Health Minister Mark Holland has tabled the legislation to create the framework for a national single-payer pharmacare program Thursday afternoon.
This legislation is a key piece of the supply and confidence agreement that sees the NDP support the Liberals on confidence votes in exchange for advancing key priorities including pharmacare.
In addition to a framework, the legislation includes coverage for contraception and diabetes medication, plus devices like insulin pumps. In order for this to be implemented, Ottawa will need to first negotiate deals with the provinces and territories to include these provisions in their medical systems.
“This is a historic day for Canadians,” said NDP health critic and lead on pharmacare negotiations Don Davies Thursday morning.
“This is the culmination of a dream that began when Tommy Douglass invented health care in Saskatchewan in the 1940s. It’s the culmination of decades of hard work by New Democrats, progressive Canadians and allied organizations.”
“This is about health equity. It’s also about affordability, about making sure somebody who’s asking, can I afford the contraception that I need to be able to control my future or do I pay for rent or food? In a time of global inflation and challenge, it’s about giving women control of their own bodies,” Holland said on contraception coverage.
On diabetes coverage, Holland said that if people aren’t able to afford treatment medication like insulin they are left at greater risk of more severe health outcomes like stroke, amputation, blindness or kidney failure.
“That’s just a matter of social justice. Imagine the cost involved in that to our health system. And I don’t think that’s the kind of country we want to have. And that’s fundamentally about what we’re talking about today,” Holland said.
The minister said that there likely won’t be money for the program in the 2024/25 budget. He hopes there will be some expenditure this year assuming agreements are reached with the provinces to cover diabetes medication and contraception.
Holland said while he doesn’t have a firm figure, he estimates $1.5 billion for the program as is but it’s a moving target due to the need to negotiate 13 deals with the provinces and territories.
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“They’re typically more expensive and they’re not necessarily the first line of treatment. But with diabetes patients, we certainly know that they’re complicated and very individualized. So having a larger arsenal of tools, I think, in the prescribers pockets and for pharmacists will be really helpful,” she said.
Walker adds that she will be curious to see how the negotiations with the provinces go, as there is currently no way for pharmacists to directly bill the federal government for publicly covered drugs.
The original deadline to introduce legislation was the end of 2023, but it was pushed to the end of February. In exchange for the extension, the NDP pushed for coverage of contraception, like birth control and emergency contraception, and diabetes medication to be included in the future implementation of pharmacare.
“We have taken that first big step of national, universal pharmacare today,” NDP Leader Jagmeet Singh said.
The NDP first said that they reached a deal for single payer pharmacare framework last Friday, and the government confirmed it.
On Sunday, Alberta Health Minister Adriana LaGrange said that her province planned to opt-out of a national program, instead looking to get their per capita share of funding in cash.
Quebec also intends to pull out of a national program because they already have a provincial drug plan.
Singh said that he is open to Quebec having it’s own plan for pharmacare as long as there are not gaps between the two programs.
Meanwhile, he calls on Alberta and the other provinces to negotiate with Ottawa once legislation is passed to get deals in place for contraception and diabetes coverage.
“There are going to be a number of provinces that are very excited to jump into this, but this is very similar to how things started with our healthcare system. Initially many said no, they said no off the top, and then they saw many people getting free healthcare in their provinces,” Singh said.
British Columbia already has universal coverage for contraception. Manitoba’s government is also working on implementing coverage for contraception, as promised in their election campaign.
During an unrelated press conference, reporters tried to ask Conservative Leader Pierre Poilievre if he would dismantle pharmacare if the Tories form government. Poilievre did not specifically address the question, just saying “Justin Trudeau is not worth the cost” before walking off.
According to officials, costing for how much the program won’t be in place until deals are negotiated with the provinces and territories.
In his remarks, Holland said the focus shouldn’t be on how much the program ultimately costs, but what it can save the health system by ensuring people receive timely treatment and medication.
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