A majority of Canadians, health-care providers, labour organizations and employers agree a national single-payer system is an idea whose time has come, according to a report by the Broadbent Institute.
Canada has attempted to bring in a national pharmacare plan nine times in the last 73 years — in 1945, 1947, 1962, 1964, 1966, 1970, 1997, 2002, and 2004. Growing income inequality, decreasing access to employer-sponsored health plans and the rising cost of private insurance are all reminders that delaying a national pharmacare plan any longer will lead to poorer health outcomes for Canadians, noted the report.
Currently, about one fourth of all prescription drug costs are covered by private insurance, according to the report, which noted much of this is workplace plans paid for by employers and employees. These plans have varying degrees of coverage, including which drugs are covered and the level of co-payment.
While there’s general support for a national single-payer program, reaching a consensus on the details of policy architecture and the role of the federal government has been difficult, noted the report.
It outlines two possible ways to achieve single-payer pharmacare in Canada. One is through 13 provincial or territorial programs with funding from the federal government with national standards. The second option is a federally financed, regulated and administered pharmacare program. The report noted this is constitutionally feasible because the federal government has jurisdiction over drug safety and price regulation.
The Broadbent Institute highlighted considerable advantages for the second option, noting a federal program would make it easier to establish a national drug formulary and to achieve the savings of co-ordinated drug purchasing.
The report also noted employers supporting workplace drug plans incur huge financial costs and face significant administrative costs, which places them at a competitive disadvantage with employers that don’t provide this coverage. Moving prescription drug costs from employers and workers to a national, universal and single-payer plan would help business investment and would add to the competitive advantage of Canadian-based enterprises, according to the report.