Saturday, September 30, 2023
No Result
View All Result
  • Media
Support Us
Macdonald-Laurier Institute
  • Home
  • About
    • Who We Are
    • Who Makes MLI Work
    • Tenth Anniversary
  • Experts
    • Experts Directory
    • In Memoriam
  • Issues
    • Domestic Policy
      • Agriculture and Agri-Food
      • Canada’s Political Tradition
      • Economic policy
      • Health Care
      • Innovation
      • Justice
      • Social issues
      • Telecoms
    • Energy Policy
      • Energy
      • Environment
    • Foreign Policy
      • Foreign Affairs
      • National Defence
      • National Security
    • Indigenous Affairs
  • Projects
    • The Great Energy Crisis
    • Centre for Advancing Canada’s Interests Abroad
    • Dragon at the Door
    • Canada and the Indo-Pacific Initiative
    • The Transatlantic Program
    • DisInfoWatch.org
    • Competition Policy in Canada
    • Speak for Ourselves
    • Justice Report Card
    • COVID Misery Index
      • Provincial COVID Misery Index
      • Beyond Lockdown
      • COVID and after: A mandate for recovery
    • Indigenous Prosperity at a Crossroads
      • Aboriginal Canada and Natural Resources
    • Past Projects
      • The Eavesdropping Dragon: Huawei
      • Talkin’ in the Free World with Mariam Memarsadeghi
      • An Intellectual Property Strategy for Canada
      • Munk Senior Fellows
      • A Mandate for Canada
      • Confederation Series
      • Fiscal Reform
      • The Canadian Century project
      • Fixing Canadian health care
      • Internal trade
      • From a mandate for change
      • Size of government in Canada
      • Straight Talk
      • Labour Market Report
      • Leading Economic Indicator
  • Events
    • Upcoming Events
    • Past Events
      • MLI Dinners
      • Great Canadian Debates
  • Latest News
  • Libraries
    • Inside Policy
    • Papers
    • Commentary
    • Columns
    • Books
    • Video
  • Home
  • About
    • Who We Are
    • Who Makes MLI Work
    • Tenth Anniversary
  • Experts
    • Experts Directory
    • In Memoriam
  • Issues
    • Domestic Policy
      • Agriculture and Agri-Food
      • Canada’s Political Tradition
      • Economic policy
      • Health Care
      • Innovation
      • Justice
      • Social issues
      • Telecoms
    • Energy Policy
      • Energy
      • Environment
    • Foreign Policy
      • Foreign Affairs
      • National Defence
      • National Security
    • Indigenous Affairs
  • Projects
    • The Great Energy Crisis
    • Centre for Advancing Canada’s Interests Abroad
    • Dragon at the Door
    • Canada and the Indo-Pacific Initiative
    • The Transatlantic Program
    • DisInfoWatch.org
    • Competition Policy in Canada
    • Speak for Ourselves
    • Justice Report Card
    • COVID Misery Index
      • Provincial COVID Misery Index
      • Beyond Lockdown
      • COVID and after: A mandate for recovery
    • Indigenous Prosperity at a Crossroads
      • Aboriginal Canada and Natural Resources
    • Past Projects
      • The Eavesdropping Dragon: Huawei
      • Talkin’ in the Free World with Mariam Memarsadeghi
      • An Intellectual Property Strategy for Canada
      • Munk Senior Fellows
      • A Mandate for Canada
      • Confederation Series
      • Fiscal Reform
      • The Canadian Century project
      • Fixing Canadian health care
      • Internal trade
      • From a mandate for change
      • Size of government in Canada
      • Straight Talk
      • Labour Market Report
      • Leading Economic Indicator
  • Events
    • Upcoming Events
    • Past Events
      • MLI Dinners
      • Great Canadian Debates
  • Latest News
  • Libraries
    • Inside Policy
    • Papers
    • Commentary
    • Columns
    • Books
    • Video
No Result
View All Result
Macdonald-Laurier Institute

CPP debate provides lessons for pharmacare: Sean Speer in the Hill Times

February 4, 2019
in Columns, Domestic Policy Program, Economic policy, In the Media, Latest News, Sean Speer
Reading Time: 3 mins read
A A

The CPP experience shows that we must also put forward constructive alternatives that respond to the needs of those poorly-served by the status quo, writes Sean Speer.

By Sean Speer, February 4, 2019

Pharmacare is bound to be an animating issue in the forthcoming federal budget Canada Pension Plan (CPP) and the subsequent election campaign.

It raises the question: are there analogous issues from the past that can help us think about the impending debate about drug coverage and the role of public policy?

The closest comparison may be the protracted debate about retirement income adequacy and whether to expand the Canada Pension Plan (CPP), which started in earnest in 2009 and culminated in five-year increases to CPP premiums last month. This experience shows the limits of being merely oppositional and the need to put forward constructive alternatives to wrong-headed ideas. The lesson should provide guidance for how critics of pharmacare engage in the current debate.

Readers will recall that the retirement income debate ultimately hinged on whether there was widespread savings gap. Proponents for a CPP expansion believed that there was significant problem necessitating a sweeping policy response. Opponents argued that the problem only involved a small cohort and did not justify a broad-based intervention. The debate went back and forth for years in Parliament, at federal-provincial meetings, and on the opinion pages of newspapers such as The Hill Times. CPP proponents ultimately outlasted their opponents and an expansion of premiums and benefits was enacted in 2017.

I still believe that a CPP expansion was unjustified. Research by Jack Mintz, Phillip Cross, and others showed at the time that concerns about the so-called retirement savings “crisis” were overblown. Only a small sub-section of the population—mainly widows with minimal work experience—were facing income adequacy challenges.

But the problem is critics of a CPP expansion focused most of their attention on challenging the premise that there was a broad-based problem and spent little time developing constructive solutions to better support the cohort that is under-saving. The upshot is that one side of the argument put forward solutions and the other side did not. The former predictably won the debate.

Which brings us back to the pharmacare question.

Presently more than 23 million Canadians are receiving drug insurance through their employers. Another roughly 10 million people have coverage through a combination of public plans. There are roughly 3.5 million Canadians who don’t have insurance and are faced with out-of-pocket costs and poorer access to medicines.

The first two groups, which, of course, represent the vast majority of Canadians, are generally well served by the current hybrid of public and private insurance. The third group, by contrast, would benefit from policy reform.

Yet proponents of a single-payer pharmacare scheme (including recently The Globe and Mail’s editorial board) would have Ottawa impose a “comprehensive” solution to solve a narrow problem. Disrupting drug coverage for 90 per cent of the population to better serve the other 10 per cent seems highly counterproductive. It amounts to the public policy equivalent of wielding a sledgehammer instead of a scalpel.

It’s not enough, however, to merely point out the flaws in a pharmacare proposal. The CPP experience demonstrates that such an oppositional poise is a strategic mistake. There’s a good chance that it leads to a poor policy outcome. Pharmcare opponents must therefore develop and put forward an alternative policy that preserves the strengths of the current model and targets those in need.

One such option is to redesign the Medical Expense Tax Credit (METC) to help those without employer-provided insurance to choose their own insurance and defray the premium costs. A new, refundable tax credit could be set, for instance, at $5,000 per household or $2,500 per individual. There would also be room to adjust these amounts based on income or health status. This approach would provide substantial public support for individuals and families to purchase different forms of private insurance ranging from basic plans to more enhanced benefits. And, most importantly, it would be targeted rather than comprehensive.

Pharmacare critics are correct to spotlight the weaknesses of a single-payer model including its exorbitant costs and poorer access to medicines. But these critiques are a necessary yet insufficient response to the growing calls for sweeping pharmacare reforms. The CPP experience shows that we must also put forward constructive alternatives that respond to the needs of those poorly-served by the status quo. It isn’t enough to discourage the use of a sledgehammer. We need to pick up the scalpel.

Sean Speer is a Munk Senior Fellow at the Macdonald-Laurier Institute.

Share this:
Tags: CPPPharmacareSean Speer
Previous Post

Despite progress on water, the threat of an Indigenous Walkerton remains: Joseph Quesnel for Inside Policy

Next Post

Ep. 22 – The Shifting Sands of Middle East Diplomacy with Shuvaloy Majumdar and Ambassador Barkan

Related Posts

Kishida’s mixed bag of successes and shortcomings: Stephen Nagy in the Japan Times
Columns

Kishida’s mixed bag of successes and shortcomings: Stephen Nagy in the Japan Times

September 28, 2023
MLI in Parliament: Richard Shimooka on defence procurement
Video

MLI in Parliament: Richard Shimooka on defence procurement

September 28, 2023
Conservative populism can break elitism and fix institutions: Jamil Jivani in the National Post
Columns

The dark reality of foreign transnational repression in Canada: Marcus Kolga in iPolitics

September 28, 2023
Next Post
Pod Bless Canada Ep. 3 – Indigenous People and the Natural Resource Economy with Crowley and Coates

Ep. 22 - The Shifting Sands of Middle East Diplomacy with Shuvaloy Majumdar and Ambassador Barkan

Newsletter Signup

Follow us on

Macdonald-Laurier Institute

323 Chapel Street, Suite #300
Ottawa, Ontario, K1N 7Z2 Canada

613.482.8327

info@macdonaldlaurier.ca
MLI directory

Support Us

Support the Macdonald-Laurier Institute to help ensure that Canada is one of the best governed countries in the world. Click below to learn more or become a sponsor.

Support Us

  • Inside Policy Magazine
  • Annual Reports
  • Jobs
  • Privacy Policy

© 2021 Macdonald-Laurier Institute. All Rights reserved.

No Result
View All Result
  • Home
  • About
    • Who We Are
    • Who Makes MLI Work
    • Tenth Anniversary
  • Experts
    • Experts Directory
    • In Memoriam
  • Issues
    • Domestic Policy
      • Agriculture and Agri-Food
      • Canada’s Political Tradition
      • Economic policy
      • Health Care
      • Innovation
      • Justice
      • Social issues
      • Telecoms
    • Energy Policy
      • Energy
      • Environment
    • Foreign Policy
      • Foreign Affairs
      • National Defence
      • National Security
    • Indigenous Affairs
  • Projects
    • The Great Energy Crisis
    • Centre for Advancing Canada’s Interests Abroad
    • Dragon at the Door
    • Canada and the Indo-Pacific Initiative
    • The Transatlantic Program
    • DisInfoWatch.org
    • Competition Policy in Canada
    • Speak for Ourselves
    • Justice Report Card
    • COVID Misery Index
      • Provincial COVID Misery Index
      • Beyond Lockdown
      • COVID and after: A mandate for recovery
    • Indigenous Prosperity at a Crossroads
      • Aboriginal Canada and Natural Resources
    • Past Projects
      • The Eavesdropping Dragon: Huawei
      • Talkin’ in the Free World with Mariam Memarsadeghi
      • An Intellectual Property Strategy for Canada
      • Munk Senior Fellows
      • A Mandate for Canada
      • Confederation Series
      • Fiscal Reform
      • The Canadian Century project
      • Fixing Canadian health care
      • Internal trade
      • From a mandate for change
      • Size of government in Canada
      • Straight Talk
      • Labour Market Report
      • Leading Economic Indicator
  • Events
    • Upcoming Events
    • Past Events
      • MLI Dinners
      • Great Canadian Debates
  • Latest News
  • Libraries
    • Inside Policy
    • Papers
    • Commentary
    • Columns
    • Books
    • Video

© 2021 Macdonald-Laurier Institute. All Rights reserved.

IDEAS CHANGE THE WORLD!Have the latest Canadian thought leadership delivered straight to your inbox.
First Name
Last Name
Email address

No thanks, I’m not interested.