Q) You have mentioned more than once that Pharmacare is likely to be one of the issues discussed in this year’s federal election. Do the three main political parties differ in how they feel about Pharmacare?
A) That’s a difficult question to answer right now, but should be somewhat easier to explain come June when the Liberal’s official position should be laid out.
However, I’ll do my best to explain how the three parties feel about Pharmacare currently beginning with the NDP who just recently released a fairly defined policy statement on the subject.
To start with, the NDP is all in on Pharmacare. Prescription drug coverage for everyone appears to be an important plank in their election platform. They favour a single payer system in which the government will cover prescription drugs for all Canadian citizens regardless of income, age or province/ territory of residence. In this system, all private plans paid for by employers (such as Bruce Energy) will cease to exist and all Canadians will be covered equally on a single drug plan (for the pros and cons of this idea, along with others regarding Pharmacare, please refer to my columns released the last two weeks).
The list of drugs to be covered (called a formulary) is to be decided by an arms-length (i.e. not by the government itself which might be tempted to reward drug manufacturers who have donated to them) group of experts who will select them based on each drug’s record of safety, efficacy and its cost effectiveness. Assessing cost effectiveness essentially means looking at drugs that seem to be equally effective (for instance at lowering blood pressure) and then comparing them as to how much each costs per day. From there, theoretically, if one drug costs significantly more than its comparables, the group would decide not to pay for that medication.
The NDP has also decided it does not want a co-pay attached to receiving a prescription drug. Co-pay is the term used to describe the amount of money you would have to spend up front to get a prescription, with the government covering the rest. The NDP feels that any amount would restrict some poorer Canadians from accessing their necessary medications. The one exception to this would be a $5 surcharge applied to those who preferred the original name brand of a drug to one of its (much cheaper, sometimes even half the cost) generic versions.
In the NDP’s version, they, as the federal government, will pay 40% of the cost of this program through transfers to the provinces and the provincial governments will fund the rest. They estimate it will cost the federal government $10 billion annually (with the provincial governments kicking in an additional $13.7B) that will be funded, in part, by increasing the tax levels on investment profits (i.e. capital gains).
It is their view that their Pharmacare plan will save families that don’t have private coverage $550 per year and employers about $600 per employee. They have ambitiously set an implementation time of 2020 to get Pharmacare up and running.
In contrast to the NDP, the PC’s position on Pharmacare is far less public. At this point in time they have not released much in the way of viewpoints on this and it does not appear to be integral to their election strategy. Most seem to believe they favour sticking largely with the status quo with perhaps some targeted spending or tax breaks aimed at reducing the number of Canadians who do not have prescription drug coverage but that belief is highly speculative.
Lastly we come to the Liberals who mentioned Pharmacare in the last federal budget back in March. The Liberals are definitely in favour of having Pharmacare but seem undecided as to how it should operate. At this point in time, they are relying on advice from an expert advisory panel chaired by Eric Hoskins, the former minister of health from Ontario. Their final report is due later this spring but in the meantime the Liberals have set aside funds in this year’s budget to create the Canadian Drug Agency that would oversee the implementation of Pharmacare and decide what drugs should be covered using the same criteria as the NDP’s arms length agency.
The Liberals have not officially indicated whether they favour a single payer model or some alternative form but comments from finance minister Bill Morneau both before and after the budget may provide some light as to which way they are leaning. In February, Mr. Morneau while giving a speech indicated that Pharmacare will be fiscally responsible and designed to fill in the gaps (i.e. cover those who do not have drug plans) but does not need to provide prescription drugs for Canadians already covered by existing plans. A month later Morneau was quoted as saying he wants to fix a problem (i.e. uncovered Canadians) rather than build a whole new system. As to when they plan to implement Pharmacare no firm timeline has been established but insiders believe they are leaning towards a 2022-2023 roll out date.
So there you have it. Three sharply contrasting views (unless the Liberals reverse the course they seem to be favouring and go with a single payer system) of what role our federal government should play in covering prescription drugs all of which come with clear benefits and trade-offs.
Along with a host of other election issues (carbon taxes….) this will hopefully guide you in which way to cast your ballot come this October.