Although it was a hot topic in this election, pharmacare is not a new discussion in Canadian health care. When Medicare was first developed in the 1940s, the intention was to include universal medication coverage.

Yet today, Canada remains the only nation in the world with a universal health care system that does not include universal drug coverage. Instead, we rely on a confusing patchwork of more than 100 public drug plans and 100,000 private insurance plans to provide incomplete and unequal access to essential medications. Canadians who don’t qualify for these plans, whose needs exceed their plan’s limitations, or whose marital or employment status changes, fall through the cracks of this fragmented system.

As an emergency physician, I see firsthand the impact of unaffordable medications on my patients. Each year, approximately three million Canadians don’t fill their prescriptions because they can’t afford them. One million Canadians each year have to choose between food and heat for their homes or buying their medications. When a person with diabetes cannot afford their insulin, they end up in the emergency department with acute and dangerous complications of high blood sugar. Their health outcomes are worse and their costs to the system are higher than if they had access to the life-saving medicines they need.

More than 400 working-aged Canadians die each year due to complications of diabetes alone, simply because they do not have adequate access to prescription medications. This is unacceptable in a first world nation, and Canadians are demanding better.

A national pharmacare program will improve access to essential medicines, reduce disease complications, and reduce costs for Canadian households and businesses. In 2017, the Parliamentary Budget Office estimated that a universal pharmacare plan would save Canadians $4.2 billion in annual prescription costs. This does not take into account the extensive cost-savings we would see in the health care system from reduced chronic disease complications, reduced hospital admissions and emergency department visits, or the economic benefits of reduced sick leave among working Canadians.

Despite their varying political beliefs, the majority of Canadian voters are united on the issue of pharmacare. In August, 67.8 per cent of respondents to a Mainstreet poll called for national pharmacare, agreeing that the federal government should create a system through which it pays for prescription drugs, regardless of the cost to government. In an Angus Reid pre-election poll, 78 per cent of voters supported a national pharmacare program. Even the 57 per cent of Canadians who intended to vote for the Conservatives, whose platform included no pharmacare plan, supported either the Liberal or the NDP plan.

The previous Liberal government created the Advisory Council on the Implementation of National Pharmacare to look into the need for a national drug coverage program in Canada. This was the fifth national commission on this topic in the past 60 years; like all the ones before it, it recommended the urgent implementation of such a program.

In their 2018 federal budget, and in their 2019 election campaign, the Liberals established a commitment to providing fair and affordable drug coverage for all Canadians. However, they have not yet offered details on what that program might look like, how it would be implemented, or when it might be achieved. The time has come for Canadians to hold their new government accountable for the policies we voted for.

As a minority government, the Liberals’ ability to pass legislation will depend upon their ability to co-ordinate with other parties. NDP Leader Jagmeet Singh, whose party campaigned on the urgent development of a universal pharmacare program, has pledged to make it his party’s first order of business in the new Parliament. We hope that our political representatives will have the foresight to remain united on this issue.

Canadians have been clear about what they want. With its re-election, they have given the Liberal Party the opportunity to fulfil its commitment to provide fair and affordable drug coverage across Canada.

Prime Minister Trudeau, can we count on you to follow through?

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Thara Kumar is an emergency room physician based in Red Deer, Alta., a graduate student at the Johns Hopkins Bloomberg School of Public Health, and a member of the board of directors at Canadian Doctors for Medicare.

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