Canadians shouldn’t have to go into debt to stay healthy. That idea was at the heart of Tommy Douglas’ philosophy and the belief that fuelled his struggle to build a national public health care system – a struggle championed by New Democrats and shared by ordinary Canadians today.
It’s the core of our entire public health care system, yet, it’s a principle under serious threat today by the continued exclusion of drug costs from that system.
Drug Costs Straining our Health Care System
Today, drug therapies form an essential component of health care. Drug treatments now account for more than 17% of total health spending – almost double the 8.8% they totalled in 1975. At more than $27 billion, we spend more on drugs than on doctors. Only hospitals cost us more. A study of 17 OECD countries in 2004 found we had the third highest drug bill, after the US and France.
Yet the Canada Health Act stops paying for drug charges at the hospital door. Fully 60% of our spending on drugs comes out of our pockets directly, or from private insurance plans we purchase of access through work. Drug costs are eating more and more out of our family budgets: between 1992 and 2002, household spending on prescription drugs jumped more than 70%, while spending on food, shelter and clothing rose 11%. Incredibly, one in five Canadians are underinsured for drug coverage and 3.5 million have no coverage at all.
Coverage depends on where you live and work
The public coverage that is out there varies widely from region to region, province by province. A drug may be covered under British Columbia’s formulary but not in Ontario or New Brunswick. Coverage could be reversed for another drug. It depends on where you live and it can mean a difference of thousands of dollars per year. The effects can be devastating for families.
On the other side of the coin, the big international pharmaceutical corporations continue to rake in exorbitant profits. In Canada, with the help of successive Liberal and Conservative governments, patents protecting drug company profits have been extended time and time again. The future haul from “new” drugs is assured, even though studies show that major therapeutic advances actually occur in only 0.2% of newer, more expensive drugs marketed between 1996 and 2006. Even the costs of our generic versions of drugs are high by international standards.
The current situation is unfair and ballooning drug costs mean it’s financially unsustainable. It’s time for a national drug plan: Universal PharmaCare. Canada and the US are the only industrialized countries in the world without public national drug plans. An effective national strategy is needed to ensure equal access to necessary drugs and to bring down the cost of those drugs. Not only is it the right thing to do, it’s the smart thing to do. Countries with higher public investment in drug coverage have lower per capita expenditures on drugs.
The plan must be comprehensive in order to be effective, and we could phase it in to be achievable, starting with catastrophic drug coverage.
It must follow the five principles of the Canada Health Act – universal, portable, comprehensive, accessible, and publicly administered. Our strategy includes negotiations with provincial and territorial partners towards a national drug formulary with bulk purchasing, the single administrator and first-dollar payment system that has so successfully cut other Medicare costs, together with changes to drug patenting, prescribing practices, and consumer protection measures.
Our phased-in approach would begin by ensuring coverage for those least able to afford the prescriptions their health requires – groups like seniors, persons with disabilities, those on low income and grow to full universal coverage as the economy can support it. The economic benefits for Canadian businesses, as well as individual Canadians, will echo the advantages already experienced from other elements in our public health care system.
A Logical Evolution for Health Care Coverage
Described as the “next step” in the 1964 Hall Royal Commission, the National Drug Forum on Health in 1997 and the Romanow Commission in 2002, it is now time to take action. The provinces have been pushing for a national drug plan since 2004 federal-provincial-territorial negotiations. However, the current government’s stated bias against national programs and its defence of corporate interests are standing in the way of ordinary Canadians who would benefit so significantly from the New Democrat PharmaCare plan.
The solutions to rising drug costs are within reach. We know that we need action on excessive patent protection, better enforcement of the ban on direct-to-consumer advertising, and we need to capitalize on our collective purchasing power – provinces, territories, and the federal government – to negotiate better prices for drugs.
Bruce Hyer will continue to stand up for families and seniors in the fight for a fair and cost-effective drug plan. For too long, other parties with corporate interests in mind have said that national prescription drug coverage for Canadians can’t be done. But it can be done, and it must be done. As health care evolves, public coverage must evolve with it to include the prescription drug coverage we need. The time for that change is right now.