OHIP+ today, national pharmacare tomorrow?
The start of the new year means new benefits for ordinary Ontarians. One of those benefits is called OHIP+. It means that more than 4,400 prescription medications are now covered by the Ontario Health Insurance Plan for children and youth age 24 and under.
As transformational as Canada’s first toe-in-the-water of universal pharmacare is, there is a perfectly-understandable natural reaction from many who are not included in OHIP+ to ask, “So why not me as well?”
Pharmacare, or health care as it applies to publicly-funded drug coverage, reflects the broader proportions on how health care money is spent:
- One third of all the money (About $55 billion per year) that Ontario spends on health care in a year is spent on one percent of the population, overwhelmingly elderly and chronically-ill;
- Two-thirds of all the money Ontario spends in a year is spent on five percent of the population, the proportion above, plus the young and those with major treatable health problems.
That means that 95 percent of us cost the Ontario health care system very little: a few hundred dollars per year. Much of the under-25 population covered by OHIP+ falls into this 95 percent. That’s why Ontario had to think carefully about the scope of what it could afford in extending OHIP to include a segment of drug coverage. To implement, and afford, a universal pharmacare program, Ontario needs a national (i.e. Canada-wide) pharmacare policy and program. This means the other provinces, and territories, need to implement such a program as well, and the federal government must include pharmacare in health care transfers.
In improving, for example, the 50-year-old Canada Pension Plan (CPP), Ontario took the lead and said it would implement its own Ontario Retirement Pension Plan (ORPP) after trying unsuccessfully to bring the feds and other provinces on side for almost a decade. That was what it took to have the Government of Canada make the first material changes in the CPP since the 1960s. The new and improved CPP did most of what the proposed ORPP was ready to do, thus making its introduction unnecessary. But the CPP would certainly not have changed without Ontario literally being weeks away from doing our own pension plan. Similarly, Ontario has been the leader for much of this decade in urging the rest of the country to recognize the necessity of expanding national and provincial health care coverage to include prescription drugs.
Perhaps OHIP+ will get the rest of the country again prodding their own leaders with Ontario-envy.
The scope of universal pharmacare is much, much greater than what any single province, even Ontario, can afford or offer. Ontario cannot, for both financial and practical reasons, ‘go it alone’ in implementing universal pharmacare. As noted above, the seniors portion of pharmacare alone, not including adults with chronic health conditions, is many, many times more expensive than the coverage for youth 25 and under. If, hypothetically, Ontario got too far ahead of the rest of the country, then the natural self-interest reaction in the rest of Canada would be that ‘if you get seriously ill, and need expensive drugs, just move to Ontario.’ That would hardly be fair to Ontarians who pay OHIP bills through their premiums and taxes for their entire adult lives.
Ontario seniors do, however, receive assistance based on income with their prescription drug co-payment. Click or touch for more info.
There is no question that a national pharmacare system is the way to go. An aging baby boomer generation ought to get it done as a Canada-wide legacy gift to their children and grandchildren. Crank up the heat with your federal Member of Parliament, and help Ontario finish the job, while every other province follows the path Ontario is blazing.