ANALYSIS: Pharmacare Hopes Shadowed by Track Record of Other Universal Care Plans

NDP Leader Jagmeet Singh meets with Prime Minister Justin Trudeau on Parliament Hill in Ottawa on Nov. 14, 2019. The Canadian Press/Sean Kilpatrick

NDP Leader Jagmeet Singh says the national pharmacare legislation his party negotiated with the Liberal government is a development similar to the advent of universal health care in the 1960s. But pharmacare hopes are tempered by the current dire state of Canada’s health care, as well as ballooning costs of national programs.

It’s not the right time to roll out a new program, some provinces say. Alberta and Quebec have said they will opt out, but they still expect their share of the money to help their health-care systems as needed.

The bumpy rollout of two other big-ticket federal programs—$10/day child care and dental care—also doesn’t bode well for pharmacare.

About a year after the launch of the national child-care program, Canada’s child care is said to be in crisis. Daycare spots are drying up and waitlists are bursting. Statistics Canada says fewer children are in day care. And the stated purpose of the program—to get women back to work—hasn’t panned out, according to the Fraser Institute.

Alberta daycares began rolling closures on Jan. 30 to protest what they call “inflexible policies” and delayed federal payments. The program is making it difficult for daycares to operate, according to the Association of Alberta Childcare Entrepreneurs.

Yet Mr. Singh says the fast rollout of the child-care program is what gives him hope pharmacare will soon reach many Canadians.

“We look at the child-care funding and the deals struck with provinces as an example of how quickly we can move,” he told CTV’s Question Period on Feb. 25.

The NDP and Liberals announced on Feb. 23 that they had reached an agreement on the pharmacare legislation. It was a key demand by the NDP in its confidence-and-supply arrangement with the Liberals, which has the NDP propping up the minority Liberal government in exchange for certain policies.

For now, the pharmacare plan will only provide Canadians with birth control and diabetes medication free of charge. Mr. Singh said his party’s push for broader coverage is an “ongoing battle.”

The federal dental care plan that recently began rolling out, which was also part of the NDP-Liberal arrangement, has ballooned in cost. Ottawa initially allocated $6 billion over five years for the program, but that more than doubled to $13 billion in the 2023 budget.

The dental program has met with delays as well. It was due to be fully implemented by the end of 2024, but registration for most adults between the ages of 18 and 65 won’t start until next year. Dental providers complained in January that they were still in the dark about crucial details of the program, only months before patients could start using it.

The cost of the new pharmacare plan remains uncertain. A Parliamentary Budget Officer’s report had put it at more than $11 billion in 2024–25, and up to $13.4 billion by 2027–28. But that was before the more limited scope of birth control and diabetes medications was set.

On Feb. 25, Finance Minister Chrystia Freeland told reporters during her trip to Warsaw that the pharmacare program would not jeopardize Canada’s fiscal standing. “It is very, very important to invest in supporting Canadians and to do so in a fiscally responsible way,” she said.

Health Minister Mark Holland had said earlier in February, however, that costs are a concern.

“We can’t afford this to be a massively expensive program. We’re not in a time where the fiscal framework can absorb massive costs, and so that absolutely is a consideration,” he told reporters on Feb. 6.

Meanwhile, the feds are facing criticism for not consulting with the provinces before drafting the pharmacare plan, which is planned to be announced before March 1.

Provincial opposition to pharmacare comes not only from Alberta and Quebec. New Brunswick and Nova Scotia also remain wary, and say they want to see what the plan entails.

Mr. Singh said some resistance is inevitable, and he’s not worried. He said when universal health care was introduced, “provinces balked at the idea” as well.

The Canadian Press contributed to this report.