Saturday, October 21, 2023

Will We Get Pharmacare?

Last week, at the NDP Convention, the delegates insisted that the Liberals deliver a pharmacare program by 2025 or their deal was off. Susan Delacourt writes:

Their arrangement clearly states that a “Canada pharmacare act” must be passed by the end of 2023, and that deadline is looming ever closer with no sign of legislation on the horizon.

“We have now the leverage given to us by our convention and our members,” Singh told reporters this week, using a bit of megaphone diplomacy to warn of tense negotiations to come with the Liberals.

Don Davies, the NDP health critic, is also ramping up the public pressure on Trudeau’s Liberals, calling pharmacare the “red line” that could spell the end of the supply and confidence agreement.

The gurus in the Finance Department -- who have Chrystia Freeland's ear -- are warning that the present economy can't support pharmacare:

Behind closed doors at the cabinet and caucus retreats in August and September, Freeland essentially warned her colleagues that while Liberals will continue to be Liberals, investing in existing large spending programs, this government can’t do everything. Here’s how she put it when talking to reporters last month:

“We are Liberals. We believe government has an important role to play in supporting Canadians, in building a social welfare net that supports Canadians and in putting in place programs that help our economy to grow.”

There was a “but” there, though. “We also understand that government is able to deliver for Canadians when government operates on a responsible fiscal footing and that, by the way, is a profoundly Liberal conviction. It was Jean Chr├ętien and Paul Martin that did the very hard work of fighting to get the triple-A (credit) rating that Canada currently enjoys. And what we are committed to is doing the things Canadians need us to do and maintaining that responsible fiscal foundation, and we are doing that. Canada has a triple-A rating, notwithstanding the great investments we’ve made in Canadians.”

Freeland and her Finance Department officials are said to be worried that a new pharmacare program would affect those credit ratings. It didn’t help either that the Parliamentary Budget Officer came out with a report last week, putting the cost of national pharmacare at $11.2 billion in the first year and $13.4 billion in five years.

You can bet that Singh and Trudeau are trying to find a way to finesse the deal.

Image: The Council Of Canadians


Cap said...

Trudeau and Singh are trying to find a way to bury the deal. The NDP delegates are already moving the deadline back to 2025, which is when the current session of the Commons runs out. In other words, they've folded. The "gurus in the Finance Department" don't want to raise taxes on the wealthiest Canadians. There never was any other way to finance pharmacare.

jrkrideau said...

If you glance at A Prescription for Canada: Achieving Pharmacare for All report from 2019 it is hard to see how Canada can not afford a pharacare program.

Canadians spent $34 billion on prescription medicines in 2018.

So from a national as opposed to Federal Government point of view we save ~ $20 billion. What do those savings do to the overall economy?

I may be wrong but I think a pharmacare program would come under provincial jurisdiction. If so, from a practical point of F-P negotiations, I cannot see how the Federal Govt could hammer out any sensible agreement with the provinces in this amount of time. It was obvious for the start that having a national program in place by 2024 was going to be almost impossible.

Owen Gray said...

If that's the endgame, Cap, then -- like electoral reform -- it's a massive betrayal.

Owen Gray said...

Perhaps, jrk. But there was also a time when Medicare seemed like an impossible dream.

e.a.f. said...

It does seem strange. The Liberals and NDP were so keen on a prescription plan going back to 2017 or even a bit before. So what happened? Perhaps we will know once the police solve the Sherman murders, if they ever do.

$35B is a lot of money. Corporations don't want to give it up and once Canada went to a federal plan I'd expect there to be more of an emphasis on generic drugs, which Sherman's companies produced.

The cost of a national drug program may cost a fair amount of money, but it would be less expensive than buying how we do today. All that money would remain with consumer/citizens. If it were necesary to raise taxes, it would be worth it. Many Canadians can't afford their medications with an end result of them winding up in hospital which is so much more expensive. Then there is the no small matter of children. Their inability to access medication will cost the health care system a great deal more over the child's life, if they live long enough.

The premature death of citizens is a huge drag on the economy and social system. Just the cost of breavement leave to employers is a fair amount. Then there is the need to deal with the children left behind. Some will have "issues", some will wind up in foster care, the list goes on. A healthy population is an inexpensive one.

I expect there is much more to this than meets the eye. If the politicians wanted to they could have a program for children, but no. so what really is the deal.

Owen Gray said...

The initial cost would be significant, e.a.f. But, in the long run, Pharmacare would be good for the economy.

Northern PoV said...

" present economy can't support pharmacare"

translation for us kids out here:

You can't have nice things, move along

Owen Gray said...

That's basically it, PoV.

TerryM said...

Maybe if he quit showering anyone other than Canadian taxpayers with money when they come calling there would be enough for Pharmacare.

Owen Gray said...

It's all about what he decides to do with the money, Terry.

Anonymous said...

Owen, pharmaceutical businesses have been very good at exploiting the public. Often the original R&D was undertaken at a public institution and eventually marketed by a pharmaceutical company with patent control. After years of negotiations with pharmaceutical businesses, Canadian provinces were able to bulk buy generic drugs for the benefit of their citizens. In the meantime, pharmaceutical companies also found ways of extending their patents.

Since Canada is a sovereign nation it has a lot more flexibility in funding a pharmaceutical program. It does not have to come completely with increased income taxes and pharmaceutical companies can contribute to a decent program. RG

Toby said...

To expand what TerryM said, Trudeau and company need to stop subsidizing huge multinational corporations that are quite capable of looking after themselves. For example, the cost of the pipeline through BC is passing $30 billion. I, for one, would like to spend it on programs that Canadians need such as Pharmacare.

Remember when Covid first hit and governments everywhere were scrambling to acquire vaccines? In order to get vaccines for Canada I think Trudeau made a deal with Big Pharma to scrap Pharmacare in any form.

Owen Gray said...

Pharmaceutical companies have made enormous profits for decades, RG. It's not surprising that they and their allies would cry foul.

Owen Gray said...

COVID should be the closing argument in favour of Pharmacare, Toby.

jrkrideau said...

But there was also a time when Medicare seemed like an impossible dream.

It think you misunderstood me. Pharamacare is quite possible but if it is essentially a provincial responsibility then the short time span is a real challenge. FPT agreements usually mean long and complicated negotiations even with good-will on all sides.

Just think of dealing with Alberta with Danielle Smith as premier plus some of her off-the-wall "advisors". Or Doug Ford who seems to want to privatize the entire healthcare system in Ontario.

Owen Gray said...

You're right, jrk. There are significant problems concerning implementation and timelines. I suspect that -- as was the case with healthcare and childcare -- pharmacare will be implemented on a province-by-province basis. Some provinces will be late to the table.