More than four years after the Hoskins report was tabled, the federal government has finally tabled a bill on drug insurance. The problems with the current system have been known for decades. Quebec’s public-private system is characterized by very high costs, inequitable financing and restricted access. In our opinion, current public policies violate the right to health of Quebecers. Indeed, how can we tolerate that one in ten people go without prescription medications due to financial issues? Quebec’s hybrid regime is therefore far from being an example for Canada to follow.
Although this bill could be improved, it is a step in the right direction and an opportunity to lay the foundations of a true public and universal drug insurance plan. Until this becomes a reality, our organizations foresee several difficulties. First, we can expect that lobbyists from the pharmaceutical industry and insurers will be very active behind closed doors and in the public space in order to torpedo any initiative that aims to reduce drug costs and therefore their profits. Collectively, efforts must be made to put collective interests ahead of those of a minority.
The issue of costs is likely to occupy a large place in the debates. For many, a public and universal plan is too costly for public finances, especially in a context where the state of the economy is deteriorating. In our opinion, this argument is not admissible. Approximately 10 billion dollars are spent on prescription drugs in Quebec per year. Whether you pay a premium to a private group insurance plan or to the public plan changes nothing. It is an essential good that we cannot do without and that will have to be paid for in one way or another.
The question is therefore not whether a public and universal drug insurance plan is too expensive, but rather how much money are we willing to collectively waste to keep alive a dysfunctional system incapable of controlling costs?
There are also legitimate fears among the population, despite strong support for the establishment of a public and universal drug insurance plan. Many fear the loss of certain protections with such a program. However, all Quebecers would benefit. Efforts must therefore be made to properly inform the population of the benefits of a public and universal plan.
But it is the refusal of the Quebec government which remains the main obstacle to social progress. For several years, he has preferred to denounce federal interference rather than resolve the problems of the current system himself. Quebec would have an interest in negotiating with Ottawa to finance a public and universal Quebec plan, rather than demanding a right of withdrawal with full compensation for the sole purpose of maintaining a problematic status quo. Quebec must take advantage of possible convergences and thus improve its negotiating power with the pharmaceutical industry. Moreover, it is already working with the federal government and other provinces to reduce the costs of certain medications.
In this debate, the Quebec government will have to explain itself. Does he want to collaborate constructively with the federal level and take the side of Quebecers who must choose between feeding themselves and taking care of themselves? Or, on the contrary, does it prefer to continue to hide behind the screen of areas of jurisdiction to favor a handful of private interests to the detriment of collective well-being?
*Co-signed this letter: Luc Beauregard, secretary-treasurer of the Centrale des syndicats du Québec (CSQ); Julie Bouchard, president of the Interprofessional Health Federation of Quebec (FIQ); Émilie Charbonneau, 2e vice-president of the Alliance of Professional and Technical Personnel in Health and Social Services (APTS); Maxime Dorais, co-director general of Union des consommateurs; Magali Picard, president of the Quebec Federation of Workers (FTQ); Caroline Senneville, president of the Confederation of National Unions (CSN); Luc Vachon, president of the Central Democratic Unions (CSD); Stéphanie Vallée, president of the Table of Provincial Groupings of Community and Voluntary Organizations (TRPOCB).