Last week’s agreement between the federal Liberals and NDP includes a commitment to implement a national pharmacare program. This is much needed because a quarter of British Columbians have little or no prescription drug coverage, resulting in skipped prescriptions, poor health outcomes, and extra costs elsewhere in the health-care system.
This federal commitment to pharmacare is a tremendous opportunity for John Horgan, both as BC premier and as the current chair of the Council of the Federation (the council of all provincial and territorial premier).
Canada desperately needs improvements in long-term care, mental health care, primary health care, and surgical wait times. But Premier Horgan knows those are complex problems with no easy fixes. He also knows the feds won’t cut checks for problems without fixes.
In contrast, improving access to medicines through national pharmacare is straightforward — if the federal government commits sufficient funding to it. This is where Horgan can show strategic leadership on behalf of British Columbians and all premieres.
It is currently proposed that provinces would not only run but also partially fund the national pharmacare program. This doesn’t sit well with premieres who are concerned about their share of the costs. But what if the federal government paid the entire cost of national pharmacare?
With $7.5 billion in federal funding, provinces could immediately provide universal coverage of essential medicines secured nationally, through bulk-purchasing agreements like the ones used to buy COVID-19 vaccines. This would give all Canadians access to the most important medicines in primary health care in Canada, such as antibiotics, heart medications, insulin, pain medications, and birth control.
The program would give provinces more than $4 billion in annual savings — because the federal government would pick up the tab for essential medicines currently paid for under provincial drug plans. The savings for BC would be at least $400 million annually.
Full federal funding of national pharmacare would be an offer too good for provinces to refuse: improved access to treatments, at lower costs to citizens, with billions in savings to provincial coffers. Not even Doug Ford could say no to that!
Not to worry, households and employers would save money, too. Right from the start of a national pharmacare program, Canadian households would save more than $1 billion per year in out-of-pocket medicine costs, and employers would save more than $3 billion per year in extended health benefit costs. This means more than $300 million in annual savings for households and employers in BC
The reason we know national pharmacare can achieve these savings — while increasing access to medicines — is because single-payer pharmacare systems in comparable countries negotiate the best prices on the global pharmaceutical market. Such bulk-buying at a national level is expected to save Canada $4 billion and $7 billion on the cost of prescription drugs. Furthermore, the improved access to medicines that comes with universal coverage is estimated to result in at least $1 billion in additional health system savings — because patients who can afford their prescriptions stay healthier and therefore out of hospital.
Thus, in planning post-pandemic health-care policy for BC and for the country as a whole, it is not pharmacare or other priorities — it is pharmacare and other priorities because pharmacare will save the money needed to do the other things.
Canadians should not have to wait for this. With unified provincial leadership, this program could start by the end of this year, rather than by the end of 2025, which is the timeline currently proposed by the federal government. The program could then be expanded to cover all necessary medicines, generate even better access to medicines, better health outcomes, and many billions more in annual savings for provinces, households, and employers.
This is the kind of bold and strategic negotiation British Columbians should expect from John Horgan during this critical time for health care in the province and nationwide. It would result in a major health system transformation that more than pays for itself.
Over to you, Premier Horgan, to be the champion for rapid and complete implementation of national pharmacare.
Steve Morgan is a professor of health-care policy at the University of BC’s School of Population and Public Health. Twitter: @SteveUBC
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