Ten million people across the country sit on a waiting list for a family doctor.

The average wait time in an Ontario emergency department is over 22 hours. There are massive, urgent problems that need attention.

But prescription drug coverage, for most Canadians, is not on one of those.

Very few Canadians live without access to any prescription drug coverage. Unfortunately, when the federal government’s pharmacare legislation passes in Canada’s House of Commons in the coming weeks – those people still won’t have prescription drug coverage.

Instead of extending coverage to those who need it most, the federal government has announced a plan to cover prescription contraceptives and diabetes medications for all Canadians – including the majority who already have health benefits.

What will that really mean for you, if you are one of the millions of Canadians who already have this kind of coverage?

Service disruption will be a reality

Very few people will have better access to prescription medication as a result of this new legislation. Bill C-64, the Pharmacare Act, may in fact disrupt coverage for more than two million Canadians who have for decades easily accessed their medications for diabetes and birth control through their workplace health benefit plans.

The Act may force a majority of Canadians who already have good coverage through their health benefits to switch to a new public plan. By mandating a “single payer approach” to diabetes and birth control medication, you’ll now have to navigate both a public plan for those conditions and your workplace plan for everything else. And what’s more, not every medication your workplace plan covered will be covered by the public plan.

Less coverage

The proposed federal program will not cover all medications.

In 2023, workplace plans covered $1.6 billion in costs for diabetes medications, 85 per cent of which was for medications that will not be covered under the federal program.

Workplace plans covered $212 million dollars for prescription contraceptives. Our analysis shows that 20 per cent of that amount paid for contraceptives will not be covered under the government’s new plan. These Canadians will be forced to switch to medications covered under the federal public plan or pay out-of-pocket for the drug of their choice.

A human problem left unsolved

Remember those Canadians without drug coverage? This plan doesn’t help them.

The 2024 federal budget committed $1.5 billion to the national pharmacare program over five years, with nothing promised beyond that. This is money that could be better used to expand coverage to those without access, or directed to those other urgent healthcare needs. For example, if the federal government used this amount of money to help those without drug coverage today, they could cover the 2 per cent of Canadians who don’t have coverage today, with a formulary similar to that which exists in Ontario.

It's not too late to consider the real outcomes and switch gears - to make a substantive difference for those who need it most. There’s no doubt Canadians need all the healthcare help we can get. But with this pharmacare bill, our government is shadowboxing while the real problems remain unsolved.

Stephen Frank, President & CEO, Canadian Life and Health Insurance Association