Prescription for a good debate

There are many ways in which Canadians describe the concept of a national pharmacare plan:

A dream. A national aspiration. A fool’s errand. A cost-prohibitive boondoggle. The subject of numerous written-but-never-implemented reports and recommendations. The elusive final piece of a true universal health-care plan.

One way in which a framework for prescription-drug coverage for Canadians has seldom been described is this: a realistic possibility.

The seemingly endless discussion about a national pharmacare plan took at least a small step toward real-world consideration last month with the release of a report by a parliamentary committee that spent two years studying the issue.

Its recommendations, 18 in all, amount to an endorsement of an initiative that would see Canada replace its various provincial drug plans and private-insurance frameworks with a national single-payer pharmacare system.

"This is Step 1," said Liberal MP Bill Casey, the committee’s chairman.

"This answers the question — and I believe the testimony was very convincing — that a national pharmacare program will give us better health care at a lower cost."

According to a 2017 report by the parliamentary budget officer, a national pharmacare program could save about $4.2 billion annually — provided that federal bulk-buying power could force drug makers to drop prices by 25 per cent, that generic drugs would be used more widely and that limits would be placed on the number of different drugs covered.

And then, of course, there still would remain the question of who would ultimately pay for a national pharmacare plan — and how. As Conservative health critic (and committee member) Marilyn Gladu noted, "People want this service, (but) they’re unwilling to have their taxes increased in order to pay for it."

Even if Mr. Casey is correct in declaring the committee’s report represents an important first step, those who hold fast to Canada’s pharmacare dream would do well to keep in mind the ancient Chinese proverb which observes that a journey of a thousand miles begins with a single step.

There is a very long way to go.

That said, however, the subject of a national prescription-drug plan is bound to gain additional momentum in coming months as two of the nation’s three major political parties are almost certain to turn the pharmacare-plan concept into an election-campaign promise when Canadians head to the polls in 2019.

The NDP has been advocating for pharmacare for years, and will rightly feel as if its pocket has been picked when Prime Minister Justin Trudeau makes a national drug plan one of the central planks of the federal Liberals’ 2019 election platform.

Conservatives, not surprisingly, are less enthralled by the notion of socialized prescription-drug coverage.

Opposition members who sat on the committee filed a dissenting report that questions the costs of pharmacare and casts doubt on the ability of the federal government to get all of Canada’s provinces and territories to agree to such a plan.

And on the latter point, the federal Conservatives might have a point — particularly when it comes to the federal government’s prickly relationship with Manitoba.

Given the hand-wringing and finger-pointing that have accompanied federal-provincial discussions regarding carbon-tax pricing, marijuana legalization and health-care funding formulas since Brian Pallister became this province’s premier, it’s easy to imagine a future in which efforts to extend Ottawa’s pharmacare effort from coast to coast might run headlong into a roadblock at the Ontario/Manitoba border.