disadvantaged to distract us from the bigger picture. They may commission studies by Canada’s right-wing press mills such as the Fraser Institute to scare us. They will do everything they can to derail this momentum, especially with a federal election shortly over the horizon.

This has been a long train coming. It began in 1964 with a recommendation to include drug coverage by the Hall Commission. It could finally come into the station a little over 50 years later depending on what happens in that coming election.

We should no longer be asking if we can afford universal drug coverage. We should be instead asking if can we afford not to have it?

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