The Long Road to Better Care for Canadians

Pharmacare Now. Pharmacare – A Plan for Everyone. Big Money Club. Pharmacare – But We Need the Full Dose. Stand Up for Pharamcare. Filling the Prescription. Just some of the many campaign and research study titles in support of pharmacare. 

On Leap Day, February 29th, those slogans and immeasurable hours of research, campaigning, persuading, and pleading, appeared to pay off as Canadians witnessed the beginning of a national, universal drug program. Although it is not all that we want (or desperately need), it is a start. 

For as long as I can recall, my union activism has included lobbying for a universal drug program. In the last seven years, that effort ramped up leading to this recent and exciting development. The following is a recap of the work and effort that went into seeing this to fruition.

I have attended numerous Council of the Federation meetings across Canada, advocating on behalf of those who cannot afford to fill prescriptions for themselves or their loved ones. I have attended rallies and townhalls in support of a pan-Canadian drug plan. Along with my colleagues on the national executive board of the CFNU, I have contributed to opinion and editorial pieces appearing in local and national newspapers and spoken at length to media about this matter. 

Like other nurses and healthcare workers, I joined letter writing campaigns and reached out to my various MLAs and MPs asking them to back this vital missing piece of the Medicare vision.

Now, a nation-wide program with coverage for contraception and diabetes medicine and related equipment, delivered by a single-payer approach through provincial public health systems, has been unveiled. With the introduction of the Pharmacare Act comes a glimmer of hope, particularly for diabetics who will be some of the first to benefit from this celebrated agreement. 

The history behind this decision has not been pretty. One-in-five do not have access to prescription drug insurance, often going without necessities like food or home heating to purchase necessary drugs. Due to costs, many uninsured Canadians go without medications altogether. As well, Canada was the only country with a public health care system that did not include universal coverage for prescription drugs outside of hospitals. 

Canadians have been patiently waiting for the federal government to introduce and pass the Canada Pharmacare Act, advancing a full pharmacare program as promised.

In December 2017, on Parliament Hill, CFNU presented research from their report titled: Down the Drain: How Canada Has Wasted $62 Billion Health Care Dollars without Pharmacare, where noted economist Hugh Mackenzie calculated the disturbing amount Canada had wasted in the previous 10 years by not implementing national pharmacare.

Amongst the presenters was NSNU member Edson Castilho, a registered nurse at the IWK Health Centre. Every day, he’d see the impacts resulting from Canada’s lack of coverage of prescription drug costs as part of Medicare and how this directly affects our children’s health and quality of life. 

In July 2018, Canada’s provincial and territorial first ministers assembled in picturesque St. Andrews by-the-Sea, New Brunswick for their annual Council of the Federation (COF), all the while Canada’s nurses were hard at work promoting national pharmacare at that summit. 

Following COF, The Advisory Council on the Implementation of National Pharmacare asked Canadians to weigh in on the Pharmacare discussion by completing an online questionnaire. That survey closed on September 28 with many NSNU members sharing valuable insights.

In January 2019, a representative online poll of more than 1,000 Canadians, commissioned by the CFNU and conducted by Environics Research, found that: 

  • 88% agreed it is better to have a simple cost-effective prescription drug coverage program that covers everyone in the country than to have a patchwork program. 
  • 85% agreed it is worth investing public money for prescription drug coverage. 
  • 84% thought prescription drugs should be covered as part of our public health care system. 

In March of 2019, the Federal Government released an interim report on the creation of a national drug agency that would oversee Canada’s pharmacare program. The CFNU released a statement in response recommending the creation of a national drug agency, a comprehensive evidence-based formulary, and core principles for national pharmacare.

In September 2019, I participated in an invitation-only symposium with other pharmacare consultants led by Dr. Eric Hoskins, the Chair of Advisory Council on the Implementation of National Pharmacare. The session brought together local pharmacare and other stakeholders invested in this national debate. 

The cross-country series dealt with outstanding issues on how to design and implement a national plan, looking to the experts in the room for advice and recommendations. An independent facilitator, Marc Beaudoin, guided the roundtables in spirited discussions on what drugs should be covered and how best to meet the needs of Canadians. 

Later that fall, the Canadian Federation of Nurses Unions, including the NSNU, called on Canada’s newly re-elected Liberal minority government to build unity across party lines to implement a program, asking Prime Minister Trudeau to make good on his 
pharmacare promise.

National pharmacare received significant political support during the 2019 election campaign, and amongst all parties, with the Liberals committing to negotiate with provinces and territories, guided by the recommendations in Dr. Hoskins’ expert report.

In March 2020, as the pandemic took hold, Canada’s nurses called on the Prime Minister to support the NDP’s pharmacare bill. The CFNU applauded the NDP for their bill to implement pharmacare across Canada, a long-overdue measure to alleviate the suffering for those who struggle to afford meds. 

The NDP’s bill was based on the recommendations of the report by Hoskins’ Advisory Council, modelled on the Canada Health Act. It would legally enshrine the core principles of Canada’s medicare for prescription drug coverage: universality, comprehensiveness, accessibility, portability, and public administration.

Further, the CFNU and more than 150 national and provincial organizations signed a statement calling on Trudeau to implement national pharmacare.

In February 2021, nurses declared Pharmacare Now! Through this online campaign Canadians could send a letter to the federal government urging it to take immediate action on its commitment to implementing national, universal pharmacare. The ask was for sufficient and allocated funding in the 2021 Federal Budget to implement an initial common formulary of essential medicines by July 1, 2021.

“Support for pharmacare is strong. Over 90% of Canadians feel it is important for everyone to have equal access to prescription drugs, the federal government’s own expert advisory council recommended a universal, public, single payer program, and the government has committed to it. We need action now,” said Canadian Federation of Nurses Unions (CFNU) president, Linda Silas.

Consistently, voters wanted a universal, comprehensive, and public pharmacare program as recommended by the government’s own advisory council. Half-dose proposals would not bring Canadians full and fair coverage. A single payer pharmacare system with the power of bulk purchasing would offer the best solution to negotiate lower prices from drug manufacturers. 

On November 15th, 2022, the CLC and the Nova Scotia Federation of Labour held its first Provincial Lobby - an opportunity for activists to lobby for various issues including the implementation of a universal, single-payer Pharmacare program. Lobby Day participants, including members of NSNU Board of Directors, met with MLAs via Zoom and/or in person. 

In late 2023, Members of Parliament were introduced to the latest advertising campaign promoting public universal pharmacare. “Canadians want pharmacare,” proclaimed the ad’s headline above the image of a broken pill. “But we need the full dose.”

The campaign was organized and funded by a pro-pharmacare coalition comprising the Canadian Health Coalition, the Canadian Labour Congress, and Canadian Federation of Nurses Unions, and the Heart and Stroke Foundation. 

Campaigns and slogans aside, nurses have adamantly and consistently supported the delivery of a national pharmacare program that provides universal coverage through public insurance. It is the belief of nurses’ unions that everyone should be covered by the same plan on equal terms, without financial barriers. Access should be based on need, not location, ability to pay, age, employment, or other factors. 

As we move forward with the new policy, our hope is that current and future governments will strengthen and expand the program. Already, neither Alberta nor Quebec support the plan. Instead, they want the cash with no strings attached. This way of thinking does not bode well.

For over 20 years, Canada’s nurses have advocated for national pharmacare. The CFNU is a signatory to the Pharmacare Consensus Principles document endorsed by more than eighty national, provincial, and territorial organizations. We have been and will remain committed to the cause.

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