It’s not often that the issues relevant to benefits plans emerge as an area of focus in the political realm. But with votes up for grabs and politicians eager to find any way to harness them, it appears issues of drugs and dental care are moving up the political agenda.
In the federal arena, the government signalled in its recent budget that a national pharmacare program is in the works. It even enticed a high-profile player in the area, former Ontario health minister Eric Hoskins, to leave provincial politics to head up an advisory council on national pharmacare.
Hoskins, of course, had been busy implementing the Ontario government’s newly launched pharmacare program for youth under age 25. But just after he left the provincial role, the Ontario Liberals expanded on their zeal for pharmacare by promising to expand the youth program, called OHIP+, to include seniors by mid-2019. While the province already covers prescription drugs for seniors, the proposed change would eliminate deductibles and copayments for them. In their 2018 budget, the Liberals also promised a program offering limited drug and dental coverage for people without workplace benefits or access to another government plan.
Also weighing in on the issues recently was the Ontario New Democratic Party, which is promising a pharmacare program that would cover everyone. Particularly notable is its promise to boost public dental coverage. Under the NDP’s proposal, all Ontarians would have coverage, with working people and their families covered through their employer and a public plan to cover everyone else. For all employed people — including part-time workers, contractors, freelancers and people working in non-traditional settings — a publicly administered program would create a minimum standard for dental plans that would apply to all employers. Businesses could meet the standard by participating in the program or choosing a comparable workplace benefits plan.
Elsewhere in Canada, the British Columbia government recently eliminated or reduced drug deductibles for low-income earners. And again on the federal front, the NDP has long touted the idea of a national pharmacare program.
It all adds up to a dizzying array of activity, particularly on the drug issue. Those who have long advocated for better public drug programs and dental care, of course, will likely be happy to see all of the developments. But is it good public policy?
There are good reasons to question some of the merits of the policy proposals and, particularly, the motivations. When it comes to the Ontario issues, the promises come just as the political parties gear up for a heated provincial election. For the Ontario Liberals, the challenges are daunting as they face poor polling numbers and very low popularity ratings for Premier Kathleen Wynne. So despite having eliminated the provincial deficit after years of efforts to steadily reduce the shortfall, the Liberals are now turning the spending taps back on. The proposals may have merit, but it all looks like an attempt to buy people’s votes by promising a host of new programs and funding. Surely, the Liberals have had 15 years to deal with drug benefits and implement other popular changes, such as a higher minimum wage.
To its credit, the Ontario NDP is at least addressing an often-ignored issue: dental care. Dental care has been a bit of a sleeper issue for the benefits industry and, in the case of the NDP’s proposal, much of the focus is on covering those without employer benefits, including workers in precarious job situations. On the flip side, the proposal does represent a significant new cost for a government already burdened by a large debt. And there are many questions about exactly how the program would work.
On the federal front, the government is at least taking time to study the pharmacare issue through Hoskins’ advisory council. Of course, the federal Liberals’ sudden zeal for pharmacare does conveniently come as they prepare for an election in 2019. And adding to the confusion about the issue were statements by Finance Minister Bill Morneau following the budget in which he suggested the pharmacare program that emerges would likely preserve much of the existing private system. That’s a reasonable suggestion to make, but the comments hinted that the government may not have fully fleshed out its framework for the issue and that, as with the Ontario situation, politics are a key motivation.
That isn’t, by itself, surprising or a bad thing. But ideally, governments would be considering the issues deliberately and from the perspective of the best public policy, rather than election cycles. In the meantime, the upcoming Ontario election will be a significant test of the extent to which issues of drug and dental benefits can be drivers of voter preferences.
Glenn Kauth is the editor of Benefits Canada.