Sean Speer: Walking back the Liberals’ pharmacare plans would be a major broken promise—and the right thing for Carney to do

There was good reason to assume that a Carney government would continue to implement the pharmacare legislation, including signing more deals with the provinces and preparing to expand pharmacare beyond contraceptives and diabetes medication following the advisory panel’s report. During the federal election campaign, not only did Carney pledge to “protect pharmacare,” but the Liberal Party platform specifically referenced its benefits for “the 3.7 million Canadians” living with diabetes, which accounts for Canadians in every province rather than just those provinces that reached deals prior to the election. The clear implication was that Carney and the Liberals intended to implement pharmacare as envisioned in the legislation. Yet recent reports now indicate that the Carney government doesn’t plan to reach additional deals with the outstanding provinces. A spokesperson from his office has said that the prime minister’s only promise wasn’t to “cut or abolish any of the existing deals.” Carney’s halt to new provincial agreements ostensibly puts at risk the plans for a full pharmacare. If he won’t provide coverage for contraceptives and diabetes medication for the roughly 80 percent of Canadians outside of those provinces currently with deals, it seems highly implausible that he’s going to proceed with pharmacare more broadly. It would amount to a major broken promise—particularly for the progressive wing of the Liberal coalition. Carney will rightly be criticized for being disingenuous during the campaign. His warnings that Pierre Poilievre and the Conservatives would cut pharmacare are rather cynical in hindsight. Yet, setting aside the potential political fallout, this would be a good decision. Pharmacare was always a flawed idea that underestimated the benefits of the current system and the costs of replacing it with government-run insurance. In a world of fiscal tradeoffs, spending billions of dollars to provide most Canadians with inferior drug coverage would have been a poor use of public dollars. It also raises hard questions about fiscal credibility. Notwithstanding some questionable accounting assumptions, the Carney government has committed to balancing the federal budget in just three years. It’s virtually impossible to square the circle between implementing full public drug insurance and eliminating the deficit. If the Trudeau era was marked by a disregard for fiscal constraints or opportunity costs, pharmacare was emblematic of that mindset. In that sense, pharmacare now stands as an early and important test for the Carney government. Breaking its promise may come at a political cost, but it’s ultimately worth it to show that it’s prepared to make hard choices. Walking away from pharmacare isn’t a retreat from compassion. It’s a necessary step toward reversing the ideological drift of its predecessor and restoring greater rigour and responsibility to federal budgeting. In a time of scarce resources and mounting pressures, the government needs to show that it’s prepared to say no—even to its own ideas.