Where are the funds for pharmacare?

Opponents of the government’s new public, universal pharmacare program were quick to pounce on Health Minister Mark Holland’s announcement of Bill C-64, the Pharmacare Act.

The pro-corporate, conservative attack lines have predictably repeated ridiculously torqued cost estimates, tossing out numbers over $30 billion for a complete program, likely in an effort to rally public opposition and spook New York-based credit rating agencies.

It’s easy to understand why the Health Minister wanted to avoid fanning the flames by including a price estimate in the official government press release. But his reluctance to speak about the funds for pharmacare during his February 29 media conference may have done more harm than good.

First, when questioned by reporters, he suggested it was hard to know the figure given the variances between provincial plans. He wanted time to study the potential cost savings alongside expenses. Then, he shifted attention to the Finance Minister before finally stating that Health Canada’s anticipated cost would be about $1.5 billion.

Now $1.5 billion is a lot of money, to be sure, but by covering only two classes of drugs (contraception and diabetes treatements), the program announced last month is a greatly scaled-back version of pharmacare that was described in the 2019 Hoskins report on National Pharmacare. Dr. Eric Hoskins recommended a comprehensive, single-payer universal plan for all essential medicines, estimated to require $3.5 billion initially.

The government has also been fuzzy about when the money will be budgeted.

The Health Minister said it’s likely that the costs won’t be booked until 2025, while also hoping to conclude negotiations with some provinces quickly, so, “we can see people getting access to drugs in this fiscal year.” This would be welcomed since Canadians need pharmacare as soon as possible, but surely this will mean expenses this fiscal year, too?

Finally, accountability for funding will be necessary. Some premiers have stated they want the money without joining the pharmacare program, prompting protests from public health advocates in Alberta and Quebec who are unsatisfied with the status quo in their provinces.

Members of the Canadian Health Coalition have campaigned for universal pharmacare for over two decades, and they aren’t stopping now. 

In a powerful joint statement following the introduction of Bill C-64, the Pharmacare Act, Health Coalition leaders urged the government to ensure the legislation adheres to single-payer, universal, public delivery in partnership with provinces and territories, along with adequate funding and accountability measures, in accordance with the principles of the Canada Health Act.

Good fiscal transparency is an essential step to set the landmark pharmacare program off on the right foot.