It’s become almost a matter of faith: health and health care are perennially among the top priorities for Canadians, but are nearly invisible in election platforms and debates. This observation has led health care providers, health care advocates and labour leaders to call for greater attention to this key issue, and others to try to explain why it is an issue of which politicians may be well-advised to steer clear.
Something changed recently when Tom Mulcair announced that an NDP government would implement a national pharmacare program. With this he joined Elizabeth May and the Green Party in advocating for a program that, if implemented, would be the biggest step forward for Canadian health care since the introduction of medicare. The Liberal party has advanced plans for controlling drug pricing through bulk purchasing of medications but have shied away from universal coverage.
Are we finally in a health election campaign? Will the Conservative party also come forward to act on an issue of critical importance to the health of Canadians? Public opinion polls in favour of introducing pharmacare suggest they’d be wise to do so.
National drug coverage has long been a priority for the over one in five Canadian households that can’t afford to buy needed prescription medicines. But in spite of decades of calls for a new program by expert panels and commissions, the idea seemed not ready for prime time. The cost of national pharmacare was seen to be too great in a time of low political appetite for new universal benefits.
But it turns out that pharmacare isn’t a money sucker – it’s a money saver. A new look at the numbers has people realizing that the cost of not having national drug coverage is far greater than that of implementing it. A groundbreaking economic analysis in the spring of 2015 by Steve Morgan and Danielle Martin demonstrated that universal drug coverage would save over $7 billion dollars in private and public spending, with little or no increase to government budgets.
Where do these savings come from? Canada is the only OECD country with universal health care that doesn’t include drug coverage, and as a result we miss out on opportunities to get value for money when we buy drugs. The popular anti-cholesterol drug Lipitor, for example, costs $800 per year for a Canadian patient. In New Zealand, where bulk-buying and aggressive price negotiations are part of a national drug plan, the same medication costs only $15 year. That’s not a typo.
This means that Canadians are either paying far more out of pocket for medications, or they’re simply not taking them at all. A recent Angus Reid poll showed that 23 percent of households surveyed had not been able to properly take prescribed medications due to cost. This is obviously bad for the health of those individuals; and it also contributes to greater costs in other parts of the health system when patients suffer preventable consequences.
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In my practice, as in medical practices across the country, I see patients with chronic illnesses like diabetes, high blood pressure, HIV and lung disease who are too often forced to choose between the medications that are essential to keep them well and necessities of life, such as rent and nutritious food. This is not just an issue for very low income Canadians – it spans across income lines as drugs become more expensive and employer benefits less common. Doctors are so concerned about the issue that the Canadian Medical Association’s General Council voted 92 percent in favour of a resolution in support of pharmacare last month. The general public agrees: recent polls show 91 percent of Canadians are also in support of universal drug coverage.
Federal elections should be a time to concentrate on what matters most to Canadians. This includes health care when we’re sick, as well as action on the upstream factors that determine whether we get ill or well, such as housing, income, child care and the environment.
What else are our elections about, if not the quality of our lives, our health and wellbeing?
Health and health care may be dangerous territory for politicians, fraught with ideology and emotion, but the argument for pharmacare is so compelling that all parties should be moved to take action.
It’s extremely encouraging to see the Greens and the NDP join the Canadian public in their support of this important step forward. The Liberal Party approach is a start, and would reduce costs, but falls short of what is really needed to remove barriers to access. Hopefully we will hear soon from the Conservatives as we move to a national consensus on this sensible and timely approach to controlling costs and improving health outcomes.
Ryan Meili is a practicing family physician in Saskatoon and founder of Upstream: Institute for A Healthy Society and Chair of Canadian Doctors for Medicare.