Political pundits deploy talking points about health care seemingly with frequency and ease. When we hear “medicare is unsustainable” or “public health care spending is out of control,” it is often accompanied by a call for increased private financing or two-tier health care. In reality, Canada spends fewer public dollars on health care than most peer nations, and, in fact, should spend more.

To the dismay of many, this election thus far has had little mention of pharmacare. The NDP has re-iterated their support for a universal, public program to start as early as next year, while the Conservatives have no platform mention of it at all, and the incumbent Liberal’s absence of timelines in this week’s platform and recently rekindled relationships with the pharmaceutical industry are raising alarms that the long-awaited program may be slipping away.

To make meaningful progress on access to affordable prescription drugs, particularly at this critical time — the federal budget must include a clear timeline and funding for the full implementation of universal, publicly-funded pharmacare.

February 2, 2021

The Honourable John Horgan, M.L.A., Premier of British Columbia

The Honourable Adrian Dix, M.L.A., Minister of Health

Re: Provincial Leadership on National Pharmacare Program

Dear Premier Horgan and Minister Dix, 

Canadians cherish their Medicare system. This support crosses all geographic, demographic and political divides. There is a reason that Tommy Douglas was famously voted the “Greatest Canadian”: and that reason is his role – and that of the Co-operative Commonwealth Federation (CCF) – in bringing single-payer public health insurance to this country. 

Since the introduction of the 1947 Saskatchewan Hospitalization Act, the CCF/NDP have – as a core mandate – advanced the vision of Medicare as a right of citizenship for Canadians. 

We are writing you to ask you to once again fulfill this historic mission through ensuring the government of British Columbia becomes a leading voice in the national effort to achieve universal, public Pharmacare. 

Tommy Douglas’s vision for Medicare wasn’t supposed to end at the hospital door. As you know, Canada is the only nation with a single-payer healthcare system that does not include the cost of drugs in that system. Canadians, by an overwhelming margin, believe this flaw in Medicare needs to be fixed. 

In a recent poll by the Angus Reid Institute conducted in partnership with UBC’s School of Population and Public Health; St. Michael’s Hospital and University of Toronto; the Carleton University Faculty of Public Affairs and School of Public Policy and Administration; and Women’s College Hospital, Toronto, nearly 9 in 10 Canadians support a national Pharmacare program. 

This near unanimity is at least partly explained by the stresses of the COVID-19 pandemic. In the same poll, nearly one quarter of Canadians reported that they have recently decided not to fill a prescription or not to renew one due to cost or taken measures to extend it because they could not afford to keep the recommended dosage schedule. 

In the September 23, 2020 Speech from the Throne, the federal government again committed to a universal national Pharmacare program and to “accelerate steps to achieve this system.”

This federal commitment was affirmed again earlier this year in the new mandate letter to the federal minister of health, issued on January 15, which asked that the federal minister work “with provinces and territories that are willing to move forward without delay, [to] accelerate steps to achieve a national, universal pharmacare program”, recognizing that the work needs to be accelerated given “COVID-19 has intensified the health inequities and barriers to care across the country”. 

It is imperative that this commitment be made real through a line item in the upcoming federal budget and in keeping with the recommendations from the final report of the Advisory Council on the Implementation of National Pharmacare. 

As per the timeline in the Advisory Council’s final report, a national formulary of essential medicines should come into force by January 1, 2022. Considering the growing and urgent need for universal Pharmacare – with hundreds of thousands of people having lost access to employer-sponsored drug plans in recent months – we are calling for this process to be expedited, so that essential medicines can be made available on a universal basis by July 1, 2021. 

In the midst of COVID-19, we cannot delay access to essential medicines any further. Hospitals are overwhelmed with patients across the country, and the risk of airborne transmission of the virus has been firmly established. To avoid unnecessary hospital visits that result from a lack of access to prescribed medications, we urgently need universal access to a list of essential medicines. 

We have called upon the federal government to dedicate $3.5 billion toward universal coverage for a list of essential medicines – as recommended by the Advisory Council’s final report – in the 2021 Federal Budget. We have also called upon the federal government to usher in this program by July 1 to speed up access for those in need. 

On July 1, 1958, the Hospital Insurance and Diagnostic Services Act came into force, and on that day in 1968, the Medical Care Act came into force. Having a list of essential medicines accessible to all people in Canada by July 1, 2021, would begin the fulfillment of an essential yet missing piece of Medicare. And it would do so on the most fitting of days – marking 153 years since Confederation – for our country’s most cherished achievement. 

We recognize that Pharmacare cannot move ahead without the participation of the provinces and territories. We are encouraged by the federal government’s Speech from the Throne commitment to work “…with provinces and territories willing to move forward without delay”. We are also pleased with your government’s recent platform commitment to universal pharmacare and the stipulation in Minister Dix’s mandate letter that he continue to fight to make sure the federal government remains focused on a national pharmacare program so you can bring down the cost of pharmaceuticals to make life more affordable for all British Columbians. 

At this critical moment, Canadians need British Columbia to lead. Your government can play a key role in the creation of this new social program for all Canadians. Your voice, your actions, will be central to the debate in the weeks and months ahead. 

We look forward to working with you to accelerate the implementation of a national, universal, public and single-payer Pharmacare program, and to the completion of Tommy Douglas’s Medicare vision. 

Sincerely, 

Rick Smith
Executive Director, Broadbent Institute

Laird Cronk
President, BC Federation of Labour 

Anita Huberman 
CEO, Surrey Board of Trade 

Jeff Sommers 
Director, Health and Policy Systems, BC & Yukon Heart and Stroke Foundation

Mark Hancock 
National President, Canadian Union of Public Employees 

Steve Morgan, PhD 
Professor of health policy at UBC and Founder of Pharmacare 2020 

Pauline Worsfold, RN 
Chair, Canadian Health Coalition 

Marie Clarke Walker 
Secretary-Treasurer, Canadian Labour Congress 

Danyaal Raza 
Chair, Canadian Doctors for Medicare 

Christina Warner and Ravi Joshi
Co-Executive Directors, Council of Canadians 

Josh Bizjak
Executive Director, Douglas-Coldwell Foundation 

Linda Silas 
President, Canadian Federation of Nurses Unions 

Larry Brown 
President, National Union of Public and General Employees

Header image is by Elsa Olofsson and is licensed under CC BY 2.0.

As Canadians, we are rightly proud of our health care system. In 2004, the “Father of Medicare,” Saskatchewan politician and visionary Tommy Douglas, was crowned in a CBC poll as the Greatest Canadian, and more than a decade later, he and the system he helped create continue to define Canada. More than a set of interlocking provincial and territorial health insurance programs, Medicare has become the highest expression of Canadians caring for one another.1 Our public health care system touches us at all stages of life: from the day we were born, attended by doctors, nurses, and midwives; through our infancy, with the immunizations and check-ups our primary healthcare team gave us then; through our adult years, when we were supported by emergency care and regular appointments at the family doctor; and to the last days of our lives, when medical professionals will provide us with compassion and empathy in palliative care.

Majority say they may not vote Liberal if government does not announce changes

New information from a survey commissioned by the Broadbent Institute shows that a majority of Canadians (54 per cent) want to see the federal government announce bold new ideas for how to fundamentally improve people’s lives and deal with climate change in next week’s throne speech. The desire for major changes is consistent across Canada and across the political spectrum. This is likely informed by the fact that only 19 per cent of Canadians think the worst of the pandemic is behind us and 65 per cent believe the pandemic has highlighted problems with how the economy and social programs are run that require major changes.

The survey, carried out by Abacus Data, also shows there is a political price to pay for inaction. Half say they will definitely or probably not vote Liberal if they do not present a plan with new ideas.

“Nearly half of Canadians think the worst of this pandemic is yet to come,” says Rick Smith, executive director of the Broadbent Institute. “People are worried, they want to see major action to address this worry, and there will be a political price to pay for any political party that doesn’t act accordingly.”

According to Canadians, the plan should include:

• Help to build up Canada’s ability to produce key products like food and medical supplies domestically (74 per cent).
• Investments to strengthen our health system including universal public pharmacare (70 per cent).
• Focuses on helping people and doesn’t allow corporations to set the agenda and benefit the most from the recovery (67 per cent).
• Increasing or creating new taxes on Canada’s richest people (60 per cent).

“The pandemic has highlighted many aspects of the economy and society that Canadians feel are not working right. From finding a good job to preparing for retirement to finding affordable housing – many recognize that the pandemic has made life harder,” says David Coletto, chief executive officer of Abacus Data. “There is clear majority support for new ideas to improve the problems the pandemic has exposed. Most Canadians expect strong action from the government.”

Fast Facts

• 45 per cent of Canadians believe the worst of the pandemic is still to come, while only 19 per cent believe the worst is behind us.
• The survey found broad support for a new wealth tax on the wealthiest multi-millionaires and billionaires in Canada (76 per cent) and for a new tax on corporations who have made large profits during the pandemic (73 per cent).
• Most Canadians think the economic and social well-being of youth, racialized Canadians, and women have been negatively impacted. In contrast, almost all Canadians (82 per cent) believe that the wealth of Canada’s richest people is better off or has not been impacted by the pandemic. 

Documents

• Report: David Coletto, Abacus Data. Canadians Expect Bold Action To Deal With The Economic And Social Impact Of The Pandemic.
• Research: Abacus Data and Broadbent Institute. Most Canadians Want To See Bold New Ideas In Post-COVID Recovery Agenda.

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About the Broadbent Institute

The Broadbent Institute is Canada’s leading progressive, independent organization championing change through the promotion of democracy, equality, and sustainability and the training of a new generation of leaders.

For More Information

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We’ve lost so much due to Canada’s misguided embrace of privatization in recent years, but one loss that sticks out with particular rawness these days is the sale of Connaught Labs, our once-dazzling publicly-owned pharmaceutical company.

In the early 1960’s, a CCF government (the CCF was the precursor to the NDP) in Saskatchewan successfully lit the path towards what we now know nationally as Medicare, a transformative event in Canadian history. This was done in the face of fierce and often bitter resistance from political opponents, from the medical community and from private insurance companies.  Canadians would do well to recall this history, and how elements of it might inform the current debate about the urgent need for a universal single-payer (i.e. public) Pharmacare program, a long overdue supplement to the existing health care system that would realize the dreams of many of Medicare’s founders.

Picture this: a patient returns to the office for a follow-up visit with their physician. When asked how the prescribed treatment is working out, they answer: “I don’t know, I couldn’t afford to fill the prescription.”