
Canada stands out as the only nation with a universal healthcare system that lacks comprehensive coverage for prescription drugs, except for hospital patients. Shockingly, 7.5 million Canadians find themselves with inadequate or no prescription drug coverage. Recent surveys indicate an overwhelming 93 percent support a national pharmacare program with equal access for all.
Because of the absence of comprehensive coverage, Canadians have been cutting corners because they cannot afford often life-saving drugs. They split pills to make them last longer or simply don’t fill a prescription because they can’t afford it.
That is why there was a sigh of relief when the minority Liberal government announced last Thursday that legislation to create a national public pharmacare program will soon be tabled. The creation of such a program was in fulfilment (partial) of a deal the Liberals signed with the opposition New Democratic Party (NDP) as a condition for their support to keep the Liberals in power.
While what has been announced can hardly be interpreted as a comprehensive pharmacare program, it does begin what NDP leader Jagmeet Singh believes will blossom into a full-fledged program in the same way universal health care came about. For the moment, the program will cover just two pressing health and wellness needs. According to Singh, the program will cover “a wide class of contraceptives including [intrauterine devices], prescription contraceptives and the emergency contraception that people take.” In addition, “a wide range of insulin and other medication” will be covered for diabetics.
While the old saying about being grateful for small mercies certainly applies here, the announcement does not deserve a standing ovation since a universal drug insurance plan was first recommended by the Royal Commission on Health Services way back in 1964. The recommendation was repeated by a Jean Chrétien-led National Health Forum in 1997. So, this is merely scratching the surface of what was recommended 60 ago.
Still, we agree with former Ontario health minister Eric Hoskins, now chair of a federal government advisory council with a goal of creating a national pharmacare plan, that initiating this process is essential, and beginning with contraceptives and diabetes medications is a prudent approach.
There is enough evidence to show that offering free contraception in Canada is cost-effective and promotes reproductive health rights considering that only 65 percent of at-risk Canadian women consistently use contraception. Furthermore, 24 percent of sexually active females not wanting to conceive did not use contraception during their last encounter. Add to this that about 35 percent of pregnancies in Canada are unintended leading to high rates of child abandonment (and all what that implies) and induced abortions. Almost every time women make these decisions because they cannot afford the high cost of contraception. Needless to say, those that are most affected are youth, lower-income individuals, Blacks, other racialized minorities, and recent immigrants.
The situation is the same regarding diabetes. And it’s no exaggeration to say that the need to address the diabetes problem is more urgent because the disease is a proven killer. Yet, since insulin arrived on the scene and transformed diabetes from fatal to manageable with medication, exercise, and diet, the disease remains a prevalent issue, affecting 1 in 10 Canadians, rising to 3 in 10 when undiagnosed cases and those at high risk are included. Furthermore, visible minorities, especially Black Canadians, are nearly seven times more likely to develop type 1 or 2 diabetes than White Canadians.
Even the well-off and those who view taxation as a sin cannot deny this obvious social need, and neither can we.
It therefore behoves us all to pressure the Liberal government to keep its word and enact legislation this year to provide the funds to cover all the needs of a proper contraceptive program and all the medications to make diabetes a manageable disease rather than a life sentence.