On October 18, The Council of Canadians released the report: A Prescription for Better Medicine: Why Canadians need a National Pharmacare Program. Rankandfile.ca editor Gerard Di Trolio sat down with the report’s author, the Council’s National Healthcare Campaigner Michael Butler, to ask him about the significance of the report’s findings, how it would benefit Canadian workers and the economy, and why now is the time to act on a national pharmacare program.
R&F: Can you put pharmacare in historical context in regards to the history of universal healthcare in Canada
Michael Butler: Canada’s health care system is not the great equalizer we like to think it is. A missing piece remains, universal pharmacare. It may come as some surprise to many people but Canada has unfortunate distinction of being the only country with a universal national public health care plan not to include prescription drug coverage. It is time to finish writing the final chapter in medicare’s story.
So, a national drug coverage plan was first recommended in Canada by the Royal Commission on Health Services in 1964 (known as the “Hall Commission”). Since then there have been numerous commissions that all advocated for pharmacare, like the Romanow Commission among others. It all points to the fact that pharmacare remains a good idea to this day. Unfortunately, we have lacked in federal leadership in the past decade to get the job done. But it’s time, Canadians can’t wait any longer. Canadians know this, polls show 91% Canadians support universal pharmacare, you can’t get much of a larger mandate than that.
R&F: What’s been happening lately with drug prices?
MB: Every week we here another story about some pharma bro or big pharma company jacking up the cost on life saving drugs. So here is the thing, this isn`t only a problem in the US and despite the maple washing by our politicians on drug costs, Canada is not far behind the US. Looking at per capita pharmaceutical expenditures, Canada’s are higher than all other OECD nations, with the exception of the United States. Canadian drug expenditures overall increased by 184.43 per cent between 2000 and 2012, a rate higher than any other comparator country, even the United States. If coming trade deals like CETA and the TPP pass, this will mean billions more in costs for Canada and make it more difficult to implement pharmacare. It is no surprise that in Canada and the US Big Pharma have been lobbying the hardest for these trade deals, much more than other industries.
The report shows that per capita cost of prescription medications has increased fivefold since 1984. In 2016, Canadians will fill over 600 million prescriptions at a cost of more than $30 billion. This amount is four times more than what we spent on prescriptions 20 years ago. For example, the prices of brand name drugs in Canada are roughly 30 per cent higher than in comparable countries like the United Kingdom that have pharmacare. More than ever profits are being put before patients, and Canadians are dying as a result. Make no mistake about that.
R&F: How is the lack of pharmacare at the federal level impacting Canadians?
MB: Your postal code or socio-economic status should not dictate if you receive necessary medication, but sadly it does in Canada. Because of our fragmented system more than two-thirds of Canadians, around 25 million, do not have access to a public drug plan. For a nation that prides itself on its humanity, this should be a national shame. It is estimated that 10 per cent of Canadians – around 3.5 million people – lack even basic drug coverage. When we look to other OECD countries, only the United States and Poland have a lower percentage of drug costs paid for by public programs. Canada is also second only to the United States in the use of private insurance.
Studies report that 23 per cent of Canadian families – nearly 1 in 4 – fail to take needed medication due to costs, which has an enormous impact on health. What is the result? In Canada it is believed that 6.5 per cent of hospital admissions are the result of non-adherence to medications, and this cost an estimated $7 billion to $9 billion per year.
It is important to mention at this point that more medicine does not necessarily mean better medicine. The report looks at this crucial issue which is perhaps more important than cost savings. Universal pharmacare improve drug and patient safety, prescribing appropriateness, get Big Pharma out of doctors offices and post-market surveillance among many many other things.
The report also looks at how low-income workers are cruelly one of the worst off in our system, as they generally do not have drug coverage as part of their employment, but they earn “too much” to be covered under public plans.
Just 32 per cent of Canadian workers earning between $10,000 and $20,000 and 17 per cent of those earning $10,000 or less receive health benefits from their employer. And it comes as no surprise that men are more likely to have a benefits plan from their employer than women.
Further, studies show that women work more often in part-time jobs that do not offer health benefits. We know only 1 in 4 part time workers have employer-provided health benefits.
For young workers aged 25 and under, only 1 in 4 have employer-provided benefits and this comes at a time when approximately 39 per cent of workers between the ages of 15 and 29 are precariously employed.
No other policy change can have such a transformative impact on labour in Canada, from autoplant workers, to retail or food service workers, to nurses.This is why unions from CUPE, to Unifor, to the CFNU, among many others, have been pushing for universal pharmacare.
R&F: What would the economic impact of Pharmacare be?
MB: Anyone who has bargained a collective agreement knows that health benefits are one of the most contentious issues at the table. And, prescription drugs generally represent the largest portion of the cost for employer-provided.
As a result of our medicare, Canada has already been an attractive source for investment from our largest trading partner, the U.S., as our universal single-payer system offers a competitive advantage for business. Medicare already provides Canadian employers with a competitive advantage equal to approximately $4 an hour. Since pharmaceuticals are the second largest component of health care spending in Canada, a universal, public pharmacare program would add considerably to this advantage
R&F: Why is now the time to make the case for pharmacare?
MB: Despite all this talk of the middle class and sunny ways, 1 in 3 Canadians with incomes under $50,000 reported that they or someone in their house were not able to take their medication as pres prescribed – if at all – because of costs. And judging by comments from our Health Minister Jane Philpott, it doesn’t look like the Liberals will get serious about pharmacare. Right now we have major health accord negotiations occurring which would be the perfect place to put in the building blocks for universal pharmacare. While pharmacare may take some time to implement, we desperately need to get the ball rolling and we have an opportunity right now. We have Liberal governments in Ontario, which has expressed strong support for universal pharmacare, and Quebec, the two major stakeholders you need on side. There is no better time than now for pharmacare.