Pharmacare agreement – a historic step forward for Canada

Canadians should celebrate a new chapter for our country with a historic agreement on a pharmacare program, say members of the Registered Nurses’ Association of Ontario (RNAO).

“We are so pleased that NDP leader Jagmeet Singh remained steadfast and held true to his party’s values and we thank Prime Minister Justin Trudeau for living up to his promise to reach a deal on pharmacare,” says Dr. Claudette Holloway, RNAO’s president, adding the legislation enshrines a single-payer system, a concept RNAO has long urged is needed.

Bill C-64 sets out a path to universal coverage, starting with specific prescription medications and related products for contraception and diabetes, and a framework that paves the way for a comprehensive program that could cover all essential medications for all Canadians from coast to coast to coast.

“This legislation is significant because it brings us one step closer to a comprehensive universal pharmacare program. When fully realized, it will advance equity and fairness in our health system. For too long, many Canadians have had to choose between filling prescriptions and paying for food or shelter. Some skip doses or cut pills in half because they lack coverage,” asserts Holloway.

Canadians without insurance are forced to pay out of pocket. And, are more likely to end up in emergency departments and admitted to hospital because of health problems arising from the inability to afford their prescribed medications. “These are the unintended consequences when you have a universal health-care system without a national pharmacare system,” says Holloway adding “the agreement lays the groundwork to address the patchwork of inequity that exists in this country.”   

The need for a comprehensive universal pharmacare program is backed up by statistics that illustrate the extent to which many Canadians are struggling with their health needs. In 2021, 21 per cent of the country’s population reported not having insurance to cover the cost of prescription medications. Alarmingly, those percentages are even higher among immigrants and racialized groups.

Over the years, drug costs have become a big driver of overall health expenditures. RNAO says critics who say implementing a national pharmacare program is expensive should examine the books of the Parliamentary Budget Officer, who pegged the estimated total cost savings on drug expenditures of $1.4 billion in 2024-2025 and $2.2 billion in 2027-2028. RNAO’s CEO Dr. Doris Grinspun says in the face of rising drug costs, the country can’t afford not to act.

Grinspun also praised the work of former Ontario health minister Dr. Eric Hoskins who was appointed by Trudeau in 2018 to chair an advisory council on the implementation of a pharmacare program. “You laid the groundwork that resulted in this legislation. Nurses thank you for your vision and commitment to realize better access to prescriptions, improved health outcomes and your desire to complete ‘the unfinished business of Medicare.’”

And, while the legislation enshrines the concept of a single-payer system, it's crucial to recognize that this is not yet a done deal – the cooperation of provinces and territories is required. Much depends on the actions of the federal government and the agreements it reaches with the provinces. During its annual Queen’s Park Day on Thursday, Grinspun, Holloway and President-Elect NP Lhamo Dolkar met with Premier Ford and urged him to be the first premier to sign onto the pharmacare agreement. “At the end of the day, we need to build health and social programs in this country rather than cutting any. This kind of progressive action will help ensure our population enjoys better health outcomes,” says Grinspun, adding “Premier Ford can start us on this road, and we are eager to help.”

Continued monitoring will also be needed to ensure that politicians don't succumb to pressures from insurance companies, pharma and other corporate interests. The successful implementation of pharmacare – and of future coverage beyond diabetes treatment and contraception – will hinge on continued advocacy and oversight to safeguard against any potential backpedaling or watering down of the proposed program. RNAO will remain vigilant, and calls on health professionals and the public to monitor and prod politicians so that the vision of a comprehensive universal – single-payer – pharmacare program, benefiting all Canadians, becomes a reality.

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 system, and influenced decisions that affect nurses and the public we serve. For more information about RNAO, visit RNAO.ca or follow us on X (formerly Twitter), Facebook and Instagram.

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