Canadians need equitable and universal access to pharmacare

March 7, 2019

When one million Canadians must choose between taking a needed medication or going without heat or food, the federal government must create a single payer system that covers everyone for the cost of medically necessary drugs, says the Registered Nurses’ Association of Ontario (RNAO).

That’s why a federal advisory panel must go further than interim recommendations it made Tuesday that would neither create equitable access to medication nor tame drug costs whose growth is not sustainable.

That need for bold change is not new. The chair of the federal panel, Dr. Eric Hoskins, wrote this about national pharmacare in 2014 when he was Ontario’s health minister: “Success will hinge not just on continuing the conversation, but political courage.”

It is courage that RNAO seeks in a federal government that must decide what sort of legacy it wants to leave as it approaches an election in October in a country in which one in five people either lacks sufficient drug coverage or knows someone who does.

Dr. Hoskins said Tuesday that current drug coverage is “Inadequate, unsustainable and leaves too many Canadians behind.” RNAO agrees. His panel was right to ask the government to develop a national drug formulary, invest in technology needed to roll out pharmacare and create an agency to negotiate drug prices and evaluate the effectiveness and cost-efficiency of drugs. But those changes, while necessary, aren’t sufficient.

“The federal government must ensure that all Canadians get equitable access to medication,” says RNAO president Dr. Angela Cooper Brathwaite.

The next steps, RNAO says, must be grounded in evidence that proves a public, single-payer system is more equitable and cost-effective than one that allows insurance companies to determine who is covered and who is not. That public system must:

1. Create universal coverage of medically necessary drugs via a single-payer system without user fees or other costs to Canadians.
2. Implement full coverage immediately.
3. Tame drug costs by creating a national agency to negotiate prices and resist excessive patent protection.
4. Ensure appropriate prescribing.

RNAO is confident Dr. Hoskins supports these steps. As health minister, he cited a study that found a single-payer system would save the health system as much as $11.4-billion a year.

“RNAO urges the federal government to heed Dr. Hoskins advice by creating a single-payer system that is rooted in Canadian values and saves money,” says CEO Dr. Doris Grinspun.

The Registered Nurses' Association of Ontario (RNAO) is the professional association representing registered nurses, nurse practitioners, and nursing students in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health-care system, and influenced decisions that affect nurses and the public they serve. For more information about RNAO, visit our website at or follow us on Facebook and Twitter.