Montreal – As the advisory council led by former Ontario minister Eric Hoskins examines the means to implement national pharmacare, a new study by the Institute for Research on Public Policy explores two broad policy options in the context of Canadian federalism.
Canada is the only OECD country with universal health insurance that does not include prescription pharmaceuticals. Although a number of provinces provide coverage for certain groups, such as the poor and elderly, it is estimated that up to 20 percent of Canadians have no drug insurance. Canada has the third-highest per capita drug expenditures in the OECD — exceeded only by Switzerland and the US.
“Gaps in access under the current patchwork system seriously threaten the health of thousands of Canadians annually,” says Colleen M. Flood, who authored the study with her colleagues Bryan Thomas and Patrick Fafard at the University of Ottawa, and Toronto-based legal researcher Asad Ali Moten. “In 2018, this is simply unconscionable,” they add.
The authors outline two options for a national pharmacare framework that they consider constitutionally viable. Under the first, provincial governments would delegate the power to administer drug insurance plans to an arm’s-length agency funded by the federal government. This process was used to establish Canadian Blood Services in the mid-1990s.
The second option would be for the federal government to adopt legislation similar to the Canada Health Act and provide annual transfers for pharmacare to the provinces and territories. The funding would be contingent on compliance with two criteria: (1) universal coverage for a basket of essential drugs, with no copayments or deductibles; and (2) decisions over what to include in the basket to be made by an arm’s-length body (or bodies).
Universal Pharmacare and Federalism: Policy Options for Canada by Colleen M. Flood, Bryan Thomas, Asad Ali Moten and Patrick Fafard, can be downloaded from the Institute’s website.
The Institute for Research on Public Policy is an independent, national, bilingual, not-for-profit organization based in Montreal. To receive updates from the IRPP, please subscribe to our e‑mail list.
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