Nearly a quarter century ago, the federal government hosted a conference on national pharmacare in Saskatoon – the birthplace of Canadian medicare. The meeting was extraordinarily frustrating to delegates who anticipated action, not talk, at the time.
We know because we were there.
You see, that Saskatoon meeting was held on the heels of Prime Minister Chrétien’s 1997 National Forum on Health. Echoing previous national commissions, the forum recommended the implementation of a universal, comprehensive, public pharmacare program to work alongside Canadian medicare.
Yet, there we were, an audience of approximately 300 health professionals, experts, public representatives and stakeholders gathered to “engage in dialogue” on an issue that already had a very clear answer.
The national pharmacare system recommended would have reduced Canadian drug costs dramatically, meaning savings for governments, businesses and households. More Canadians would have access to medicines because they would be fully covered, but manufacturers would no longer be able to charge more in Canada than they did in comparable countries.
Drug companies preferred that Canada adopt a system of mandatory private insurance based on the model they had just convinced the Quebec government to implement in 1997 — at great cost to Quebec households and businesses. Insurers favoured the Quebec model too – what industry wouldn’t want people to be legally required to purchase their products without regulations on profit margins?
In 2019, the Liberals campaigned on a promise to act on pharmacare plan. Such a national pharmacare system was mentioned in the 2020 Throne Speech, Budget 2021 and 2021 mandate letters. But there has been little concrete action toward implementation.
Instead, the federal government has reverted yet again to “stakeholder engagement,” rather than policy action.
This doesn’t bode well for Canadians. For example, following extensive stakeholder engagement, the federal government recently walked back implementation of the new regulations for prescription drug prices just days before they were to take effect. The reason? Drug companies weren’t happy.
Rather than implement policies designed to put public interest first, the government has promised to consider the pharmaceutical industry’s proposals for price regulations.
Here’s the thing: Major public policies to establish lasting institutions in the public interest cannot be arrived at by stakeholder consensus. If Premier Tommy Douglas and Prime Minister Lester Pearson had believed that, Canadian medicare would have never gotten off the ground because of the medical profession’s fierce opposition to public health care.
Delaying implementation of national pharmacare further in pursuit of consensus among stakeholders is a fool’s game. Citizens strongly support the immediate implementation of a universal, public pharmacare program, even as a policy priority during the COVID-19 pandemic. They needn’t be further consulted.
Drug companies, on the other hand, do not want what is best for Canadians. They want what is best for their shareholders: weak policies and, therefore, high prices.
Every year that passes without implementing a national pharmacare program wastes billions of dollars, causes a million Canadian families to struggle to make ends meet, and results in hundreds of premature deaths.
But it is not too late to implement a national pharmacare program that becomes a lasting, positive legacy for generations to come. It just requires leadership: true leadership that champions the public interest over powerful stakeholders.
A federal election is not a bad time to find out who will commit to clear, concrete action on national pharmacare, and who would prefer to continue with the fool’s game.
Steve Morgan, PhD, is a professor of health policy at the University of British Columbia. Linda Silas is a nurse and president of the Canadian Federation of Nurses Unions.