Today is a day that many in Ottawa have been looking forwards now for many months, partially because of the importance of the announcement coming but also partially because of its possibility to affect the Fall election. Today was the day that Dr. Eric Hoskins released the report from his Advisory Council on the Implementation of National Pharmacare. Given previous announcements from the Liberal government and their budget, many thought that today’s recommendations would mirror what was already being announced. That made the resulting recommendations come as quite a surprise, like a bolt of lightning coming out of the sky on a clear day:
Wow folks, I can honestly say that I didn’t see this coming: Dr. Hoskins is recommending that Canada implement universal, single-payer, public pharmacare. The recommendation is to do a phased in process, ending with a fully comprehensive formulary, to be in place no later than January 1, 2027. By January 1, 2022, more than half of drugs in most formularies would be covered, so while this would be a slower moving process, it would give the universal coverage. They also recommend capping any co-pays at $2 per prescription and a limit of $100 per month. That could make a huge difference in the lives of so many.
The striking thing about this report to me is how it affirms so many things that the NDP has been saying for years about the value and importance of having such a pharmacare program, things that other parties, the Liberals included, have shot down and denied. Even just as recently as this February Finance Minister Bill Morneau shot this very idea down, saying that any proposal needed to be “fiscally responsible” and that “we need a strategy to deal with the fact not everyone has access, and we need to do it in a way that’s responsible, that deals with the gaps, but doesn’t throw out the system that we currently have.” That last part is extremely instructive here, because what Dr. Hoskins seems to be proposing here is doing just that; throwing out the current system and basically saying that it’s insufficient.
We’ll see what the Liberals decide to do with these recommendations and in my opinion, that decision could make all the difference for the Fall election. The New Democrats have tried to stake out this territory on pharmacare all for themselves, clearly under the assumption that the Liberals would take a “fill the gaps” approach that wouldn’t be anywhere near as comprehensive as what is being proposed today. This policy ground was the last big place they had to stand on their own and be able to differentiate themselves, so if the Liberals actually accept these recommendations fully, the NDP would be squeezed to the point of potentially being pushed off the political map. The only difference that I can see between this recommendation and the NDP pharmacare proposal is timelines and how quickly this would be done. That’s not enough of a difference to stand on in a campaign and to maintain that ground.
For the Liberals though, this report now gives them a serious quandary. Minister Morneau was very clear on his opposition to what has now been recommended and I doubt that he was alone in the cabinet and caucus. Also the Liberals have gone a long way to run down the NDP proposal and the very idea of a national, universal, single-payer pharmacare system. To now turn around and run on it would lead to legitimate questions about their sincerity or if they have the political will to follow through on such a promise. They made many big promises in the last campaign that never came to pass, so many voters would be looking at such a promise as this through that lens, not just at the policy itself. Long story short, will Canadians trust the Liberals to actually do this? That is a question that right exists due to the Liberals track record.
How the Liberals respond to these recommendations will say a lot about not just how they feel about their current chances in the Fall, but how they also feel about where their true challenges will come. If they decide to walk away from these recommendations and not enact them, you can say that they feel very confident about where they are. If they accept them, you can say that they are worried about the Fall and feel they can eat more and more of the NDP’s lunch, a Canadian political tradition as long as any other. Today represent an interesting turn in events, one that will go a long way to saying what the result in October will look like.