In the past year, I’ve had the opportunity to talk to hundreds of people across the country about the need for public, universal drug insurance in the context of the Council of Canadians’ campaign for pharmacare. Labour unions have been key partners in this fight, having spearheaded the struggle for this much needed expansion of our public health care system over the past decade. Among union members, as among the general public, support for pharmacare is near universal. Many key activists are current or retired union members, especially in the health care sector.
But occasionally, union members attending our town halls or online meetings have said they feel that pharmacare doesn’t really concern them since they already have drug coverage provided by their job. It’s an understandable attitude, but it is mistaken. As the recent, hard-fought strike by Metro grocery store workers makes clear, a public, universal pharmacare system is vital for all workers, not just those without workplace drug insurance.
Metro pulled pharmacare to hurt striking workers
The five-week Metro strike began on July 29, when over 3,700 workers in the greater Toronto area walked off the job demanding higher wages, more full-time jobs and greater job security. In response to the unexpected rejection of their contract offer, Metro management cut off drug benefits for its employees on the picket lines and their spouses.
“I found that kind of cruel,” Helen Llorens, whose husband works at Metro, told the Toronto Star. “The right to strike is a right, and (workers) shouldn’t be punished for that.”
Shockingly, employers in Canada can punish workers by snatching away their drug coverage in response to a strike – even if they have paid into workplace benefit plans for years, like Llorens’ husband had. While labour law in some western provinces has provisions that limit bosses’ ability to cut off access to benefits, in Ontario and other provinces it is perfectly legal. Once a union is in a legal position to strike, employers are free to modify the terms of employment – including access to drug and other health benefits.
“It’s a union-busting technique,” says Kevin Skerrett, an Ottawa-based labour activist. “And it can be effective.” In his 29 years as a union researcher with CUPE, Skerrett has been directly involved in several strikes where the employer threatened to suspend access to drug and other health benefits.
“When an employer issues this kind of threat, it can scare the bejeezus out of union members and union leaders.”
Perhaps the ugliest aspect of Metro’s decision to drug benefits cut-off was that it was put into effect quietly, leaving shocked employees to discover what had happened at the pharmacy. Jason Sylvester, a Metro meat department manager, learned about the benefits freeze when he was unable to pick up his son’s ear infection medication. Llorens told the Star that she too found out her husband’s drug insurance had been suspended when picking up medicine for her son at the pharmacy. The union received no warning of the cut-off, Global News’ Ahmar Khan reported.
The union responded by setting up a stop-gap drug benefits fund, but the attack by Metro management clearly rattled some workers on the picket lines.
“I’m going for shoulder surgery next week. I’ve been cutting meat for 20 years and that takes its toll on your body,” Sylvester told CityNews. “I’m a little bit stressed about that too, because we’re not covered right now.”
Without public pharmacare, it’s work or suffer
Employers don’t often act on their threats to take away drug benefits, since the optics of putting employees’ health in peril are not good, Skerrett notes. When teaching assistants, research assistants and contract faculty at York University struck in 2018, for instance, the university administration threatened to cut drug benefits, but backed down after an outcry.
“Most public-sector employers recognize this as a nasty, vicious thing to do,” says Skerrett.
Metro, conversely, was unapologetic about the tactics it used against the striking workers. “Benefits are part of the employees’ pay and when they are on strike, the employer stops paying its employees,” Metro spokeswoman Marie-Claude Bacon said in a statement to CityNews. During the course of the five-week strike, the corporate grocery chain posted record profits. Its CEO, Eric Lafleche, is paid over $5.4 million per year.
Employers in both the public and private sectors do at times follow through on threats to freeze drug benefits for striking workers – even if it could have potentially serious health consequences for workers and their families. In 2018, Rio Tinto cut off drug benefits to 1,000 striking Steelworkers in Labrador City, NL, despite the company making $500 million in profit that year.
“It was a little bit of a shock,” Iron Ore Company of Canada worker Chris Hill told CBC News after receiving a letter from Rio Tinto announcing the cut-off. “I know there’s members out there that … are suffering from some serious medical issues.”
When negotiations between Canada Post and CUPW broke down in 2011, management immediately suspended postal workers’ drug, dental and health coverage, cutting off benefits even before a strike was officially declared. CUPW denounced the withdrawal of employee medical benefits, saying some of its members were facing huge bills for medications that would have been covered by their drug plan, CBC reported.
CUPW grievance officer Kevin Mooney told Labour Notes at the time of the strike that the targeting of drug coverage, medical benefits and sick leave was “horrible” for people who were vulnerable at that moment. “We have members in the hospital,” he said. “One woman has cancer and is getting a bone marrow transplant.” As a result of Canada Post’s decision, the woman lost her coverage for prescription drugs and her sick leave payments.
The case for public pharmacare
How is it possible that employers like Metro are able to do such a thing? Beyond the peculiarities of Canadian labour law, it has to do with the fact that Canada – unlike every other country with a developed public health care system – does not yet have universal, public drug coverage. Whether workers get drug coverage or not is largely left up to employers to decide. Provinces offer a variety of stop-gap programs, but most are aimed at specific groups like seniors, children and low-income families, excluding much of the working-age population.
A public, universal pharmacare system would be an enormous improvement for the over 7.5 million people who are un- or under-insured (typically defined as paying more than 50 percent of their drug costs out-of-pocket). It would be a major improvement for young, low-income and racialized workers, who are often over-represented among the uninsured. Hefty pharmacy bills would be a thing of the past, as would “cost-related non-adherence,” which sends hundreds of thousands of people to the ER every year because they cannot afford their medications.
For those with workplace drug coverage, pharmacare would make their access to medications more secure and less costly. Untying drug coverage from employment would mean workers would be free to change jobs or retire without thinking about how it would affect their drug insurance. Over one-fifth of working-class households have at least one individual who feels trapped in their current job because they fear losing their drug coverage. They would also pay significantly less to fund public pharmacare than they currently pay via paycheck deductions for private insurance premiums and out-of-pocket expenses.
But as the Metro strike demonstrates, pharmacare would have an added benefit for workers that is less often talked about. Drug coverage would cease to be a job perk offered by bosses that they can use to divide and weaken their employees when they go on strike. Universal, public pharmacare would make access to prescription drugs a right for everyone, no longer subject to the whims of vindictive employers.
We get what we fight for
Pharmacare, however, is far from a done deal. The insurance industry has ramped up efforts against public pharmacare, looking to drive a wedge between insured and uninsured workers. And Big Pharma is waging a very active behind-the-scenes lobbying effort to block any form of pharmacare that would allow the federal government to negotiate lower drug prices.
Whether we get a public, single-payer pharmacare program that covers everyone or one that merely “fills the gaps” of the existing, broken system will be decided by how vigorously workers, unions, public health care defenders and other progressive groups mobilize to fight back against the industry offensive.