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Since we've been talking about seniors' pharmacare, perhaps it's time to change the modifier and resume a longstanding conversation about universal pharmacare.

Canada is the only industrialized country in the world that boasts a universal health-care program but offers no parallel national scheme so those who need prescription medications can actually get them.

The reality is that most of those who aren't seniors or covered by private health-care plans -- minimum wage employees, seasonal workers, the ever increasing numbers of contract hires in the exponentially expanding freelance economy -- don't have a drug plan at all.

And, as we've discovered during the ongoing debate over changes to seniors' pharmacare in Nova Scotia, even many of those who are supposedly covered also find themselves unable to foot the extra costs for co-pays, premiums and other deductibles, and therefore go without prescribed medications.

The best estimate is that one in 10 Canadians cannot afford the prescription medications they need.

Ironically, Canada and its provincial and territorial governments pay more for prescription drugs than most other western countries.

That's because, despite best efforts by some provinces, we're still hobbled by a patchwork of public and private purchasing schemes so we can't take advantage of national bulk buying, or force pharmaceutical companies to bid for our business.

In 2014, provincial and territorial governments spent $10.4 billion on prescription medications.

The reality, according to the Canadian Medical Association Journal, is that a Canada-wide, no-deductible prescription drug benefit program financed through personal income taxes would save rather than cost taxpayers, reducing public and private spending on prescription drugs by 32 per cent.

We've been talking about the need for such a program since at least the 2002 Romanow report on the future of health care. Unfortunately, that discussion got pushed off the front burner, the stove and out of the kitchen during the Harper years.

Although Justin Trudeau has not expressed support for a national pharmacare program -- the Liberal platform simply said it would make prescription drugs "more affordable" -- his new Liberal government is committed to meeting with the provinces to discuss a new Canada Health Accord.

A national pharmacare program should be part of that discussion.

Is our premier prepared to be part of this discussion?

This article first appeared in Stephen Kimber's Halifax Metro column.

Photo: Tanya/flickr

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