06) UNIVERSAL PHARMACARE COULD SAVE BILLIONS
By Kimball Cariou
Even before the time of Karl Marx and Friedrich Engels, labour radicals, Communists and other social activists have always been accused of proposing completely impractical, utopian schemes.
In Britain, the “Factory Act of 1847" to shorten the working day in textile mills to 10 hours for women and youth was furiously denounced by employers and right-wing economists. One absurd argument was that since the entire profit “earned” by capitalists was produced during the final hour of the day, this reform would bring down the whole economic system. Since that era, the working class struggle to shorten the working day and reduce the intensity of exploitation has often made gains, without destroying capitalism. More recently, the historic progress towards a shorter work day (and week) has been pushed back by the neoliberal economic offensive.
The point is that “wild-eyed” social reforms often turn out to be far more practical than the ruling class would have us believe. A partial list in Canada would include old age pensions, unemployment insurance, universal medicare, the right to organize trade unions, etc. Most such ideas were branded as dangerous threats, or at the very least, completely unaffordable. The fact that these reforms were initially raised by Communists made them even more unacceptable. Yet all of these reforms were eventually adopted in response to massive working class struggles. It’s also true that the ruling class grudgingly accepted such measures in part to “prove” that revolution was unnecessary in Canada, where many working people were favourably impressed by the gains of their sisters and brothers in the USSR and other socialist countries.
For decades, the Communist Party of Canada has advocated another such reform: the expansion of Medicare to include universal pharmacare, and dental and optical care. Predictably, right-wing economists and politicians have always called this demand a pipe dream.
But now, a study in the prestigious Canadian Medical Association Journal says that a universal prescription drug plan could reduce total spending on medications by billions, providing full coverage at an affordable price for taxpayers.
Few Canadians realize that ours is the only developed country with universal health insurance coverage which does not also offer some form of universal pharmacare. That particularly hurts the ten percent of Canadians who cannot afford to take their medications as prescribed.
The study in the March 16 CMA Journal says the extra total cost to government of providing universal pharmacare could range from about $1 billion, to as high as $5.4 billion a year, depending on how much was saved through bulk purchases of medications and other measures. Such a program would save the private sector the $8.2 billion annually it spends on prescription drugs, mainly through employee health plans.
"When we did the analysis, we were, at first, a little bit surprised," said study author Steven Morgan, a professor of health policy at the University of British Columbia. "Wow. Canada can really save billions of dollars by covering everybody for virtually every drug? And then we started to look deeper at the math, and it made perfect sense. You save about 10 per cent by getting better generic prices, you save about 10 per cent [on] brand name prices and you save an additional 10 per cent by encouraging more cost-effective prescribing. Mine those three things together, you save 30 per cent of a very large budget. Therefore you're saving billions of dollars."
Morgan’s numbers are based on conservative estimates. He and the other authors say that if Canada adopted policies comparable to countries like Switzerland, Italy and Spain, and achieved the rates of generic drug use seen in some provincial drug plans, a universal public drug plan would reduce total spending on prescription drugs in Canada by $7.3 billion per year.
They point out that U.S. studies suggest that providing free prescription increases the chance that patients will take the medicines they need. In the long run, this improves their health and reduces demands on the health-care system.
Morgan’s conclusion: "Pharmacare is not unaffordable for taxpayers. Quite the opposite. It is unsustainable for taxpayers not to have a universal pharmacare system."
That’s not something the Harper Conservatives, or event the federal opposition parties, really want to hear. For all the government’s talk about defending taxpayers, they are far more committed to protecting the big pharmaceutical companies, which have a monopoly on one of the most profitable sectors of the entire capitalist system.
Interviewed by the CBC, Health Minister Rona Ambrose refused to say whether she would favour a pharmacare program. Instead, Ambrose wanted to talk about a bulk purchasing system for provinces to cut costs.
That sounds like a very tiny reform, mainly aimed to allow the Tories to take credit for spending cuts, while they keep slashing Medicare and the rest of Canada’s social safety net. But as the population ages, the need for universal pharmacare will become more acute. In the federal election later this year, the Communist Party will put this demand high on its list of platform points. Expanded public health care is not a utopian dream - it’s an urgent priority for working people, and a demand which also makes complete economic sense.
(The above article is from the April 1-15, 2015 issue of People's Voice, Canada's leading socialist newspaper. Articles can be reprinted free if the source is credited. Subscription rates in Canada: $30/year, or $15 low income rate; for U.S. readers - $45 US per year; other overseas readers - $45 US or $50 CDN per year. Send to People's Voice, c/o PV Business Manager, 706 Clark Drive, Vancouver, BC, V5L 3J1.)