Private-public collaboration is key to unlocking healthcare for all

July 21, 2023

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Opinion article by Zahid Salman, July 2023

Universal health care is a source of pride for Canadians—it’s rooted in our values, it’s what binds us, it differentiates us from our neighbours to the south.

The pandemic increased existing strains on the system during a time of unprecedented demand. This surge in need created a system that is now struggling to provide equal access for all, and individuals are quickly falling through the cracks.

Currently, there are an estimated one million Canadians who don’t have access to prescription drug coverage. While drug coverage varies by province, the commonality across the country is that the ‘working poor’ currently have no coverage for essential medicines, which affects individuals with low-income, part-time jobs, and those who are self-employed that exceed the threshold for financial aid and who don’t have access to private insurance through employer plans. It’s the employee who served you coffee this morning who can no longer pay for her diabetes medication; the single parent working multiple jobs just to keep their family afloat who has to choose between drug coverage and feeding their family; the gig worker living with HIV who requires specific medications to survive.

The United Nations has declared that access to essential medicines is a fundamental human right, and yet this portion of the Canadian population—the majority of them being immigrants and those from marginalized and/or racialized groups—are being forced to make an impossible choice between prioritizing their health and keeping the lights on. Between buying medication and feeding their families. This leaves people with poor health outcomes, unnecessary trips to the emergency room, a reduced quality of life, and—in some cases—death solely due to a lack of access to drugs. A report from the Canadian Federation of Nurses Unions estimates that hundreds of working-age Canadians die each year because they can’t afford the very prescription medication that will keep them alive. This isn’t the Canada we know, and it’s certainly not the system on which we pride ourselves.

To address the gap in drug coverage, some are calling for a single-payer national pharmacare model. This is an initiative that would be cost-prohibitive, unnecessarily disrupting the current coverage of 27 million Canadians, and is not supported by the majority of Canadians. Recently, the Parliamentary Budget Officer estimated that if a national pharmacare program had been implemented in 2016, the cost to taxpayers would have topped $7.3-billion per year. Some estimates put this to closer to $13.4-billion. And while an Abacus Data Survey conducted in January 2020 suggested that 95 per cent of Canadians support a plan for "government and insurance companies to work together to ensure affordable access to common prescription drug coverage for all," it also suggested that only 48 per cent are supportive if the program covers fewer drugs than their current plans. The majority were not supportive of a program that would replace their existing plan.

Rather than overhauling the current system entirely, the answer is to fill in the coverage gaps by focusing on the one million Canadians without access to essential medicines, just as the government is focused on filling the coverage gaps with its planned national dentalcare program. To demonstrate this is the most immediately impactful and sustainable model of ensuring all Canadians have access to essential medicines, GreenShield is launching a pilot program that fully funds the provision of essential medication to low-income Canadians without public or private drug coverage.

As Canadians, we must remember the role of a universal healthcare system is to provide essential health services for all. Through better collaboration between all stakeholders, we can achieve that: alleviating the stress on the health care system while simultaneously providing access and coverage to those who need it most. This would be a truly workable and impactful universal service.