As was ever thus, the Twitter Machine erupted with fury and disingenuous outrage when health minister Patty Hajdu told reporters that she couldn’t guarantee that a national pharmacare programme would be in place at the end of the current parliament (for which we don’t know when that will be, as a hung parliament rarely lasts beyond two years.
“Some of that will be predicted by, predicated by, the responses of the provinces and territories,” said Hajdu, because *mind blown* healthcare is largely the domain of the provinces and any pharmacare system would have to be negotiated with them – in particular, a national formulary, which is going to be extremely complicated to ensure that existing plans don’t get left behind or that the new national plan isn’t worse off than any existing ones that it would replace.
What is especially irritating are all of the voices crying out that this just means the Liberals were lying on the campaign trail, which is false and ridiculous – Trudeau spent the campaign not overpromising on this file, but rather kept saying that it was contingent on negotiation with provinces, which is why their fiscal plan only called for a “down payment” on such a programme rather than the whole thing, but nevertheless, the promise was to go by the principles of the Hoskins Report, which they have bene doing thus far. The NDP, by contrast, insisted that this could be done by 2020, and whenever anyone brought up the fact that the provinces may object, the line was largely that why would anyone say no to federal dollars? It’s absurd, of course, because provinces are rightfully afraid that they would be stuck with an expensive programme to run if the federal government suddenly cut out transfers or funds to it because they suddenly had other priorities (which has happened in the past).
And to that end, we have a bunch of premiers who are balking at it, Quebec and Alberta want to be able to opt-out with compensation, and Ontario is instead insisting that the federal government pay for drugs to treat rare diseases – the most expensive kind, and the ones where costs are rapidly escalating. So of course they want the federal government to pay for them rather than to share the burden. It’s predictable, and for anyone to be shocked and appalled that the Liberals have to deal with this reality is really, really tiresome.