Over the last several decades, prescription drugs have become critical to preventing, managing and treating health conditions. Yet Canada’s health-care system has not been updated to ensure that all Canadians can access outpatient medications.
After letting report after report recommending designs for drug programs gather dust, the Government of Canada is finally moving forward with testing “pharmacare” models.
While details about these models are lacking, both seem to entail piecemeal expansion of drug coverage following separate negotiations with each province. As a comparative health systems researcher focusing on Canada and the United States and former director of American public health insurance programs, I believe this approach risks incorporating several negative aspects of the complex and unequal US health insurance system.
Proposed approach
On Feb. 29, federal Health Minister Mark Holland introduced Bill C-64 (Pharmacare Act) in Parliament stating government’s intent “to work with provinces and territories to provide universal, single-payer coverage for a number of contraception and diabetes medications” as a first step toward national universal pharmacare.
In subsequent comments, he referenced a federally-supported pilot project in Prince Edward Island as being under consideration for transfer to the rest of the country. This project “fills in the gaps” by expanding the list of drugs covered by that province’s 26 pre-existing public drug plans while also reducing plan participant co-payments, as being under consideration for transfer to the rest of the country.
According to the minister’s statements and the legislative text, whichever model the federal government ultimately pursues will be implemented and funded through bilateral agreements with the provinces and territories.
