Federal Minister of Health Mark Holland said “fiscal reality” may make it difficult to meet the demand by the NDP to have a pharmacare bill passed through the legislature in eight weeks.
Mr. Holland said meeting the deadline “is going to be challenging,” speaking to reporters on Oct. 17 outside the legislature.
The Parliamentary Budget Office (PBO) released a report on Oct. 12, “Cost Estimate of a Single Payer Universal Drug Plan,” which came up with a cost estimate of $11.2 billion in the first year, 2024–25. The PBO estimated the second-year cost would increase to $14.4 billion, in 2027. The PBO said it would cost the public payer more, but there would be “economy-wide savings” on drug expenses that could be $1.4 billion in 2024–25.
Under a 2022 supply-and-confidence agreement with the NDP, cabinet promised to pass a pharmacare bill by Christmas 2023 as a condition of avoiding a snap election, according to Blacklocks’ Reporter on Oct. 17.
At a recent policy convention, the NDP passed an emergency resolution calling on the party to withdraw from its agreement to work with the Liberals, if the government does not implement a universal, public pharmacare program.“There are hard conversations not only that are being had with New Democrats as the Supply And Confidence partners but with all parliamentarians, with stakeholders, about what is the art of possible here,” said Mr. Holland. “That’s complicated.”
Mr. Holland was asked if there was enough money to carry through with the plan. “It is absolutely true that we’re in a challenging fiscal environment where we have to be prudent and be aware of the fiscal reality that we’re in and that’s the basis under which we’re negotiating,” he said.
The Liberal government has not introduced a pharmacare bill, with just over one month remaining until the end of the year on the sitting calendar for the Commons.
“Getting to a decision on how we are going to navigate that space is going to be challenging,” said Mr. Holland. “I’m always willing to compromise but that compromise has to be in the best interest of the public health system and it has to be realistic against the fiscal climate that we’re in.”
He said conversations with the NDP “have been very constructive, and they certainly haven’t been punched with ultimatums and threats.”
Mr. Holland said the conversations “are an incredibly complicated issue in Pharmacare,” and that the federal government is also dealing with provinces, territories, and a “myriad of private health care providers in this space.”
“It’s going to be very difficult to navigate,” he said, adding that Canadians expect the government to “be prudent with the fiscal framework.”
A Health Canada April 27 internal memo on pharmacare said the plan could be expensive.
“Canadians are generally supportive of improving affordable access to prescription drugs but are also sensitive to cost considerations as government health-related expenses continue to grow,” said the memo.
“A May 2022 Fraser Institute poll following the federal budget found that 79 percent of Canadians support universal national pharmacare with no costs attached. Support fell by almost half to 40 percent if the program was to be financed by an increase in the GST.”
On Oct. 16, the Health minister said if the pharmacare bill was introduced sometime before the legislature wrapped up for the year, even if it didn’t proceed through final passage, it would probably appease the agreement with the NDP.
“In my mind the spirit of that agreement is just that we would have legislation introduced this session,” he said. “That’s my intention, to see us introduce legislation before the session is up.”
