Trudeau touts 'real progress' on pharmacare, calls on premiers to start cutting deals

Prime Minister Justin Trudeau said Friday provinces and territories need to start negotiating pharmacare deals as soon as possible, a day after legislation to enact the program received royal assent.

"This is real progress, but now we need the provinces and territories to come to the table and sign agreements with us that supports Canadians and takes pressure off their household budgets as soon as possible," Trudeau told reporters as he wrapped a trip to the Association of Southeast Asian Nations Summit in Laos.

He said the program will help people who are struggling to pay for prescriptions, and said his government "not only (believes) in a woman's right to choose, we act on it."

The pharmacare bill passed the Senate without amendments Thursday, and received royal assent shortly after. In the long term it will inform the creation of any future universal pharmacare plan but in the immediate term the bill paves the way for the federal government to sign deals with provinces and territories to cover diabetes and birth-control medications as part of the public health system.

The deals are required for the medications to be covered in each jurisdiction.

With the Liberal minority government hanging on precariously, it's not clear how much time the government has to sign any deals, and NDP Leader Jagmeet Singh warned Friday that the status of pharmacare remains 'fragile."

"I'm worried," Singh said in a news conference on Parliament Hill.

Conservative Leader Pierre Poilievre, whose party would win a significant majority if an election were held right now, has indicated he would "reject" a single-payer drug plan. Some premiers have balked at the idea of signing onto it.

"So my message to Justin Trudeau is 'you can't delay and drag your feet the way you did to get to this point," Singh said. "You can't fight us at every turn like you did up until this point. Now you've got to get to work and meet with provinces and territories and get deals signed. That is the only way that people will actually receive the benefit."

Pharmacare has been a central part of NDP policy for years and Singh made it a pivotal piece of the now-defunct supply and confidence deal he made with Trudeau two years ago. He would not say on Friday whether NDP support for the Liberals on future confidence votes will be tied to how quickly the government gets deals with the provinces.

Liberal Health Minister Mark Holland has said he hopes to have all provinces and territories on board by next spring. British Columbia has already signed a memorandum of understanding to provide coverage. Manitoba, which began covering prescription birth control on Oct. 1 to fulfil an election promise made by the NDP government there, has indicated interest in making a deal with Ottawa.

Others have been more skeptical. 

"I'm not saying it's going to be easy," Holland told reporters on Friday. "Getting this bill adopted in the House and getting it through the Senate was incredibly difficult."

He urged premiers to look past partisanship, singling out Alberta Premier Danielle Smith, who has said she will opt out of the federal program, saying, "Can we not agree that we need to live in a society where people have access to the medication that will stop them from getting sick?"

A spokeswoman for Ontario Health Minister Sylvia Jones said in a statement Friday that Ontario hasn't received any details on what the government is proposing to do with this bill.

"Instead of calling on the provinces to strike a deal with no detail, the federal government should focus on working collaboratively with provinces to adequately support health care services across the country," said Hannah Jensen in an email.

"This year alone, our government has invested over $85 billion in our health care system which has allowed us to have the highest rate of primary care providers and the shortest wait times across the country, provide publicly funded drug coverage for nearly half of our population through OHIP+ and the Trillium drug plan, while also investing in innovative, publicly funded, life-changing treatments.”

Alberta’s Minister of Health Adriana LaGrange said the province is committed to finding ways to make drugs more affordable and accessible, but that the federal government has not shown its vision for pharmacare beyond contraceptives and diabetes medication. 

“Alberta has some of the most comprehensive public drug programs in the country, covering more than 5,000 drugs, and we intend to maintain our current benefit offerings. The federal government can assist us in enhancing our current offerings by not adding duplicate programs or creating unnecessary and costly administrative burdens,” she said in a statement.

The Liberal government has had similar negotiations to sign deals with the provinces and territories to sign deals for health-care funding.

The initial program that covers diabetes medication and contraceptives is a "universal, first-dollar, single-payer model," according to the health minister, meaning that patients will not pay for the medications. He has in the past said that people who have a private health plan that covers the medicines can choose whether to use their health coverage or the federal plan.

But Holland refused to speculate on whether a future national pharmacare program will be a mixed-payer system or a single-payer system, an "ideological debate" that he argued has been going on for too long. The answer to that question will be "driven by data, science and evidence," he said. 

The law calls for the government to convene an expert panel within the next month to investigate the next steps in establishing a full-fledged pharmacare program. 

That committee will report its recommendations to the health minister within a year. . 

This report by The Canadian Press was first published Oct. 11, 2024.

-With files from Liam Casey in Toronto.