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 The modest broadening of the healthcare program is set to become one
of Prime Minister Justin Trudeau's key campaign promises ahead of
the October election, which is shaping up to be a close fight.
The government would not commit to meeting 100 percent of the cost
of prescription drugs for those who have no insurance through their
workplace, the sources said. That suggests the government is leaning
toward a narrower, more insurance industry-friendly model of
pharmacare, as it is called, than that recommended by a government
health committee last year.
A spokesman for Finance Minister Bill Morneau declined to comment.
Officials have yet to decide how much detail to provide about the
pharmacare system in the budget, which is expected in the week of
March 18, the sources said. They may release a general commitment to
boost coverage and leave the specifics for the campaign, they added.
But new information on pharmacare's inclusion in the spring budget
and its limited scope gives a first glimpse of the government's
blueprint for what has been called the "unfinished business" of
Canada's publicly funded healthcare system, called medicare.
The sources, who spoke in recent days, requested anonymity because
they were not authorized to speak to the media.
Canada's health system covers care provided in hospitals and
doctors' offices, but prescription medication remains largely the
purview of private insurance, often offered through employers, and a
patchwork of public plans geared primarily toward the old and the
very poor.
Opinion polls consistently show strong popularity for Canada's
public healthcare system.
There have been calls for Canada to extend medicare to include
prescription drugs since medicare came into existence in the late
1960s, and multiple studies have recommended its inclusion.
Surveys have found 20 percent of Canadians are either uninsured for
prescription drugs or under-insured, and one in 10 Canadians goes
without prescription medications because of an inability to afford
them, according to the standing committee on health’s pharmacare
report released in April 2018.
Manulife Financial Corp, Sun Life Financial Inc and Great West
LifeCo are among the major insurers in Canada.
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FILLING IN GAPS
The Liberal-dominated government health committee strongly
recommended Canada adopt a universal, national pharmacare program
that covers drug expenditures for all Canadians for a wide range of
drugs.
That would not only improve equity and access, advocates said, but
lower drug costs because there would only be one buyer negotiating
with pharmaceutical companies.
The government's budget watchdog estimated that would cost about
C$20.4 billion ($15.5 billion) a year - a hefty price tag for the
government, but offering an overall saving of C$4.2 billion compared
with the total now spent on prescription drugs.
What the government is likely to include in its budget is a much
more targeted plan aimed at filling the gaps in coverage not already
filled by private insurance or existing public plans, the sources
said.
That matches with the government’s finance committee recommendation
late last year, which Morneau, himself a former benefits industry
executive, has said he would prefer.
It is also in line with what the insurance industry has been asking
for. Standing to lose business to a universal government plan, the
insurers have argued that most Canadians have good private coverage
and that pharmacare changes need only affect a small uninsured
minority.
But the Liberals will likely face criticism from policy advocates
and left-leaning political opponents for not pursuing a more
comprehensive plan. Without a universal system overhaul, advocates
argue, people will continue to slip through costly cracks in the
coverage system.
An advisory council appointed to study the implementation of
pharmacare is expected to come out with recommendations this spring.
(Reporting by David Ljunggren in Ottawa and Anna Mehler Paperny in
Toronto; Editing by Denny Thomas and Peter Cooney)
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