There are few downsides to a Universal Pharmacare programme, as Professor Gordon Guyatt, university professor and Fellow of the Canadian Academy of Health Sciences points out.
Scott Douglas Jacobsen: Who does or would benefit from universal pharmacare coverage? I ask these questions because of the conversation in Canada at the moment. Canada has a national healthcare program, but not a national pharmacare program, unlike other comparable developed countries.
Professor Gordon Guyatt: The answer is most of the Canadian population will benefit from universal pharmacare coverage.
Jacobsen: Who would benefit the most from universal pharmacare coverage?
Guyatt: Who benefits most will be people who are poor, who are not on social assistance, who are under 65, and who cannot currently afford their drugs, these people have real health problems because they are unable to afford their drugs.
Jacobsen: How many people does this include?
Guyatt: It is in the order of 15-20% of Canadians. They will be the biggest beneficiaries. The next group who would benefit would be people who can afford their drugs, but who are currently paying for their drugs either through private drug plans or paying out of pocket.
The reason that they will be beneficiaries is because a national pharmacare program will make them pay somewhat more in taxes, but they will be paying much less overall than at present.
The net benefit in terms of their take-home will be appreciably greater. That is, the amount they have in their pockets at the end of paying for their taxes or drug costs will be more. Those people will be the beneficiaries. A little less of a beneficiary will be someone, like me, where part of the benefits program of the job is a drug program.
I have to pay a bit out of pocket, but some personal drug costs are paid for by my employer. That is, they are in part paid for through the benefits package of the job. I might benefit somewhat less than others, but I will still be better off than others who do not have the program.
You might say, of the potential national pharmacare program: it is not in their interest at all. It is the very wealthy who have no problem currently paying for their drugs and who pay a higher tax rate than other people. A national pharmacare program is of no benefit to them.
The very wealthy can afford their drugs with no problem at the moment. Their higher taxes might be a wash or even a net loss. That would be the one group who would not benefit. The very wealthy would not benefit from a national pharmacare program in Canada.
Put it this way. If you were to grade the benefits, then the scale would be from the poor who cannot afford their drugs who would get substantial benefits.
This would include substantial benefits for most Canadians – middle-income Canadians – who will be paying more taxes, but will be saving substantially on drug costs. Then, at the other end of the sliding scale, the least benefit would be for the wealthy.
What is not, unfortunately common knowledge that there are going to be very large savings for Canadians with a national drug program. I do not think that is common knowledge, and it is important for the general population to be aware of this.
Jacobsen: Why do you think this is the case?
Guyatt: Control of the media. The wealthy, the ones who have the least to gain and would benefit the least from a national pharmacare program both in terms of decreased cost and equity have a disproportionate influence on what people hear and see on television, and read in newspapers and other media outlets, then the benefits of a national pharmacare program – might be more well-known among Canadians. That is something that has to be remedied.
Jacobsen: Thank you for the opportunity and your time once more, Professor Guyatt.
Professor Gordon Guyatt, MD, MSc, FRCP, OC is a Distinguished University Professor in the Department of Health Research Methods, Evidence and Impact and Medicine at McMaster University. He is a Fellow of the Canadian Academy of Health Sciences.
We conducted an extensive interview before: here, here, here, here, here, and here. We have other interviews in Canadian Atheist (here and here), Conatus News (here), Humanist Voices, and The Good Men Project. Here we talk about national pharmacare.