Federal budget includes $5.3 billion for dental coverage plan, but few details on pharmacare

Health experts have for years called on the federal government to expand health coverage to dental care, prescription drugs and a host of other expenses to help low-income Canadians, the uninsured and other vulnerable groups.Chris Young/The Canadian Press

The federal government is moving forward with the largest expansion of the country’s health care system in decades, with plans to cover the cost of dental care for low-income Canadians and the first steps toward creating a national pharmaceutical care program outlined in Thursday’s federal budget.

But several key promises Liberals campaigned on last year were not mentioned, such as $3.2 billion to support the hiring of 7,500 new doctors and nurses and a commitment to raise the minimum wage for personal support workers to at least $25. per hour. And while the Liberals promised to spend $6 billion to address waiting lists, the budget only committed $2 billion.

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Finance Minister Chrystia Freeland told a news conference that the government remains committed to the promises in its platform and more will come in future budgets.

“This is something that we need to work hard on together with the provinces and territories to get it right,” said Ms. Freeland. “It’s a tough challenge.”

He said Canada spends more than other countries on health and performs worse overall, suggesting a smarter approach to health spending is needed.

“Canada’s biggest challenge is not that we don’t spend enough on health care,” said Ms. Freeland.

But it is unclear how the government intends to improve health outcomes. In a statement, the Lung Health Foundation said it wanted the federal government to put conditions on health transfers to ensure provinces met improvements in health care, but the budget did not include any of those details.

The budget details priorities designed to address some of the problems caused or worsened by the ongoing pandemic, including funding research on the long-term impacts of COVID-19 and an expansion of student loan forgiveness programs. to encourage doctors and nurses to work in rural and remote areas.

But the budget did not include any new spending to address chronic problems in the country’s long-term care system, many of which were exposed during the first waves of COVID-19, when thousands of older people fell ill and died. And while the government is committing $100 million over three years to reduce, treat and prevent opioid harm, experts say it’s not enough.

“I would say the crisis is probably going to be much more than $100 million in demand,” said Margaret Eaton, national executive director of the Canadian Mental Health Association. “People are desperate for support and there are very few programs available that are evidence-based and effective.”

Commitment to a dental coverage program for low-income Canadians and to a national pharmaceutical care program to cover the cost of prescription drugs are integral parts of a trust and supply agreement between the Liberals and the NDP, under the which the New Democrats pledge to support the government as long as they act on their priorities.

Health experts have for years called on the federal government to expand health coverage to dental care, prescription drugs and a host of other expenses to help low-income Canadians, the uninsured and other vulnerable groups.

Under the budget, the government will spend $5.3 billion over the next five years on a new dental coverage plan, to be rolled out later this year starting with children under 12. Families earning less than $90,000 a year will be eligible for coverage and those earning less than $70,000 will not have to pay any flat-rate copays for dental visits. Next year, coverage will be extended to children under 18, older adults and people with disabilities. The program will be fully implemented by 2025 and the government says it will spend $1.7 billion on the program annually once it is fully operational.

Michel Breau, chief of advocacy and governance for the Canadian Dental Association, said the commitment to dental coverage will benefit many low-income and vulnerable people. He said the association wants the program to work with existing provincial health plans rather than create an entirely new system.

The budget had few details on the implementation of pharmacare beyond saying the government wants a bill passed by the end of next year, followed by the creation of a list of essential drugs to be covered and a plan for purchasing from Wholesale.

Steve Morgan, a pharmaceuticals expert and professor at the University of British Columbia’s School of Population and Public Health, said it’s unclear whether the federal government is serious about implementing a national drug coverage plan. Without one, millions of Canadians will continue to struggle to pay for medications or stop taking them altogether, all while the country spends too much on drugs, Dr. Morgan said.

“There is nothing that really says a [pharmacare] the plan is going to happen,” he said. “We will spend somewhere in the range of $5 to $7 billion more on prescriptions this year than it would have if we had a national pharmaceutical care program.”

Canadian Center for Policy Alternatives senior economist David Macdonald said in a statement that the budget represents a “major missed opportunity” to invest in pharmacare, an overhaul of long-term care and a better health care system.

Canada’s health transfer to the provinces and territories will be $45.2 billion in 2022-23, which the government says is an increase but is well below what the provinces and territories have been requesting. Canada’s prime ministers have been pushing for the federal government to increase its contribution to health care costs from 22% to 35%.

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