I have more than once advocated the support of a national pharmacare program for Canada on this blog. It, therefore, gave me hope when the Trudeau Government recently plucked Ontario’s Health Minister, Eric Hoskins, to chair a special Federal Commission to look into the introduction of a national pharmacare program for the nation. Yesterday, Ontario Premier Kathleen Wynne said that her budget will include a blueprint to expand Ontario’s pharmacare program, known as OHIP-plus, which currently covers people up to the age of 25. She said she will move forward without the federal government for now and beginning August 1, 2019, seniors will no longer have to pay a deductible or co-payment for more than 4,400 prescription drugs.

Skeptics immediately said that both the Federal and Ontario Liberal Governments made these promises to win votes in the upcoming elections. For the highly unpopular Kathleen Wynne, in particular, this is obviously a campaign promise to woo the votes of the boomer and senior populations. She says the program will cost $575 million a year when it is fully operational in 2020-21. Drugs covered in the program include medications for cholesterol, hypertension, diabetes and asthma. Campaign promises can be broken but this latest announcement has won my vote.

Health care ranks highly among voter concerns in national polls, so it did not surprise me when Finance Minister Bill Morneau introduced the feasibility study of a national pharmacare program when he unveiled the Federal budget last month. The budget announced the creation of an advisory council, headed by Dr. Eric Hoskins, that would investigate whether public health-insurance plans could be expanded to cover prescription drugs. A national pharmacare plan had been previously proposed by the New Democratic Party (NDP).

The appointment of Dr. Hoskins, in itself, is already a step in the right direction. Dr. Hoskins, while in office as Ontario’s Health Minister, has always been a strong advocate for a national pharmacare program. In his new role, he will study the options, their costs, explain the trade-offs and determine which is the most feasible. Currently, about 26 million Canadians have private drug benefits, largely through employers. There are 102 public drug insurance programs, but that still leaves 700,000 people with no drug coverage, and an estimated 3.6 million with inadequate coverage, according to the Parliamentary Budget Officer.

A national pharmacare plan could save anywhere from $4 billion to $11 billion on the $28.5-billion prescription drug bill (from 2015). These savings could come from joint buying, more strictly regulating drug prices, more aggressive use of generics, and limiting the list of drugs that are covered. The Globe and Mail reported that while a single, national plan would theoretically save money on drug purchases, it would also mean a large-scale shifting of costs from the private sector to the public sector. The single biggest obstacle to pharmacare is the unwillingness of federal, provincial and territorial governments to absorb those costs and then increase taxes to pay the bill.

National pharmacare means insuring that every Canadian has access to necessary prescription drugs regardless of ability to pay. This philosophy has very few detractors, but there are many technical, financial and political impediments. But the appointment of Dr. Hoskins to chair the advisory council suggested the government’s seriousness about this initiative. It is well known that Dr. Hoskins, a physician himself, is a long-time proponent of an ambitious national pharmacare program. He has publicly backed that the best way of doing pharmacare is to throw out the system we currently have. The basic idea is that medically necessary drugs would be covered under the Canada Health Act and provided by provincial health plans for everybody, including those who now have private insurance. The federal government’s bulk-buying power would drive down prices for these new plans. People who felt the public coverage was inadequate could buy supplementary insurance on the private market, just like they can under medicare.

Skeptics and the Opposition are already criticizing the Trudeau government for paying lip service. But given Dr. Hoskins’s credentials and track record, and the timing of the Federal elections next year, it will only work to the Liberals’ advantage to devise a fiscally-responsible national pharmacare plan that would work.

Judging from the latest national polls, the Federal Government seems to be on the right track. A new Nanos Research poll that surveyed 1,000 Canadian adults by phone and online between March 7 and March 12, after the Liberals tabled their third federal budget on February 27, indicated that Canadians support the idea of public health insurance that covers prescription drugs. But they don’t like running deficits nor do they want new taxes to pay for the programs. But Canadians cannot have their cake and eat it too! How will the national pharmacare program be paid for otherwise? The NDPs have not come up with a good idea for financing this program either. So we should let Dr. Hoskins do his job and come up with a sensible plan. In Canada, we have had public hospital insurance since 1957, and public insurance for physicians since 1966. It is about time that we see another large-scale national health initiative on the horizon.