Up until recently, federal Health Minister Mark Holland was circumspect about his government’s pharmacare legislation and what it would mean for those with employer-provided drug plans. Critics warned that the legislation’s commitment to single-payer insurance put private plans at risk. The minister insisted that it didn’t.
This week, he clarified his message. In a letter to the Senate which is now considering the legislation, he confirmed that “under [the federal pharmacare] program, the cost of these medications will be paid for and administered through the public plan, rather than through a mix of public and private payers.”
The minister’s comments are a big deal because although the legislation only covers diabetes medication and contraception in the short term, it envisions covering a wider range of drugs over time. The consequence therefore could be that private plans are effectively outlawed altogether.
Yet, like lunch, there is no such thing as free insulin. Almost every government policy—regardless of the denials of the government of the day (and this is true across the political spectrum)—involves tradeoffs. And in the case of single-payer pharmacare, there’s far too much diversity and unique forms of coverage, and these coverages are far too embedded in existing, negotiated relationships, for all Canadians to come off better. Unless the government is willing to institute a public insurance model that’s as gold-plated as that held by its own employees at the Palais de Congress, there are groups within Canada that will necessarily lose.
At this moment, drug coverage is one of the few areas in Canadian health-care policy that actually works. A supermajority of Canadians (67 percent) have drug insurance coverage through their work, associations, or private care, and another one in five are covered by existing government plans. While there’s no doubt that the government can play a role for the minority of Canadians who both have no coverage and can’t afford to pay out of pocket, the one-size-fits-all approach outlined by Holland is a poor solution.
Particularly for workers under a union contract. They’ll be among the biggest losers.
