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“Everyone in Canada deserves access to the care they need, including to prescription medications…” Mark Holland, Former Minister of Health of Canada.
Canada’s healthcare system funds many medications, either fully or partially, by public and private health plans for eligible residents. Public healthcare is government-funded and provides some coverage for specific medications. In contrast, private health insurance is employer-provided or individually purchased through insurance companies and tends to cover the costs that public healthcare does not.
Provinces and territories get to choose what medications they will provide coverage for. Unfortunately, this means that some medications, including those that support a vital function, remain inaccessible through unrealistically high prices. The inaccessibility created by imbalances in wealth and employment creates barriers to accessing lifesaving medications. This creates an impossible choice between medications and other essential necessities.
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Join the Sphere →Health as a Human Right
Article 25 of the Universal Declaration of Human Rights states that health is a fundamental human right, indispensable for the right to access a life of dignity. Under the category of healthcare and basic human rights, human beings are entitled to equal access to life-sustaining medications.
This creates issues when medications are treated as commodities by pharmaceutical and private insurance companies, leading to consequences that may force individuals to make unsafe choices regarding medication usage. The World Health Organization (WHO) notes that there are four core components of the right to health, including availability, accessibility, acceptability, and quality.
While Canada does a fair job meeting most of these core components, they neglect components relating to economic accessibility. This creates a grey area within the Canadian healthcare system, where only those who can afford the high prices have access to their medications.
Firsthand Experiences
Speaking from experience, I have faced the consequences of this grey area within the Canadian healthcare system when I was let go from my job, ending my private insurance plan. The medications and medical supplies that support my ability to participate more meaningfully in society suddenly became unaffordable and out of reach.
This forced me to risk my own health by reusing materials, as well as using materials longer than recommended by safety guidelines, just to prolong the need to buy new ones. British Columbia’s provincial healthcare plan, Pharmacare, provides support based on your income from two years previous. This appeal took months to be processed, leaving me with the burden of cost I could not afford until I regained employment with a job that offered private health insurance.
There is some privilege within my story, where I was able to eventually gain support through a private health insurance plan, while other individuals continue to suffer the consequences of inequitable access to medications in Canada.
Barriers to Access
My experience is not a single story. One in twenty individuals in Canada skips doses or utilizes medications longer than safely recommended due to high cost. Prescription drugs are now considered the second highest cost in Canadian health care. Without intervention, this number will only increase. Due to limited access to employment within Canada, marginalized groups, such as immigrants, racialized groups, seniors, and the 2SLGBTQIA+ community are disproportionately impacted.
This ties in with the increase in unemployment, as many individuals struggle to find work that would provide the opportunity to access private health insurance plans. These barriers intersect with the high cost of living in Canada, forcing individuals to choose between medications and other necessities, such as food and shelter. If individuals are forced to go without medications consistently, these barriers may lead to unnecessary suffering or death.
Bill C-64 and National Universal Pharmacare
In February 2024, the former Minister of Health, Mark Holland, proposed Bill C-64, which introduced the implementation of national universal Pharmacare. Fast forward to now, and this implementation has stalled with the news that there is no new federal funding for additional Pharmacare deals. While this initiative proposed a major step forward in the accessibility of prescription drugs, this requires the Canadian federal government to follow through with their promise. If Bill C-64 is implemented, this means better access to medications for Canadians, which may result in fewer visits to hospitals and emergency rooms to manage health conditions.
One criticism of Bill C-64 is that it may become costly through the increase in taxes or other fees to address the cost of coverage for prescription drugs. This is expressed by the Conservative Party, who argue that Bill C-64 offers an inferior program that will cover less and operate at a higher cost to Canadians.
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Another criticism is that the current wording of Bill C-64 implies that national pharmacare will use a universal single-payer system, potentially impacting coverage with private health insurance plans. This means Bill C-64 would cover prescription medications already covered by health insurance plans, instead of putting money towards covering other costly medications that are not covered. However, when individuals can access medications as needed, the long-term costs to the healthcare system begin to drop as more individuals can manage their conditions without needing to access emergency medical services.
Where To Next?
While there is no cut-and-paste solution to the ongoing medication crisis that many Canadians are facing, immediate action needs to be prioritized to address the disproportionate inequalities faced by those who require medications to achieve a decent standard of living. Inspiration can be taken from the Netherlands, where approximately the same amount of money is spent on healthcare as in Canada.
The Netherlands’ healthcare system ensures that its citizens are universally covered for prescription drugs by partnering with private health insurers to keep household prescription drug costs lower, and providing further discounts and safety nets to vulnerable groups. While purchasing basic health insurance is mandatory, private health insurers are obligated to accept all eligible applicants, and these insurance plans cover many treatments, including prescription drugs.
One solution might include requesting generic versions of medications, which often come at a cheaper price point. Using generic brand medications can save money and increase the number of medications made available. Studies have shown they have a similar performance to name-brand medications, as they contain the same active ingredients. Still, further studies have shown that some generic medications can produce harmful side effects that may cause further illness from contaminants in the medication. This leads to negative perceptions of generic brand medications, even though they are heavily regulated to ensure quality and effectiveness.
As the cost of living in Canada increases every year, prescription medications become increasingly out of reach for Canadians. If access to medications is deemed a fundamental human right, then it should be treated as one, instead of being treated as a luxury that is only provided to those who can afford it.
Edited by Isaac Code
