VICTORIA — B.C. wants more money from Ottawa for health care before a national pharmacare program is created, says Premier John Horgan.
Horgan echoed other provincial and territorial leaders at this week’s Council of the Federation meeting in Toronto by calling for a 5.2 per cent increase in the annual federal health transfer, instead of the planned three per cent, as a first step before the federal government proceeds with universal prescription drug coverage.
“We were welcoming a discussion about a national pharmacare plan, but those of us who really already have significant plans would prefer that we first and foremost get back to a more equitable distribution of resources to deliver health care broadly,” Horgan said Monday.
An additional $30 million would flow to the province this year, were Ottawa to agree to increase transfers to the amount specified by the premiers.
Other premiers were more hesitant about a national pharmacare proposal, which Prime Minister Justin Trudeau promised in the election. They agreed to lobby for an opt-out clause if Ottawa decides to push the program into reality.
“Don’t start broadening health care when you can’t get it right now,” said Manitoba Premier Brian Pallister. “We need sustained funding.”
Canada’s current drug coverage system is a fragmented and unfair patchwork of more than 100 government-run plans and 100,000 private drug insurance programs, according to a June report by the federally commissioned Advisory Council on the Implementation of National Pharmacare. One in five Canadians have no drug coverage or inadequate coverage, the council found.
A single national system for prescription drugs would mean a copayment of as little as $2 a person for essential medicine and $5 a person for other drugs, as well as exemptions for those on social or disability assistance and a cap of $100 a year on any household payments, according to the council’s recommendations.
B.C. is budgeted to receive $5.4 billion in federal health transfers this fiscal year.
The province spends $23 billion of its $58.3-billion annual budget on health care and pharmacare.
Health Minister Adrian Dix said B.C.’s increases to health spending have outpaced the growth in federal transfers, and addressing that immediate financial pressure on existing services is the priority.
“Our priority is the Canada health transfer,” Dix said Tuesday. “But if (the federal government) comes forward with pharmacare proposals that actually have financial support behind them, then obviously that’d be of interest to every single province.
“What we’re saying is let’s get our fiscal house in order on the Canada health transfer, and then we can have that discussion.”
The federal advisory council, chaired by Dr. Erik Hoskins, recommended Ottawa cover all the additional costs for provinces in creating a national pharmacare program. That includes $3.5 billion by 2022 to launch a national system for essential medicines, and then $15.3 billion by 2027 after the system rolls in more coverage for different drugs.
National pharmacare would save an average Canadian household $350 a year in drug costs, businesses an average of $750 an employee for drug benefits, and employees $100 a year in plan premium payments, read the report.
Whether Ottawa can afford such a program, if it will introduce new taxes to recover the costs, or whether it expects the provinces to pick up part of the tab, are some of the questions expected to be addressed by the Trudeau government in Thursday’s federal throne speech.
It’s routine for premiers to push Ottawa to increase federal health transfers, said Steve Morgan, a professor of health policy at the University of B.C. who has studied national pharmacare for 25 years. But what’s different now is that politicians from the federal Liberals and NDP, which control the balance of power in Ottawa, promised action on national pharmacare in their election platforms.
“You’ve got a majority of a parliamentarians in Ottawa now who were elected as members of parties that had this kind of promise in their platforms, and that would suggest the provinces can expect significant funding,” said Morgan.
“But it will be funding with strings. Provinces just like more money without accountability. And pharmacare is a very significant offer of funding, but there will be very clear accountability. That’s exactly how we got Canadian medicare.”
A national program would also save between $5 billion to $7 billion annually in drug costs because Canada could exercise its bulk purchasing power and get better deals from manufacturers, said Morgan.
Politicians can expect pushback from private insurance companies and global pharmaceutical firms that stand to see profits reduced by a national Canadian program, he said.
“British Columbians should care about this because our system of financing medicine is an uncoordinated patchwork of public and private drug plans that results in many people falling through the gaps,” said Morgan. “It also results in everybody paying higher costs than they need to pay because truly universal systems of prescription drug coverage … those systems have enormous purchasing power on the world market for pharmaceuticals and may dramatically lower prices.”