Today's discussion:

It’s time to stop believing in policy fairy tales

In a big-picture sense, Canada's public policy is in a very worrying stat. Productivity is in a tailspin. A greater share of GDP is spent on here-today-gone-tomorrow current spending by governments and households than in decades. Tax policy is uncompetitive.

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Alice

Pharmacare is a bad idea. It will drive private insurance businesses out, and reduce the variety of drugs available. It will stifle innovation in pharmaceuticals and bio tech in Canada. All this for the 2.8% of Canadians (or so I read in one article) that have no type of coverage.

I choose not to have coverage. I retired early, with a decent pension, my husband still works. Our dental and drug needs are minimal. It would actually cost us more to pay for insurance than to pay as we go. My best friend is in the same situation, low needs, so no need to pay for insurance.

Instead of a full coverage policy on pharmacare, I would prefer that the provinces take this up and do the coverage that their constituents want and need.

If Trudeau and Singh want to be provincial politicians, they should run as such. Not be federal politicians trampling all over the constitution they are sworn to uphold. Have they even read it?

8th March 2024 at 8:43 am
Michael F

I don’t need expensive medications either but don’t believe an old friend should have to pay over $1000 a month for his wife’s arthritis meds which are only partially covered by his benefits. And I don’t think the less fortunate should have to make difficult choices when they can’t afford the necessary drugs that will help keep them out of the hospital and more expensive treatment. Why are conservatives so selfish? Insurance companies are not your friend.

8th March 2024 at 12:20 pm
Michael B

Perhaps it’s because conservatives don’t trust the current government to operate an affordable, just and effective pharmacare program.

9th March 2024 at 2:45 am
Ian MacRae

Remember universal healthcare. It began with a 50/50 share between the feds & provinces. Then Trudeau Sr. dropped payment-only for block grants. Those have shrunk to the current 30/70 share. The block grants have led to managed (wait listed) with admin costs rising to 30%.

On top, claimants will have to pay the bill in full up front then submit a reimbursement claim to a government that takes 12 -18 months to renew a passport.

The single drug formulary will result in fewer drugs being avalable for Canadians. New drugs will not be offered to Canada as the proposed price will be too small.

Pierre Polliiviere will have a challenge t unwind this disaster. Perhaps that is what Trudeau Jr. wants to achieve.

8th March 2024 at 9:34 am
RJKWells

Anyone who seriously believes that Ottawa can deliver pharmaceutical products and services more effectively than existing private and provincial programs should spend some time at a First Nations community. Go see firsthand how well they have done in the management of core services – health & dental care, water & wastewater treatment, housing, roads, education, police & fire protection – that Canadians elsewhere take for granted.

If you’re still not persuaded, might I refer you to a certain app the Feds said would only cost us $80,000? All this from a government that cannot even manage the procurement of military hardware, let alone national defense.

They tell Canadians that their intentions are noble, yet their track record on many issues speaks for itself.

8th March 2024 at 10:08 am
Ryan

“Believing in that outcome goes against my training as an economist taught not to trust bloated government monopolies.”

A bit beside the point, and I know the author is being facetious here, but I think this is also telling of a larger problem in economics as a field. Economics is, by far, the most ideologically driven and least scientifically oriented field in the social sciences and humanities (“market = good; government = bad”), and this homogenous way of thinking (and teaching future economists to think) clouds the ability to think critically and holistically about serious economic issues. To be clear: there is absolutely merit in economic analysis (obviously), and there are some great economists currently working in the field from a variety of ideological orientations (e.g., Trevor Tombe, Mark Blyth, Richard Wolff; Joyce Jacobsen, etc.), it’s just that the field as a whole has become so ideological, detached from real life, and allergic to new ways of thinking that I’m not sure how it can really regain its credibility barring some kind of intellectual (or even methodological) revolution.

8th March 2024 at 8:42 am
Petet

Now do Political Science.

8th March 2024 at 9:23 am
Jaak

This piece is clearly from the pen of a benefactor of uber adequate emloyer-provided benefits and a likely adequate post-retirement pension. This sounds elitist and dismissive to someone living on CPP/OAS and having experienced 4 types of cancer. Very disappointing. I’m glad that I don’t bank at Scotiabank.

8th March 2024 at 10:30 am
Gord Edwards

I’ve heard frequently that lack of access to medication results in conditions worsening and increased costs to the healthcare system. No doubt this is true. But the claim is that Pharmacare expenditures will be offset by savings in the broader healthcare system.

When such claims are made I don’t see anyone questioning the math. I’ve heard different numbers for how many are uninsured. But a Stats Canada study in 2022 states that 79% of Canadians have some type of access to prescription drug insurance, although the level of coverage can vary widely across benefit plans. It goes on to state that 9% reported not adhering to their prescription medication because of cost.

It seems that 91% of Canadians are able to access required medications under the existing systems in place. Even if one picks a more pessimistic number (21% say) who are somewhat impacted in their ability to access required medication this does mean that they will never need to access the medical system if they had lower cost access to medication. Medication isn’t magic.

Pharmacare would likely result in an incremental savings to the broader health system. But I have trouble believing it would substantially offset the costs let alone be cost neutral. I’d counter that lack of access to primary care – getting conditions diagnosed and prescriptions written – has a down stream effect that eclipses any impact on peoples’ health or health care costs that Pharmacare proponents claim. We need to spend tax dollars where it will get the most value for the population.

8th March 2024 at 9:50 am
Don Morris

Yes,it IS time top stop believing in fairy tales and one of the most often repeated tales is the “revenue neutral” new tax.
Common sense tells you a government wouldn’t implement a tax that didn’t make them a profit, but the media loves to expound on the government’s behalf about rebates and revenue neutrality, both mythical.
Pharmacare is just another in a long line of socialist fantasies that looks good in a photo -op and in reality delivers little or nothing.
Can any intrepid reporter name a government program or project that was delivered on time, on budget, and lived up to the pre-launch rhetoric? There has never been such an animal and given the “expertise” of the people involved,there never will be.
Next up: the Guaranteed Universal Income.

8th March 2024 at 11:30 am
A. Chezzi

Why do Con have such an aversion to plans such as pharmacare which will benefit Canadians? Why do Con have such an aversion to sharing the wealth of this country? Why do Con have such an aversion to innovative programs which will carry Canada into a good living? With the exception of the railroad, none of the innovative programs which pushed Canada forward were initiated by Con. If Con were really about affordability, they would get involved in such programs. Instead of gripping and complaining, Con need to work with others to create a better life for Canadians.

8th March 2024 at 9:15 am
Kim

Why do socialists think someone else should pay for their every little desire?

8th March 2024 at 10:24 am
Michael F

Access to prescription drugs is a desire? For many they are essential. Why are conservatives so selfish?

8th March 2024 at 10:38 am
RJKWells

The better question would be why is Ottawa so intent on taking more of what little wealth we have remaining from us, adding to the huge sum they already take? Their Pharmacare Plan is not at all innovative. It is an attempt by the Feds to usurp what we already have in place – provincial and private programs that work quite well. We don’t need their help.

Our Constitution sets out the responsibilities of federal and provincial governments. This latest foray by Ottawa is illustrative of their trying to stray into areas they have no business being in, all the while mismanaging the important responsibilities to which they must pay greater attention.

If they are that intent on wanting to engage in the delivery of these services, federal politicians should step down and go run provincially.

8th March 2024 at 10:32 am
Michael F

What an absolutely terrible article. I will move my mortgage away from Scotia as soon as possible. What next? Will conservatives start talking about ridiculous ‘death panels’ like republicans did during the healthcare reform debates in the US in the Obamacare era? Funny thing he brought up the comparison of using public versus private liquor stores. Here in BC the BCL store I prefer has a much better selection of wine at better prices than the private shop in my neighbourhood. Why are conservatives so obsessed with making sure the less fortunate get nothing while letting the filthy rich commit what amounts to crimes against society?

8th March 2024 at 11:52 am
RJKWells

The questions you pose about conservatives have a sort of amusing quality, Michael. They’re kind of like if someone were to ask you why you hate the poor, because that’s who you’ll end up disappointing with promises you can never hope to achieve – champagne taste on a beer drinker’s wallet, and all. That’s the real crime against society.

The ‘less fortunate’ you refer to are already well looked after by the provinces. Ottawa’s continual attempt to shoehorn their way into what are provincial responsibilities will impact the very category you claim to support. Whether it’s pharmaceuticals, housing, or other support services, these are programs best provided and managed by the governments closest to their constituents. A hint for you: it ain’t Ottawa.

Ottawa ran out of money long ago. With the debt load they’ve saddled onto the backs of Canadians, printing more money will only add to the inflationary pressures they’ve already put on us and diminish our competitiveness. The ‘less fortune’ you claim to support will be the ones most impacted by the problems Ottawa has created in its neverending search for relevance. Introducing another unnecessary, unneeded program doesn’t cut it.

If it ain’t broke, Michael, the Feds can stop thinking they must fix it.

8th March 2024 at 5:07 pm
Michael F

Isn’t that the the job if government is? To protect and make the lives of the citizenry better? How many billions does the CRA miss yearly with offshore accounts and loopholes for corporations and the mega rich?

8th March 2024 at 9:20 pm
Cathy

The comment, “ Now obviously when it comes to truly essential drugs…” shows lack of understanding of prescribing and how health relates to productivity. Of employees surveyed, 47% indicate that chronic illness either made their job difficult or caused them to miss work.
Phase 1 of the new Pharmacare program covers diabetes meds for people without coverage. Many with diabetes cut corners, unable to comply with their medical plan because they cannot afford the cost. Because of this some will die or end up with other hugely expensive chronic conditions or needing surgery, becoming more dependent on others for care. Anyone else think double amputation surgery is cheaper than covering the cost of some insulin as prevention?

You state that there isn’t a choice for meds like chemo, but I can tell you that some provinces don’t agree. In Ontario, chemo for cancer treatment is not covered when not administered in hospital. The focus and growing need for oral over IV administered chemotherapy, keeps people more independent, sometimes able to work and away from more expensive in-hospital therapeutics.
Prescription coverage is a significant issue with significant inequities across the country.

8th March 2024 at 9:27 am
Lauraine

This article is definitely written by a dried out banker. The pharmacare proposal is an essential part to a preventative approach to health care. It should not have anything to do with the cons mentality of, who deserves it and who does not.

8th March 2024 at 1:00 pm
Shirley Blair

The consequence of the faustian bargain minority Liberals signed with the NDP, is that entitlements by design, will hamstring future governments grappling with debt, deficits and priorities. It’s hard to imagine a leader principled yet popular enough to dampen baked in expectations.

8th March 2024 at 12:03 pm
mike

Our small business in Calgary has three owners – directors within the family. Our extra private insurance costs $5800 / year. Just dropped it as the store business can no longer afford the expense. What does that have to do with Government run drug pushers?. Other than it is more cost effective to be business self insured and pay a couple hundred a month for required prescriptions. Our business does not waste money and we run extremely lean. Can the Feds say the same thing. How many more people will they have to hire ( also federal liberal voters as they will want to keep there jobs. ) Do you really want another federal employee union running a program for Canadians. We can all make our own choices based on what we think our small business and family requires. Why something else that the Federals liberals want to control and tell us what we can or can’t do… Reduce all governments – don’t continue to have a false employment numbers based on federally hiring. Either the people you hire make you money or cost you money. Blotted federal employees do not make money for the government.

9th March 2024 at 9:52 am
Dennis

I could see a co-pay system, income indexed and administered by a Canadian company that is already in this business. The Dental plan apparently will be run like this. If I was in Government ,I would start by seeing what other Western Countries do.

8th March 2024 at 6:06 pm
Michael Bath

Québec’s pharmacare covers ALL those not covered by a private or employment medical plan. Some medications are not included and if a generic is available you have to accept it.
The annual cost depends on income and has a maximum of $731 added to the tax bill. Children under 18 are exempt as are recognised post secondary students to age 25. In addition to the surtax it is co-pay – has deductibles – with a maximum of $99.65, which the poorest cannot afford.
“…Quebec has a highly fragmented system that results in the highest per capita costs among all provinces,” says Keith Newman, a member of the board of the Canadian Health Coalition.”
What the RAMQ itself, the bureaucracy, costs taxpayers is anyone’s guess.

8th March 2024 at 11:23 am
Xiaoming Guo

The system is not working anymore. Most executions of policies cannot reach the expected results without creating worse problems. The rich have lawyers and accountants to take advantage of every policy so the rich get richer. Even if the policy is claimed for the poor, in the end, the gap between the rich and the poor widens. The whole system is corrupt.

8th March 2024 at 9:44 am