Poilievre’s dubious ideas about pharmacare—brought to you by Big Pharma

Conservatives are trying to whip up hysteria about health benefits disappearing and private insurance plans being abolished

This piece was published in Canadian Dimension on October 19, 2024.

Pierre Poilievre wants you to be afraid, very afraid, of single-payer pharmacare. It’s coming for your health benefits, will jack up your taxes and take away your medicines. It may even run off with your teenage daughter.

Earlier this month, with the Liberal government’s pharmacare legislation before the Senate, Conservative leader Pierre Poilievre announced in the House of Commons that he “rejected” the Pharmacare Act, tarring it as a “radical plan” that will rob unionized workers of their existing workplace coverage and “impose an inferior government plan that does not work.”

Conservative MPs have amplified these accusations on social media, trying whip up hysteria about health benefits disappearing and private insurance plans being abolished. Since the Pharmacare Act became law, Poilievre and his party have doubled down on these scare tactics.

By now, we all know (or should know) that fact-checking Conservatives is a largely futile endeavour. But this particular lie about the Pharmacare Act is so big, so egregious, and so widespread – repeated in recent editorials and news stories about pharmacare – that it is necessary to set some facts straight.

The Pharmacare Act is a cautious (too cautious, many would say) but important first step towards including prescription drugs in the umbrella of treatments and services covered by national medicare. This is what’s done in virtually every peer nation with a public health system. And it is in line with what numerous commissions and expert reports have recommended.

The Pharmacare Act makes medications free of charge and accessible to anyone with a health card, starting with diabetes drugs and contraceptives and then expanding to a list of “essential medicines.” Much like the Canada Health Act, the Pharmacare Act will deliver this universal, “first dollar” coverage by providing federal funding to level up existing provincial drug plans.

Pharmacare isn’t just about making medicines available based on need, rather than income; it is also about reining in out-of-control drug prices. The Act provides for the development of a bulk buying plan to help bring down Canada’s sky-high drug prices, which are currently second highest in the OECD world.

The prices Canadians pay for insulin and other diabetes drugs, for instance, are one-and-a-half to two times higher than in countries with public, universal drug plans that negotiate prices with pharmaceutical companies, according to Canada’s drug pricing agency. The bulk buying plan could save the government up to $703 million per year on those medications alone if our drug prices were more aligned with what other countries pay.

Scary stuff, right?

What the Pharmacare Act emphatically does not do is ban private drug insurance plans. Indeed, the text of the bill doesn’t mention private insurance plans even once. But Poilievre insists that Canadians should be spooked because of the legislation’s stated goal of laying the foundation for a single-payer pharmacare program. A single-payer pharmacare plan “means all private plans must be banned,” Poilievre declared in Parliament.

The trouble is that the Act’s blueprint for single-payer pharmacare – the Hoskins report – flatly contradicts this scaremongering. The preamble to the bill specifies that national pharmacare “is to be … carried out in accordance with the recommendations of the Advisory Council on the Implementation of National Pharmacare.” The Advisory Council, headed by former Ontario health minister Dr. Eric Hoskins, emphasized repeatedly in its June 2019 report that there would be no “drastic switch to a fully public plan.” Instead, the Council called for a “stepwise implementation of a system that still allows private plans to supplement public drug coverage, as many countries do.” (p. 100) This is exactly what the Pharmacare Act does.

Dr. Hoskins was crystal clear that there was no question of abolishing private drug benefits, even once the program was fully developed:

National pharmacare should offer comprehensive and affordable coverage so that no one will need supplementary private drug insurance. Nonetheless, individuals should be able to purchase private insurance … for drugs not listed on the national formulary. (p. 58)

So no, the Pharmacare Act does not ban private insurance plans. This shouldn’t be surprising or hard to understand. Single-payer health care hasn’t resulted in the wholesale abolition of private health benefits or the nationalization of the entire insurance industry, so it’s not clear why single-payer pharmacare would.

Where on earth did Poilievre come up with this frankly wacko idea about the Pharmacare Act?

The answer, which should shock no one, is the two groups that stand to lose the most from a policy that would benefit nearly everyone else: Big Pharma and the insurance industry.

Lobbyists for these two industries have been pedaling a number of baseless, alarmist claims about single-payer pharmacare for years, including the idea that people will lose access to private drug plans. Their peak industry associations, Innovative Medicines Canada and the Canadian Life and Health Insurance Association, have spread their scaremongering message through sponsored content placed in major media outlets, biased polling, and misleading social media ads.

And they have relied on a network of Conservative-linked think tanks and media commentators to give greater credibility to their message. This is part of a longstanding strategy by Big Pharma and its allies, which use think tanks to create an “intellectual echo chamber” of industry-friendly messages in the media and in Parliament, something the Council of Canadians profiled in our exposé, “A Prescription for Profit.”

Thus, behind Poilievre’s fact-free denunciation of single-payer pharmacare is a vast lobbying and disinformation effort launched by Big Pharma and its insurance industry allies. While most of this corporate lobbying has concentrated on the Health Minister, once the shape of the pharmacare became clear, attention turned increasingly to the Conservatives.

“The current government seems unlikely to rethink its pharmacare policy,” lamented Brett Skinner in the pages of the National Post after the legislation was unveiled. Skinner, a pharma lobbyist-turned-think tank expert, suggested opponents of single-payer pharmacare seek out the “government-in-waiting” of Pierre Poilievre and the Conservatives for a more sympathetic hearing.

After news broke that a pharmacare deal had been reached, insurance and pharmaceutical industry lobbyists were quick to set up meetings with the Conservatives’ health critic and deputy leader, Stephen Ellis.

On the heels of the first reports that pharmacare legislation was coming, Ellis met with lobbyists from Manulife (February 27th), the Canadian Life and Health Insurance Association (February 27th), the pharma-funded Canadian Pharmacists Association (February 28th), Innovative Medicines Canada (March 1st) and the insurance industry lobby group Smart Health Benefits Coalition (March 1st), according to the federal lobbying registry.

A second flurry of Big Pharma lobbying occurred when the Pharmacare Act was up for review by the Standing Committee on Health, which Ellis co-chairs. Ellis and the three other Conservative MPs on the committee met with lobbyists from Innovative Medicines Canada, Pfizer, Novo Nordisk, Merck, Bayer, and Gilead on May 23rd, just as hearings on the pharmacare bill began.

In committee, Ellis took up Big Pharma’s scaremongering talking points with gusto. Under the Pharmacare Act, Ellis alleged, union workers could “lose their [health benefits] plan and all they have is a couple of birth control pills, no physiotherapy, no chiropractic, no support hose, and no mental health access.”

Conservatives have also repeatedly cited a discredited study funded by Innovative Medicines Canada – the drug manufacturers’ leading lobby group – to claim that only 3% of Canadians need pharmacare. “We know that 97.2% of Canadians are already eligible for some form of prescription drug coverage, which is not some funny Conservative talking point,” Ellis declared in the House. “I think it is important to point that out because we are attempting to have an honest conversation here.”

Poilievre has brought the same level of honesty to the conversation about pharmacare in the wake of the Act’s passage. In CP24 interview, Poilievre echoed Ellis’ claim that “over 90%” of Canadians have private plans (the actual figure is closer to 60%) and insisted that “if you vote for [Trudeau and the NDP], you risk losing your drug plan.”

Poilievre’s rote recitation of Big Pharma’s lies on pharmacare might surprise some who have been fooled by the Conservative leader’s faux populist schtick. After all, hasn’t Poilievre lambasted corporate lobbyists in the National Post as “utterly useless,” claiming that they won’t get a special hearing from him and his party? He has specifically targeted” crooked Big Pharma” on social media, and in press statements has denounced Prime Minister Trudeau because he has “refused to stand up to the greedy pharmaceutical companies.” (On this point, Poilievre is not entirely wrong.)

But it has come as no surprise for those tasked with looking out for the substantial interests in Canadian society. “The entire public affairs community in Canada smiled knowingly reading that National Post article,” one veteran lobbyist said to an iPolitics.ca reporter. “A government led by Pierre Poilievre with his ministers will absolutely continue to engage the way they have with corporate Canada.”

On pharmacare as on so many other issues, corporate lobbyists seem to understand better than most that Poilievre is a sheep in wolf’s clothing. He’ll do their bidding and follow along with their agenda, they’ll just have to put up with a little gnashing of teeth.