Ontario’s extended prescription drug coverage likely to spread nationwide, thanks to Wynne

Just as Tommy Douglas is renowned as the “Father of Medicare” in Canada, Kathleen Wynne may soon – in another few years — be revered as the country’s “Mother of Pharmacare.”

This prospect may seem highly improbable, given the Ontario premier’s prevailing unpopularity. Doctors, nurses, patients, pundits, and both opposition parties have all protested the deep cuts in health care staff and services, and the extended wait times that have marred her administration.

But she could recover from much of this opprobrium before next year’s provincial election. Her planned $11.5 billion boost in health care spending has been scorned as a cynical pre-election ploy, but its benefits, whatever the motivation, will unquestionably benefit many thousands of families – especially those lacking prescription drug coverage. Starting in the New Year, $465 million will be allocated annually to provide this essential care to the province’s four million children and adults under the age of 25.

When added to the three million seniors and 900,000 families on social assistance already covered by the Ontario Drug Plan, it will come close to providing a full pharmacare program in the province. Granted, a significant number of citizens – those between the ages of 25 and 65 – will still be left without guaranteed coverage. But this gap is almost certain to be filled shortly, if only to avoid the charge of “ageism” or political discrimination between the “haves” and “have-nots.”

It shouldn’t take long afterward for mounting public pressure to force the other provinces to emulate Ontario’s pharmacare breakthrough. That’s what happened after the government of Saskatchewan pioneered the first two components of public health care – the services of physicians and hospitals – in 1962. One by one, the other provinces caved in, not daring to deny their citizens the same benefits; and eventually, in 1967, the federal government’s passage of the Canada Health Care Act made medicare a national program.

But it was, and still is, a very limited form of public health care. Tommy Douglas always regarded his two-pronged approach as just the first step toward the kind of all-inclusive coverage that was provided by most countries in Europe. He reasoned that, if these countries could afford pharmaceutical, dental and vision coverage, so could Canada. More than half a century later, however, his vision of European-style coverage in Canada remains unfulfilled. The main deficiency is universal public drug insurance. Since 1967, not even one of the many premiers of provinces governed by Tommy’s party, the NDP, has mustered the courage to extend his legacy, leaving that initiative, finally, to Ontario’s Kathleen Wynn.

One in four Canadians has no pharmaceutical coverage, and thousands can’t afford to fill prescriptions. Many covered by private insurance plans are beset by rising premiums, deductibles, co-payments, and fluctuating levels of coverage from province to province.

The main objection to the adoption of universal pharmacare in Canada is that it would lead to a steep increase in costs that would drain government treasuries. This is a totally unfounded claim. In fact, the reverse is true. Pharmacare would save Canadians and their governments as much as $10 billion a year.

This was the principal finding of an authoritative study conducted six years ago for the Canadian Centre for Policy Alternatives by researchers Marc-André Gagnon and Guillaume Hébert. Their study marshalled solid facts and figures proving that pharmacare would actually enhance government revenue as well as the health of those in need of prescription drugs. This would result from tapping the bulk purchasing power of all levels of government and reducing the medical and hospitalization costs of treating the multiple victims of pharmaceutical care deprivation.

The Gagnon-Hébert study was praised by health care experts in both Canada and the United States.

Marcia Angell, M.D., former editor-in-chief of the prestigious New England Journal of Medicine, hailed it as “a well-done analysis that clearly shows a universal publicly-funded prescription drug program to be not only be better for Canadians, but cheaper. The only downside is that the pharmaceutical companies might have to trim their obscene profits.”

Robert Evans, an economist at the University of British Columbia, was even blunter. “Big Pharma, private insurance companies, anti-tax ideologues, and apathetic governments,” he charged, “have kept a public program of drug cost coverage beyond our reach.”

Unlike Canada, the European countries repulsed the fierce lobbying of anti-pharmacare forces, and those that also opposed dental, vision, and other integral forms of health care. They knew that a government that failed to help its citizens stay well would find it much more costly to treat the myriad ills befalling them from government neglect.

This is a lesson most Canadian governments, unfortunately, have yet to learn. But just as Tommy Douglas prodded Saskatchewan to take the first two vital steps toward comprehensive public health care 55 years ago, so Kathleen Wynne at last has pushed Ontario to take the long-delayed third step toward that ultimate goal. Her pharmacare program will endure and eventually spread across the country as a bequest to Canadians everywhere.

Whatever the result of next year’s provincial election, that achievement will suffice to have her proclaimed Canada’s “Mother of Pharmacare.” And if she somehow does remain Ontario’s premier as well, her provision of pharmacare will truly be seen as the culmination of a “Wynne-win” strategy.