Canada is the only developed country with a universal health care system that does NOT provide universal coverage of medically necessary prescriptions. A universal, single-payer national program for prescription medications continues to be one of the most needed, and supported initiatives across Canada. Most recently, a poll showed 9 in 10 Canadians support national Pharmacare. And the health and economic impacts of the COVID-19 pandemic only continues to make our need more urgent, as precarious employment jeopardizes people's access to drug coverage and medical benefits. Giving people universal access to the medications they need would save countless lives, and it would save billions of dollars a year by preventing health problems or speeding recovery from health problems.
Pharmacare doesn’t appear at all the Liberal platform. While they continue to move forward, albeit slowly, on Pharmacare commitments made in their 2019 election platform, progress has effectively stalled throughout the COVID-19 pandemic. Despite the increased need for pharmacare, the government has not provided clarity beyond the 2019 Advisory Council report in terms of funding commitments, or timelines.
New Democratic Party
The NDP says they will implement universal, national Pharmacare starting in 2022, and have committed to providing $10 billion to fund it. Back in February, NDP MP Peter Julian (New Westminster-Burnaby, B.C.) introduced a private member's bill (C-213) into the House of Commons to enact the Canada Pharmacare Act, and to set a legal framework for a national Pharmacare system. The bill ultimately failed to pass second reading when it was voted against by nearly every Liberal and Conservative MP.
Bonus: In addition to Pharmacare, the NDP says they’ll work to expand our Medicare to include vision, hearing, mental health, dental, and fertility care.
The Conservatives have, by and large, refused to support universal Pharmacare initiatives. Instead, they say they will negotiate with the pharmaceutical industry to reduce drug prices and ensure “regulatory certainty”—Something Pharmacare would certainly most effectively achieve.
The Greens have also recognized the importance of a universal Pharmacare program, including the creation of a bulk drug purchasing agency. They say they will launch Pharmacare by 2022 and roll out a comprehensive formulary by January 1, 2025.
Bonus: They also support universal Dentalcare.
The COVID-19 pandemic has laid bare our urgent need for major seniors’ care reform. A staggering 14,000 seniors in care died from the joint impact of COVID-19, and a seniors care system that was woefully unprepared to deal with the crisis. Over the past year and a half, health care workers, experts and advocates have renewed with urgency their calls for government action and national Long-Term Care standards to protect care residents and workers, including enacting national standards and removing profit from care.
According to a recent poll in the Star, more than 70% of respondents say overhauling Long-Term Care homes should be a top priority this election.
The Liberal Party has promised $9 billion in funding to improve Canada’s residential seniors’ care system. Priorities include: increasing bed availability; creating a new Safe Long-Term Care Act to establish national standards in care; training up to 50,000 new personal support workers; guaranteeing workers’ minimum wage to $25 per hour; increasing the Guaranteed Income Supplement by $500 for singles and $750 for couples; restoring the retirement age to 65, and; encouraging seniors to remain in their homes via tax credits. Importantly however, there is no commitment to phase out for-profit care in the Long-Term Care sector. Further, plans to “work with provinces” means it is up to premiers to enact recommended changes, potentially leaving seniors in some provinces without equitable access to quality care. Notably however, the Liberal government could have already set national standards, but have so far declined to do so. Instead, the promise for national standards has been taken over and sidelined by the accreditation and standards-creating industry, with limited scope or enforcing powers.
New Democratic Party
The NDP is the only party that has promised to end private, for-profit Long-Term Care, and bring existing homes under the public medicare umbrella. They have also committed to establishing and implementing national care standards for residential and home care, governed by the same principles as the Canada Health Act, and funding to provinces will be tied to meeting these standards. The party also plans to work with provinces to develop violence prevention and workforce strategies to recruit and protect staff, and promise to provide better wages, job stability and health and safety protections for workers.
The Conservatives, like the Liberals, have promised an earmarked $3 billion to provinces to expand residential care beds. They plan to encourage seniors to stay in their homes by giving family caregivers $200 per month, allowing seniors or caregivers to claim the Medical Expense Tax Credit for home care, and increasing the Home Accessibility Tax Credit limit. They say they will build up the roster of personal support workers by giving them priority in immigration programs, and doubling the Canada Workers Benefit for low-income workers, including personal support workers. But the Conservatives have rejected setting legislated national standards, Instead, they plan on creating a guide for standards, working with provinces to develop best practices, meaning that under a Conservative government, national LTC standards would be non-binding and unenforceable. They also have no plans to get profit out of Long-Term Care, but say they will “partner with the private sector rather than over-rely on government,” despite evidence that private care results in understaffing, poor working conditions, and compromised safety for residents and care workers.
The Greens have promised to bring Long-Term Care under the Medicare umbrella, provide robust funding, and reorient care towards community-based models. They plan to improve quality of care by establishing and enforcing National Standards, including mandating a minimum of four hours of regulated care per resident per day. They say they will increase and stabilize staffing by investing in training and education, increasing pay, improving benefits, implementing paid sick leave, legislating pension protections, and prioritizing care workers for immigration status. They will also fund a National Dementia Strategy and invest in elder abuse and violence prevention strategies.
Research and experience in Canada and world-wide has shown that privatization in health care and public services result in higher costs, longer wait-times, and the siphoning of resources and workers to the private system, ultimately exacerbating existing health care inequity. Despite this, Alberta and other provinces have seen creeping privatization over the decades, especially in areas like surgical services, medical laboratory services, and continuing care. If we have learned anything from this pandemic, it should be that we all depend on well funded, staffed and resourced public health care. People Canada-wide need a more responsive public health care system, and that can only be achieved by improving and expanding our current system, not by allowing private, for-profit alternatives.
Throughout their platform, the Liberals aren’t particularly clear about where exactly they intend to allow privatization in our health care, and in seniors’ care. However, Prime Minister Justin Trudeau was very vocal in his criticism of Conservative leader Erin O’Toole’s seemingly pro-privatization position on the matter. And, the Liberals say they will provide significant new health transfer funding in order to reduce wait-times, while strengthening federal powers to deduct health transfers from provinces that allow extra billing.
New Democratic Party
The NDP platform commits to a “historic expansion of the services covered under our national health care system,” and outlines several programs they would expand our Medicare to cover, including Long-Term Care, Pharmacare, dental, vision, hearing, mental health, and fertility care. They have also promised that they will enforce the Canada Health Act to stop provinces from allowing extra-billing and privatization.
The Conservatives say they would encourage the expansion of private health services as provinces see fit, and leverage ‘innovation’ in the private sector to address ‘inefficiencies.’ Party leader Erin O’Toole has said he intends to “find public-private synergies” to improve wait times… reiterating an age old myth. In fact, research has shown that wait times are often worsened by privatization. While he says he supports Canada’s public universal health care system, he has not revealed which services he would allow to be privatized and commoditized, potentially undermining the universality of the Canada Health Act, and worsening care access for all.
The Greens have committed to expanding Medicare to include Long-Term Care, universal Pharmacare and universal, basic dental care. They have also promised to provide long-term funding to the Public Health Agency of Canada (PHAC) to protect public health, and re-negotiate Canada’s Health Accord to prioritize mental health and rehabilitation services, access to safe abortion services, and access to gender-affirming health services
Across the country, people are dying of overdose at a rate of 17 lives lost each day, as of June 2021. In Alberta, where the government has focused on recovery and has largely forgone evidence-based harm reduction approaches, we have seen a major increase in the death rate since the start of the pandemic. Between January and May of this year 624 Albertans died from drug poisoning, compared to 343 Albertans during the same period in 2019. We urgently need action to protect people from the toxic drug supply, and to ensure that treatment is truly accessible to individuals when and how they need it. We need health policy based on evidence, not ideology—and that means putting harm reduction principles at the forefront, including supporting expanded supervised consumption services, and ensuring safe supply.
Unlike the NDP and Greens, the Liberals have not included decriminalization or safe supply in their platforms. Justin Trudeau has said his government will work with interested community partners on those initiatives instead. The Liberals also say they will amend the Criminal Code to repeal certain mandatory minimum drug-related penalties, and have promised $25 million to launch a public education campaign aimed at reducing stigma, and an additional $500 million on evidence-based treatment.
New Democratic Party
The NDP has promised to declare the overdose crisis a national public health emergency, and work to end the criminalization and stigma for drug users “so that people struggling with addiction can get the help they need without fear of arrest,” while instead targeting drug traffickers. The party has promised to work with provinces to create a safe supply of medically regulated alternatives to toxic street drugs, support supervised consumption services and expand on-demand access to treatment. They also say they will launch an investigation into the opioid crisis and the role that pharmaceutical companies may have played, seeking “meaningful financial compensation for the public costs of the crisis.”
To deal with our worsening overdose crisis, the federal Conservatives are campaigning on the same flawed and dangerous “recovery-oriented” approach that the Alberta government has been using. But as Alberta well knows, relying on treatment facilities alone is far from enough to prevent overdose deaths. In Lethbridge, where the government opted to pull funding from their only supervised consumption site—formerly the busiest in North America—the overdose death rate has risen to double the provincial average. Further, the majority of treatment facilities are private, for-profit, and are often wildly unregulated. Experts say recovery and treatment must be part of an evidence-based continuum of care that includes harm reduction, safer supply and decriminalization, regulation, housing and employment options, etc.—all largely absent from the Conservative platform.
The Greens have promised to declare the drug poisoning crisis a national public health emergency, and to create a nationally regulated safe supply. They also plan to invest in treatment and service access, including increasing funding to community-based and harm reduction programs and organizations, and creating a national Naloxone program. They have promised to decriminalize possession of illicit drugs for personal use, and provide automatic pardons for individuals previously convicted of cannabis possession.
Watch Sandra Azocar on health care priorities:
PSAC Prairies: Federal Election Issues that Matter to You!
Voice of Albertans with Disabilities: Federal Voter Forum
Sources and further reading: