By Bacchus Barua
Economist
The Fraser Institute
With fears related to COVID-19 and the economy running high, a new poll
by the Angus Reid Institute reveals near universal support for some
sort of public pharmacare plan. However, it also inadvertently revealed
that, despite such support, most Canadians don’t actually need it.
Conducted in partnership with a list of experts who
have long advocated for a national publicly-funded plan, the survey
reports that 86 per cent of respondents support “the concept of having
pharmacare” in Canada.
But
the same survey also reports that 72 per cent have “most or all of the
cost of their prescriptions covered by insurance and government
support.”
A much lower (though concerning) 23 per cent of respondents report having difficulty paying for their prescriptions.
So
on one hand, a clear majority of Canadians seem to support a universal
pharmacare program, while on the other only a minority (albeit a sizable
one) seem to actually need it.
One reason for this relative incongruence may have to do with perception. For example, many Canadians may be unaware that provincial plans already help low-income families pay for prescription medications.
Every
province offers drug coverage to social assistance recipients at low or
no cost. And provincial governments also administer a variety of social
programs to cover drug costs for the disabled and those with chronic
conditions such as multiple sclerosis, cystic fibrosis and HIV.
It’s
therefore worth asking whether the 44 per cent of Canadians who,
according to the survey, are concerned about their ability to afford
prescription drugs down the road are actually aware of such programs.
And if they’re not, perhaps a first (and much less expensive step) would
be for governments to do a better job of educating residents about the
existence of such programs.
Another
reason may be envy. Canadians have been repeatedly told that Canada is
the only industrialized universal health-care country that doesn’t
provide universal coverage for prescription drugs.
What
goes unsaid is that the other countries provide universal health care
in a markedly differently way than Canada. While countries such Australia and the United Kingdom provide coverage for pharmaceuticals through government-run programs, others (such as Switzerland and the Netherlands)
provide universal access for all health-care services – including
pharmaceuticals – through private insurers. And all four countries allow
a private-sector role in the insurance and delivery of medical
services.
It’s
clear that many Canadians still fall through the cracks. The survey
contains useful information on who these Canadians may be – those
earning less than $25,000 a year (44 per cent) and visible minorities
(36 per cent).
Advocates
for a national pharmacare program should consider whether a new and
expensive public program that covers a small list of essential drugs for
all Canadians (including millionaires, for example) is actually the
most efficient way to assist groups who need it most.
And
there’s the question of whether issues of affordability actually have
more to do with the types of drugs covered rather than whether
individuals are insured. For example, if a breakthrough drug isn’t
listed for coverage (whether on a private or public plan), individuals
will likely have difficulty paying for it.
Given that private insurers usually offer coverage for a greater number
of drugs than government plans, it’s unlikely that expanding a
government plan to include the general population will alleviate these
type of cost-related issues.
While
many may interpret the results of this poll as a green light for a
national publicly-funded pharmacare plan, they should actually make
people (including policy-makers) pause and reflect on the information.
Rather
than jump the gun and implement a broad plan that covers every Canadian
(at great cost) for drugs they can already afford, advocates should
seek to identify the 23 per cent of Canadians who fall through the
cracks and connect them with (and improve on) existing programs.
Bacchus Barua is an economist at the Fraser Institute.
