Alberta’s opting out of federal pharmacare just might save your coverage

Your drug coverage would have been at risk, if not for Premier Danielle Smith’s decision to opt out of an ill-conceived federal government-run pharmacare plan.

The crux of the issue is that it would create the framework necessary to impose a government-run monopoly on drug insurance. It would cover diabetes and contraceptive medication at first. But as the New Democrats put it, other categories of medication would be added to that monopoly over time. This would mean waving goodbye to private insurance coverage for those treatments.

The thing is, the vast majority of Canadians already benefit from private prescription drug insurance plans. Nationwide, over 24 million of us have one. In Alberta, 63 per cent are covered by those plans.

For those of us in that situation, the progressive imposition of a government-run insurance scheme replacing privately run plans could mean losing coverage for certain specific treatments. Just look at the number of treatments covered. A recent Montreal Economic Institute (MEI) study highlighted the fact that in Alberta, 4,465 unique medications are covered by the province’s drug insurance plan.

That doesn’t sound bad, until you consider that private insurers in the province cover 8,994 unique medications. That’s more than double the coverage of the public plan! Forcing all Albertans to fall back into the public plan would mean that a lot of medication could suddenly be removed from insurance coverage.

And this is not unique to Alberta. Across Canada, on average, coverage is 51 per cent more extensive in a province’s private plans than in its public plan. This impacts not only what drugs are covered, but also which ones are accessible at all in the Canadian market. Some pharmacists, such as Dr. Alan Low of the Medicines Access Coalition in British Columbia, have already begun sounding the alarm.

When you consider that less than half of new drugs having entered the Canadian market over the past decade are covered by public plans, that leaves a lot of new medications we could be missing out on.

Then, there is the whole issue of approval delays for coverage of new treatments. On average, it takes 226 days for a private insurer to add a new medication to its list of covered treatments, once Health Canada has given its approval.

That might seem like a while, but it’s nothing compared to the delays faced by those on government-run plans, which take an average of 732 days after Health Canada’s approval to be added to the list. Many could therefore soon be waiting over three times as long!

This is typical of what happens when Ottawa doesn’t mind its business. With regards to medication, the federal government’s responsibility lies with regulation, market entry, and patents. Full stop.

It is not responsible for setting up expensive new health-related programs and offloading those costs onto the provinces. Pharmacare legislation joins environmental and energy-related matters and child care on the long list of areas where the federal government is stepping into areas of provincial jurisdiction.

The premiers of both Alberta and Quebec were quick to point that out, and to notify Ottawa that they would opt out of the plan if it were adopted.

By protecting provincial autonomy, they just might have saved the quality of our prescription drug insurance coverage.

Krystle Wittevrongel est analyste senior en politiques publiques et leader du Projet Alberta à l’IEDM. Elle signe ce texte à titre personnel.