Pharmacare: We Almost There?
Are we there yet?
In the wake of the Liberals 2024 Budget, we pulled Nik Barry-Shaw into the studio to unpack what it all means for the long fight for Pharmacare in Canada. Nik is a campaigner with the Council of Canadians.
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Greetings friends. My name is Jess McLean and I'm here to provide you with some blueprints
Speaker:of disruption. This weekly podcast is dedicated to amplifying the work of activists, examining
Speaker:power structures and sharing the success stories from the grassroots. Through these discussions,
Speaker:we hope to provide folks with the tools and the inspiration they need to start to dismantle
Speaker:capitalism, decolonize our spaces and bring about the political revolution that we know
Speaker:we need. Welcome Nick. Can you introduce yourself to our audience, please? Sure. My name is Nick
Speaker:Berry Shaw. I'm the trade and privatization campaigner with the Council of Canadians. But
Speaker:these days, my job title is probably more like a pharmacare campaigner. Trade and privatization.
Speaker:That's a lot to unpack there alone. I know we came here to talk about pharmacare, but it
Speaker:was like, oh, snap. The Council of Canadians, for folks who have no idea. What that is. Can
Speaker:you give us the coolest notes? Yeah, the Council of Canadians was founded back in 1985, mainly
Speaker:as a kind of a left nationalist organization opposed to free trade. And it was very much
Speaker:in that kind of left nationalist mold. Certainly the person affiliated with the council that
Speaker:people would know the best would be Maude Barlow, who was the chairperson for many, many years
Speaker:and played it. a kind of pivotal role in the fight against free trade in the late 80s and
Speaker:then against NAFTA and against the trade agreements like the MAI and the FTAA for those of that
Speaker:generation for whom those acronyms mean something. These kind of free trade deals that were being
Speaker:drafted by corporations in the years when history was supposed to have ended and they were just
Speaker:going to kind of steamroll over everybody. And so the council played a pretty important role.
Speaker:in organizing and mobilizing Canadians in those various fights in the 80s, late 80s, 90s, and
Speaker:into the 2000s. And since then, you know, trade continues to be an important part of what the
Speaker:Council does, but also fighting against especially healthcare privatization and fighting for the
Speaker:expansion of the public healthcare system has always been a key element of what the Council
Speaker:is about. And... So yeah, I think in general we are one of the few like genuinely membership-based
Speaker:and membership-funded organizations out there that have a national reach. We get 92% of our
Speaker:funding from our members, from donations. We have, I believe, 42 chapters across the country.
Speaker:And certainly for me as someone coming to this from... from Montreal, I'm based in Montreal,
Speaker:I grew up in Montreal, done, lived my whole life in Montreal, and so being involved in
Speaker:kind of the radical left in Montreal, and I'm sure it's the case in many other places, it's
Speaker:mostly rooted in universities, in larger cities, and often you don't have much reach outside
Speaker:of those places, and so the council is very different in that regard, because we have chapters
Speaker:in smaller and mid-sized towns, like... all across the country. And so as an organizer,
Speaker:that's been really fascinating and interesting to be able to kind of be planning and working
Speaker:on campaigns that have a different kind of scope than what I've been familiar with in previous
Speaker:work. This is like totally off topic and I wasn't gonna bring it up, but the four Canadians in
Speaker:the name makes me cringe, just like I'm a staunch. anti-nationalist. And I understand in the context
Speaker:of the free trade and the way that, especially the CAW or the auto workers were being controlled
Speaker:by an American union without their best interests. And so this left it, but you said the term,
Speaker:so I have to talk about it. Right. I was like, you can't drop leftist nationalist without
Speaker:maybe unpacking a little bit so folks understand because anything nationalist now, especially
Speaker:with the word Canadian in it. has a real different flavor to it, if you know what I'm saying,
Speaker:right? It kind of comes. Yes, it does. And so I wonder, does it still have a really nationalist
Speaker:focus, or do you wanna maybe address what I've just thrown at you? No, no, I totally get that.
Speaker:Yeah, the Council of Canadians, it's right there in the name. There have definitely been discussions
Speaker:within the organization, within the membership about changing the name. I think those discussions
Speaker:are always complicated, so we've stuck with what we have. I think ideologically, the organization
Speaker:has kind of moved a substantial distance away from left nationalism. It's not as important
Speaker:a part of our rhetoric, of our ideology, and so on, but I think at the same time, it's still
Speaker:important for a good number of our members and supporters. But I think, yeah, like if you
Speaker:follow... you know, the kind of trajectory of like what Maude Barlow was saying, you know,
Speaker:and what she's done, you know, to the council's credit. I mean, I've only been working with
Speaker:the council for like two years now, but I think you could kind of trace an arc where the council
Speaker:kind of evolved out of a kind of more basic left nationalism where everyone from Maude
Speaker:Barlow to Mel Watkins to Paul Martin, which... blew me away when I was reading. It was like
Speaker:they were part of the founding group, you know, so it was a very like broad, and I would say
Speaker:not actually that left nationalism in some ways at the beginning. And moved in a much more
Speaker:internationalist direction, you know, various campaigns around water, which has been really
Speaker:important for the council over the last, you know, decades. I've done a lot of work with
Speaker:First Nations communities around these things. When what's a wet and was happening those shortly
Speaker:before I joined the organization. I know the council was fairly involved in is happening.
Speaker:Is happening. Well, yeah, there's ongoing, but when the rail blockades and stuff, when it
Speaker:was at its peak, the council was fairly involved in that. I understand. And so, yeah, I think,
Speaker:I think the name, I think, yeah, still poses a problem for some people. Yeah, I think it's
Speaker:just kind of a. gut reaction for me at this point, even when I dig deep, it's just like
Speaker:when I read it. Anytime someone uses the rhetoric actually of four Canadians when they're talking
Speaker:about federal policy worries me because your citizenship actually isn't dependent on a lot
Speaker:of federal programs, nor should it be, right? And so that's kind of politician talk, but
Speaker:we don't wanna get too far off topic. We do really wanna unpack pharmacare and... the legislation
Speaker:that recently passed, which, you know, arguably definitely a victory for those who've been
Speaker:advocating for pharmacare, which has not seen any movement in a very, very long time, despite
Speaker:many election promises by the victor. It's not like we were banking on a single party to win
Speaker:there. The liberals have promised this for a long, long time. And so back in... Late February,
Speaker:early, anyway, not that long ago, you wrote a piece, what I would describe as a victory
Speaker:piece, a celebratory piece with cautionary tales. Definitely not like the NDP tweets that are
Speaker:coming out today that have me raging where they're just claiming they've delivered pharmacare
Speaker:and dental care and winter protection and all of these things that have just been delivered
Speaker:to us today. It's far more complex than that. So I'm glad you're here to kind of get people.
Speaker:to understand the legislation, and then we'll talk about the budget a little bit, and what
Speaker:that means for PharmaCare, plus all kinds of goodies in between. But what excited you about
Speaker:the legislation for PharmaCare, because there was a lot of ways it could have gone. I think,
Speaker:yeah, first I should just say that the legislation has been introduced, but it hasn't been passed.
Speaker:So now it's in second reading. I mean, I'm learning about all the arcane of parliamentary procedure
Speaker:by working on this campaign, but it's gonna go to the committee and then it's gonna go
Speaker:to third reading in the Senate. And so it'll probably get passed sometime like in the fall
Speaker:of 2024. I think that's probably like an optimistic timeline, but the legislation that's been introduced.
Speaker:Bill C-64, I think, is a victory for, you know, the Council of Canadians and for our allies
Speaker:and the Canadian Health Coalition, the unions like the CLC that have been, you know, fighting
Speaker:for this for many, many years, and a lot of the patient advocates and other organizations
Speaker:that have been fighting for this stuff for a long time. And I think... what we were particularly
Speaker:happy to see in there was first of all, it didn't have any out-of-pocket costs, right? So it's
Speaker:what's called first dollar coverage in the legislation. So it means that when you go to the pharmacy
Speaker:and you're getting medications that are covered by this national plan, you're going to get
Speaker:them with your health card. You're not going to be paying with a credit card. And I think
Speaker:that's- Michelle, I'd like to forward for a second. It's a good line. He said that to us.
Speaker:It's a good line. I think we should rip it off. It's a good line. Find a different way to deliver
Speaker:that. No, no, I think we should totally appropriate the... You're reclaiming it? ..the sloganeering
Speaker:of the right when they come with a good one.
Speaker:And in this case, it is actually true. I mean, I think the thing about Doug Ford is like,
Speaker:yeah, that's how it should be, but it ain't what's going on with his healthcare privatization
Speaker:schemes. quite the opposite. But so that was important. So the fact that there's no out
Speaker:of pocket costs, I think that was very important. The fact that it's universal is huge, meaning
Speaker:that everyone covers everybody. It doesn't cover only, the system we have now is this public-private
Speaker:patchwork. Some people have workplace plans. Some people are covered by... public plans
Speaker:that are run by the provinces, and some people have no coverage at all, and there's wildly
Speaker:different levels of coverage. Sometimes you have a big copayment, sometimes you have a
Speaker:huge deductible, so you basically don't get any money back before you pay huge amounts
Speaker:out of pocket. And so it's a mess, and there's lots of people who not only fall through the
Speaker:cracks, but a lot of people who, even with the coverage that they have, can't afford their
Speaker:meds. This is like the means testing we talk a lot about on the show that really gets me
Speaker:pissed off when means testing is introduced to any aspect of healthcare. It's a huge problem
Speaker:because also income levels are really hard to gauge. They lack nuance, family size, cost
Speaker:of living increases, or whether you're in an urban or rural setting, none of that seems
Speaker:to matter. It's just a really arcane way to deliver something that everybody should have.
Speaker:then it makes barriers too, right? Then there's paperwork and other steps that even if you
Speaker:do qualify, you don't, because you don't understand or don't complete the process correctly. So
Speaker:that absolutely is an important point for me too, because it's been the dental care. I mean,
Speaker:I'm not even gonna talk about it, but. No, no, it's actually important to talk about dental
Speaker:care because that was- Now you're gonna get us all wrong left. That was what, yeah. But
Speaker:that was what the insurance industry, and that's what Big Pharma really wanted. Like if you
Speaker:read their lobbying briefs that they were submitting to the Ministry of Health. For PharmaCare.
Speaker:That's what they wanted for PharmaCare. For PharmaCare, they're kinda like in their inter-industry
Speaker:meeting, because Pharma and the insurers are constantly meeting and convening strategy sessions
Speaker:and thinking of how they can shape PharmaCare legislation. They were doing that even before
Speaker:the Supply and Confidence Agreement kind of put PharmaCare back on the political agenda.
Speaker:So they were gunning for something that would be basically a dental care style, means tested,
Speaker:only covers the uninsured, or you have income cutoffs and so on. None of that, right? And
Speaker:I think that's really hugely important. And it was a big defeat for the insurers. And if
Speaker:you look at what their main lobbying industry association was saying afterwards, they were
Speaker:saying, we have serious concerns, they're really upset with the... It felt like the government
Speaker:hadn't listened to them and they'd been lobbying the health ministry like crazy in the lead
Speaker:up. So, you know, I think that the universality is key because it really does entrench the
Speaker:principles that, you know, make our public healthcare system so widely loved and so effective in
Speaker:the pharmacare as it's gonna roll out going forward. Let's talk about that industry lobbying
Speaker:a bit because although this was surprising that it didn't seem to take any of their input,
Speaker:some of their lobbying has been very successful within the ministry, within the cabinet. The
Speaker:Breach did a great article, we'll link in our show notes. You guys opened up about that in
Speaker:your statement where heavy, heavy pressure. I don't think folks realize the amount of layers
Speaker:of lobbying that are involved. Nick touched on it. being pharma and insurance companies
Speaker:colluding and working together. We're talking about like entire teams of highly paid professionals
Speaker:that spend their entire time and effort trying to pressure governments in different ways,
Speaker:kind of like Nick does, but for evil, you know, and much bigger teams with a lot fancier offices,
Speaker:I imagine. I hope because your money should be going elsewhere. But you know what I mean?
Speaker:On top of that, they have think tanks and other kinds of policy type groups that do that work
Speaker:for them or that they create themselves sometimes. It's just so much and they're usually quite
Speaker:successful. So although I'm always very skeptical of any legislation passed these days, like
Speaker:I, there are these pluses are really big considering. but you call them they a lot. Can we name some names?
Speaker:Like we love to talk about blah blah, like when we're talking about other issues, we know who to really go after. Who are the biggest players in Canada
Speaker:that are pushing for lesser pharma care? Yeah, that would be, I mean, there's the big name pharmaceutical corporations
Speaker:like Pfizer, like Johnson & Johnson, like GSK, GlaxoSmithKline, AbV. You know, there's a fairly long list of them.
Speaker:I've been compiling the list. I didn't want to hear that. I just need one. I have to focus
Speaker:my answers. Oh, there's too many. And they have so many resources behind them. So I've been
Speaker:tracking. They haven't even gotten into the insurers yet. No, no. So that's pharma. And
Speaker:then they have their industry body, which is called Innovative Medicines Canada. And that
Speaker:sort of is, you know, regroups all of these brand name drug manufacturers in Canada. And...
Speaker:You know, the CEO of Innovative Medicines Canada is routinely recognized as one of the most
Speaker:influential lobbyists on the Hill. And then on the insurance side, we have really like
Speaker:three big insurers in Canada. We have Manulife, Canada Life, and Sun Life. Those are like the
Speaker:big three. Another one that kind of stands out, because I've been going through the lobbying
Speaker:data for a while now, is Greenshield Canada. which is surprising because it's close to some
Speaker:of the union movement. They work a lot with Unifor and a lot of unions have their insurance
Speaker:plans with Green Shields because it's technically a nonprofit, but they are part along with the
Speaker:big three insurers. They actively participate in the industry lobbying group called the CLEA,
Speaker:which is a very unfortunate acronym, Canadian Life and Health Insurance Association. So,
Speaker:They are very involved and they've been lobbying as much as some of these really big players
Speaker:that have like 10, 20 times the revenues. And so again, this is something I haven't, like
Speaker:this pure speculation on my part, but I'm like, how the hell is this like small insurance company
Speaker:that's supposedly nonprofit playing such a big role in fighting public single-payer pharma
Speaker:care? They have run paid, like sponsored content. in the Globe and Mail. They did a day-long
Speaker:seminar hosted by André Picard that they sponsored. They have done a pilot project that they announced
Speaker:saying, you know, don't do a universal system. We're going to show you how to just do pharma
Speaker:care for, you know, for the poorest of the poor. Oh, we know what that would look like. Yeah.
Speaker:So. really and but presenting it as like this you know of course we care about the struggling
Speaker:you know low-income workers and those are the people that we're doing this for and don't
Speaker:do a universal thing that's just giving money to wealthy people so really bizarre kind of
Speaker:class politics masking what is obviously an industry agenda so i'm like i know we know
Speaker:that they've been funded by a pharmaceutical company we don't know which one right Because
Speaker:it was anonymous and no one's done any digging I haven't had time to do any digging on that
Speaker:but like obviously they're working hand in glove, right? Obviously like they're punching above
Speaker:their weight because somebody is giving them money And so those are the really the two kind
Speaker:of Those are the players on the two sides on the insurance side and the firm aside And yeah,
Speaker:I mean we're up against a lot of money a lot of money a lot of yeah a lot of capitalist
Speaker:power for sure, I don't like Have you ever seen the movie Thank You for Smoking? I haven't,
Speaker:sounds good though. It follows the life of a lobbyist for the tobacco industry. He dines
Speaker:with the head lobbyist for the firearms industry. And I think pharmaceuticals, I can't remember
Speaker:what, but they were like three vices, I can't remember. And... You might appreciate it now
Speaker:having to do what you do, but it does give me the impression it's just like one person lobbying
Speaker:on behalf of all of these huge things. And that's really not what it's like now. I mean, maybe
Speaker:it was in the 80s, but that is a huge conglomerate forced to be up against a member funded organization.
Speaker:I imagine there's probably not a lot of groups dedicating massive amounts of resources to
Speaker:grassroots, pharmacare organizing. And there's just so many issues to fight for. And yeah.
Speaker:Yeah. I mean, this is an issue that the council has been pushing for in various ways since
Speaker:2000. But going into, I guess shortly after the supply and confidence deal was signed,
Speaker:and we were even working on a campaign on pharmacare before that. But with the supply and confidence
Speaker:agreement, we were like, okay. This is an actual opportunity. We have a chance to fight for
Speaker:something here. We know the liberals are very weak and they've only gotten weaker. They're
Speaker:depending on the NDP to prop them up and they've made this formal commitment to pass legislation,
Speaker:to bring legislation on pharmacare. And so, yeah, let's try to concentrate our energies
Speaker:on that and let's try to. raise the temperature as much as possible. Let's try to be strategic.
Speaker:So we did a lot of like mapping of writings and looking at who the MPs were that were really
Speaker:on the bubble on the liberal side, looking at who's in cabinet and who is probably gonna
Speaker:lose the next election. So like, you know, that versus like an MP in the Anglophone part of
Speaker:Montreal. It's like, you know, they're not- Who doesn't need to listen to anybody. Yeah,
Speaker:they don't need to listen to anybody. Except to whoever funds his election. Exactly, yeah.
Speaker:I mean, they probably don't even need funding for their election. They're just going to get
Speaker:a... The war chest is full. You're right. Yeah. So we did a lot of that kind of pre-planning
Speaker:for the campaign. And yeah, I mean, I think it made sense. And I'm pretty happy with what
Speaker:we've been able to achieve. I don't think it's, you know, immodest to say that we've been playing
Speaker:an outsized role because we put the time in and we've been trying to, you know, doing a
Speaker:lot of work. I think one of the orientations that we actually learned... in part from the
Speaker:pharma industry itself was the importance of patient voices. And so making connections with
Speaker:people who have diabetes, people who have a kid with a rare disease, you know, people who
Speaker:have been through the struggle themselves, right, who have found themselves confronted with these
Speaker:ridiculously high drug costs and in many cases have paid for it not only with out of pocket
Speaker:but with their health, right. and who can speak to that of just how dire the need is for PharmaCare.
Speaker:And so we've built relationships with a number of people like that who could be spokespeople.
Speaker:And we organized an 18 city tour, PharmaCare kind of town halls, where we made sure to give
Speaker:these people kind of a platform to speak out alongside experts. And yeah, and I think that
Speaker:was sort of, we were in part drawing inspiration from the Machiavellian. kind of workings of
Speaker:big pharma, right? Because they understand who their worst enemy is, right? They understand
Speaker:that like the thing that is kryptonite for them is like people like Aaron Little, this woman
Speaker:from Port Elgin, Ontario, whose daughter has a rare disease and a pharma company came along
Speaker:and bought the rights to her drug and basically jacked up the price 3000% and was asking families
Speaker:of kids with this rare... kidney disease to pay $300,000 a year to keep their kid alive,
Speaker:basically. And what they do is they give money to the patients to advocate on their behalf.
Speaker:So there are all these pharma-funded patient groups out there that pharma has basically
Speaker:co-opted to get them to go out there and say, look, we need the provincial government to
Speaker:cover this on their plan. we need insurers, private insurers to cover this. Because as
Speaker:soon as you're charging hundreds of thousands of dollars for a drug, there's no actual market
Speaker:for that, right? Like there's no one, no one has that kind of money to like, to pay for
Speaker:the drugs. But so they use those patient voices to basically push their commercial interests.
Speaker:And I think to neutralize criticism from these groups. But there's a ton of people, you know,
Speaker:people like Erin Little who are out there. And in her case, to her credit, they tried to buy
Speaker:her off. And she said, you know, fuck you. Like this is outrageous. This is bigger than me.
Speaker:Yeah. And this is bigger than me. And she had a social conscience about it and was like,
Speaker:yeah, you know, like she, she had people donating her money because, you know, she, and as she
Speaker:put it, she was like, yeah, my daughter is this cute little blonde girl. So of course people
Speaker:want to run GoFundMaze for her. But if like, if I was black, if my daughter was black, like
Speaker:would they be doing that? You know? So, you know- It does leave a lot up to chance, right?
Speaker:Or privilege. Yeah. Yeah, exactly. And so meeting and connecting with people like that and bringing
Speaker:them into the campaign, in some cases people like Bill Swan, another patient advocate from
Speaker:Nova Scotia who's been working on this stuff since the 80s, has COPD, ended up in hospital
Speaker:as a young man because he couldn't get a puffer, because he lost coverage after he aged out
Speaker:of his father's plan. You know, and these people aren't special in the sense that this stuff
Speaker:happens to people every day. It's just happening all the time. There was a poll that was done
Speaker:recently, and it showed 22% of Canadian households have someone who hasn't been able to afford
Speaker:their medication in the last year. Right? So that's... Even with that experience level being
Speaker:high, there's still a lot of Canadians or people in Canada that don't realize how bad the lack
Speaker:of coverage is. because there are some provinces that cover seniors, for example. And, you know,
Speaker:if you're lucky, you could go your entire life without needing regular medication. You kind
Speaker:of go from maybe your parents paying or being covered for medication. You kind of skirt through
Speaker:if you're lucky and you don't need it. And you just assume everybody is in the same situation
Speaker:and they'd be horrified to know that there are now some, like, chemotherapy drugs that aren't
Speaker:covered by OHIT. Anybody in Ontario knows what's... being covered is less and less and less. But
Speaker:that brings me to one of the critiques that I'm sure even you have about the legislation
Speaker:being introduced and the rollout, only including two classifications of drugs to begin with.
Speaker:Those folks need with diabetes, as well as contraception of a few different forms. To my understanding,
Speaker:it's not just a birth control pill. nor is it just insulin, right? So they're kind of categories
Speaker:of drugs. That doesn't even cover some of the folks that you were just talking about, right?
Speaker:Or the people that I was talking about. So how can we look at that critically, but also hopefully?
Speaker:I think, yeah, I mean, I think it's a foot in the door. You know, we have a foothold kind
Speaker:of towards... bigger program because the legislation does lay out a process for expanding it to
Speaker:a bigger list of essential medicines, which most people who've looked at essential medicines,
Speaker:it's usually like the kind of drugs that your family doctor, if you're lucky enough to have
Speaker:one, will prescribe you. These are the most commonly prescribed drugs. So there is that
Speaker:in the legislation, which is positive. But yeah, it started very small. And I think this is
Speaker:partly the revenge of Big Pharma and the insurance industry is, you know, I'm sure that this is
Speaker:something that the liberals, when they have those meetings with those lobbyists, they're
Speaker:telling them, they're like, don't worry, we're going to give the people this much and no further,
Speaker:you know. And even, I mean, you can hear it, right? Like, as soon as the legislation dropped,
Speaker:as soon as it was introduced, Mark Holland, the liberal health minister, went out there
Speaker:and said, you know, I'm not ideological. I'm not sure if we should continue with a public
Speaker:single payer system, right? Even though report after report has shown that it's cheaper, it
Speaker:provides better coverage, it will save us billions of dollars on drug costs. He still thinks we
Speaker:don't have enough data. He says this is a proof of concept. We're doing a pilot project, right?
Speaker:And we're going to see. And the example he cited as an interesting kind of alternative to what
Speaker:we have been pushing for and what the NDP... to its credit had been pushing for in the negotiations.
Speaker:Public single-payer pharmacare, the alternative is PEI. And PEI has a deal with the federal
Speaker:government where they basically give a bunch of money to the provincial health plan, which
Speaker:is fine. I mean, the federal government should be investing more in healthcare, but crucially,
Speaker:it's not single-payer. And the importance of... a program being single payer is that if you
Speaker:cover everybody and you have the federal government negotiating on everyone's behalf, you're able
Speaker:to negotiate down the price of these drugs, right? And that's what big pharma does not
Speaker:want to see. For so many reasons. That's what they're fighting tooth and nail. Because you
Speaker:look when the announcement that we were going to have pharmacare legislation coming. came
Speaker:out with the Supply and Conference Agreement back in March, 2022. I'm only imagining the
Speaker:reaction. So you guys, your wheels started turning, but these folks are always thinking about Farbakar
Speaker:already. They must've been like, oh shit. But that's the interesting thing is their response
Speaker:was, we're pleased to hear this. And we hope that the federal government will go forward
Speaker:and strengthen our public-private system, right? And so it's kind of weird because like, it
Speaker:took me a while to understand this because it's like, why the... why the hell does Big Pharma
Speaker:Care, who's paying? They just want the highest price for their jobs. That's a red flag, right?
Speaker:Their response is a big red flag. That's the problem is they don't want a single payer public
Speaker:system, because then they're gonna be in the same situation that they're in with virtually
Speaker:every other country with a developed healthcare system other than the US, where you have some
Speaker:kind of universal Pharma Care system and where the government negotiates centrally with these
Speaker:pharmaceutical companies. and get significantly lower prices, right? In Canada, we're paying
Speaker:the second highest prices in the world now. We were third for a long time. Now we've passed,
Speaker:I believe it was Germany. And so we're second only to the US. We're paying the second highest
Speaker:prices. And we have tons of people who don't have insurance. And we have tons of people
Speaker:who are covered by, you know, really, yeah, really patchy, really inadequate in public
Speaker:insurance or private insurance. So, you know, that's what they're fighting against, right?
Speaker:And so they've always taken this outward stance of, you know, okay, yes, pharmacare, but work
Speaker:within the existing system. And don't, you know, they try to claim that it's gonna blow up everything
Speaker:else if we do this single payer system. So, OK, I want to go back. Now it's time to talk
Speaker:about the budget. So I want to. Because my ears went up when you spoke about revenge from the
Speaker:industry, you know, in this kind of delayed. rollout because the announcement was for 1.5
Speaker:billion. Like that was the number that was always not always floated out but as part of these
Speaker:budget announcements that we got teasers for. But then we find out it's actually over five
Speaker:years with like less than 60 million for its first year and you folks have done the work
Speaker:you've done the math you're telling us that it's about three billion to cover these to
Speaker:drugs. So because when the announcement came, they asked Jogmeet Singh about it and he was
Speaker:skeptical even then. He seemed to know that there would be lacking funds in the budget.
Speaker:There was not much said about it at the time, but it was part of his initial announcement,
Speaker:like not to really expect much in the 2024 budget itself. And to me, that was just like another
Speaker:red flag. the reaction of the industry that you're talking about there plus the budget
Speaker:announcements, the details. You want to react to all that now. The foundation is still there,
Speaker:but there's a real risk that it's not adequate enough for longevity. Is that? Yeah, there's,
Speaker:I think it's weird because I'm learning the nuances of budget process as we go. So there
Speaker:is a possibility to kind of like up the amount of funding that is there for PharmaCare as
Speaker:things go along. But it's definitely concerning. Like they should be announcing loud and clear,
Speaker:you know, the federal government should be announcing loud and clear to the provinces that this is
Speaker:going to be fully funded, that they're going to, you know, cover a significant chunk if
Speaker:not all of the cost. I mean, like, you know... $3 billion on the federal budget of, I think
Speaker:480 billion or something, it's like 0.6%. You know, it's a rounding error in the federal
Speaker:budget. They could easily, easily tomorrow just cover the whole thing, right? And so the very
Speaker:fact that we're having- I'm sure you could find some of those in there. Like, can we have that?
Speaker:Like, is that possible? Anything that falls from the table, can you kind of beef up pharmacare
Speaker:a little bit? Yeah, I think I was looking at like, when they announced that they were gonna
Speaker:have the- federal civil service cut back on outside consultants and international travel.
Speaker:I think like the annual savings from that were something like five billion over three years
Speaker:or something. I mean, it's just like they're spending that much money just on external consultants
Speaker:and fucking flying people to conferences. Because I'll tell you what to do. I'll do it for free
Speaker:because I'm so pissed off about everything, you know, just yeah. That must have been frustrating
Speaker:because like when you, when I read your article back from February, and rightfully so, you
Speaker:know, it was really celebratory. And you deserved a moment, but then I feel like I get, I get
Speaker:frustrated. Usually I blame the NDP and I focus my rage there because the messaging sometimes,
Speaker:and I'm... I'm bad for this. Like I know we should celebrate any victories because we don't
Speaker:get very many. I understand the importance for the psyche, but I feel like that's just like
Speaker:not my job. So I apologize for everyone out there who feels like I just, I shit on every
Speaker:victory, but I feel like there's always gotta be someone in the room that's going, we gotta
Speaker:keep going. Please keep going. Like, please do not applaud these people. Like, please,
Speaker:like, please just look at them like Oliver and be like, can I please have some more? Like,
Speaker:but. but in a much more assertive way, right? Like at a time where your foot should be on
Speaker:the gas, when that foot is in the doors is not when you kind of lean back, it's when you push
Speaker:forward really aggressively to get in and make it stay there. Because we know the liberals
Speaker:aren't gonna win the next election unless something crazy happens. And we know that the conservatives
Speaker:want nothing to do with pharmacare, let alone a single payer. So, There's two risks, right,
Speaker:that I want to focus on because you gotta mitigate them somehow. The provinces could be a barrier,
Speaker:right? They're, the rollout has complications there with getting them to agree, especially
Speaker:with this paltry sum, as well as the threat of the conservatives if it's not implemented.
Speaker:I've mentioned this before, but it's really important. Kathleen Wynne did this to us in
Speaker:Ontario, so folks should remember. We got all this great labor legislation, but she only
Speaker:introduced it when she knew she was about to lose an election. So it was—it might have been
Speaker:an attempt to win that election, but I think, like, the writing was on the wall. It was just
Speaker:to kind of placate the movements, I think, to get them to pull back a little bit and almost
Speaker:all of it. I think all of it. I would be hard pressed to think of one bit of that bill, including
Speaker:the minimum wage that got canceled, that remained, and they knew it wouldn't because a lot of
Speaker:it had delayed rollouts or only applied to a small target group at the beginning. And so
Speaker:no one really missed it when they axed it, except the minimum wage. That really should have pissed
Speaker:people off. And it did. You know what I'm saying? If something is entrenched, it's delivered
Speaker:to as many people as possible, it becomes way more difficult to come in and rip it away from
Speaker:them. That becomes a real political liability for people. But if it's just this piecemeal
Speaker:thing that's not working, dental care is gone. They're not gonna be able to save that from
Speaker:the conservatives, because it's a fucking mess. And people will probably applaud them because
Speaker:of the bad media around it. So what can we do to farm a care now?
Speaker:Like, what's your plan of attack now that you've got this budget? I think you mentioned the
Speaker:provinces and I think, yeah, that's sort of, is one of the elements of the legislation that
Speaker:is a double-edged sword, right? So it's good in the sense that it's not like dental care,
Speaker:it's actually a public program that will be administered publicly. So like Dental Care,
Speaker:they got Sun Life to be the company that is administering, they basically took out a plan,
Speaker:you know, with Sun Life for all of the people who meet the criteria that they set out, which
Speaker:is crazy complicated. For a universal program, it makes sense, and they're running it through
Speaker:provincial drug plans, and it kind of works like the health transfer where it's like the
Speaker:feds give you this money and you basically have to level up the coverage that you offer people
Speaker:to be. They have to, yeah. Because some of the health transfers have not a lot of strengths.
Speaker:Again this is one of the weaknesses of the legislation is it's very clear for diabetes drugs and for
Speaker:contraceptives that it has to be first dollar, it has to know out of pocket costs, it has
Speaker:to cover everybody. And then it says, okay, and then we're going to expand to essential
Speaker:medicines within a year of passing it, which will, chances are, happen. after the October
Speaker:2025 election, unfortunately, but it'll be coming. But there it's a little, there's a bit of gray
Speaker:area, right? And so if you read what like the insurance industry people are saying, or the
Speaker:pharmaceutical funded think tanks, they're like, okay, yeah, well, next phases will be not universal,
Speaker:will be not single pair, will, you know, and so they're angling for that. So that's something.
Speaker:That's so hard to imagine. What a complicated mess that you'd have two sets of drugs on one
Speaker:and then a whole different system set up for the other. That seems like valuable and expensive.
Speaker:I think the real end game, the immediate goal for us from here till the federal election
Speaker:is, can we get as many provinces as possible to sign on? and have as many people across
Speaker:the country as possible receiving their contraceptives, receiving their diabetes drug for free through
Speaker:their health card, you know, and can we make that happen before October 2025? Because if
Speaker:this is still a program that is just on paper, you know, there's nothing easier for a future
Speaker:Polio government to walk in and just tear it up, you know. So, okay, pharmacare is done.
Speaker:Taking away people's access to insulin, to their diabetes drugs, to their free contraceptives,
Speaker:it's going to be harder. I'm not saying, I mean, Polio could do it, but it's going to be harder.
Speaker:And we'll, you know, I think we'll face that fight when we get there, if we get there. But
Speaker:I think the priority right now is to have as many provinces get on board and roll this out.
Speaker:We know a number of them are already favorable. I mean, the obvious ones being BC and Manitoba.
Speaker:where the NDP is in power provincially. Doug Ford says he needs to see some details and
Speaker:the usual suspects, Alberta and Quebec, what is their deal? I mean, before they even see
Speaker:any details, they're like, no, fuck you, feds. Yeah, I mean, Quebec. We love being a thorn
Speaker:in your side, take that. Quebec is a foregone conclusion. I mean, I guess for Daniel Smith's
Speaker:UCP government too, been doing some digging on this because there are some lobbyists who
Speaker:have been hired by Shoppers, which is owned by Loblaws, and they have been lobbying the
Speaker:provincial government on PharmaCare, the Alberta government on PharmaCare. I'm like, you have
Speaker:to clarify it, because that asshole was the first person to meet with Ford when he won,
Speaker:so they're everywhere. They're everywhere. And so yeah, we've focused pretty much exclusively
Speaker:on the insurance companies and Big Pharma through this campaign, but... I mean, there's just
Speaker:so much legitimate rage against law laws, and they're clearly playing a role in pushing provinces
Speaker:to kind of to fight back or reject the national pharma care plan that I think, yeah, we're
Speaker:going to be we're going to be digging more into that and putting out some research soon on
Speaker:that. I feel like at this rate, Shoppers Drug Mart is going to be the single. provider of
Speaker:medication for Ontarians. I mean, they had that deal with manual life that they had to, I think,
Speaker:retract because people got so pissed off, but it just gives people an idea of how entrenched.
Speaker:We've talked about Gail and Weston even in private clinics, medical clinics, and buying the real
Speaker:estate that's underneath them, as well as our groceries and rental units. So the sway within
Speaker:government, as you can imagine, is massive. So that's just like another layer your opponents,
Speaker:but... It's interesting, because when Galen Weston and the Loblaws people get called to
Speaker:testify, and they say, why are your food prices so damn high? And they say, oh, our profits
Speaker:are coming from pharmaceuticals. Don't worry. Nick is sitting over there giving him the finger.
Speaker:Yeah, we fucking know. No, thanks. And everyone's supposed to be relieved at their grocery store.
Speaker:Oh, well, it's not here. It's when I go get my medication that they're really fucking me.
Speaker:And... Or when I need money at the bank, they're getting my fees there. Because yeah, like that
Speaker:was some sort of out for them. They're so disconnected from why we hate them. But let them remain
Speaker:oblivious. And that's the kind of thing, like the deal that they signed with Manulife was
Speaker:basically they were going to funnel everyone who has a plan with Manulife into their stores.
Speaker:And if we move towards a universal public single pair where people were covered no matter where
Speaker:they are and no matter what kind of job they have, that would be impossible. Those deals
Speaker:would not be on the table for law laws. And they would also probably face scrutiny for
Speaker:the kinds of dispensing fees they're charging at their pharmacies because the federal government
Speaker:will be involved in that too. So, yeah, they have some interests that in seeing this national
Speaker:pharmacare project fail. See, I know everyone's talking about housing a lot. I mean, everybody,
Speaker:well, we are because we can't afford it, but politicians are using housing as a real hot
Speaker:button issue. But when you talk about the level of lobbying that's involved with the pharmacare
Speaker:and that one lobbyist for the innovative medicines of Canada being like the most influential person
Speaker:on the Hill, I can only imagine there's gonna be a lot centered on this and... a lot riding
Speaker:on it for these lobbyists. Their money is clearly going to be in one camp here. I know they like
Speaker:to hedge their bets, which is great, and they still will. But they'll have a real incentive
Speaker:here to get the conservatives to win, because the liberals I don't think are any position
Speaker:to back out of this or even to go back to a multi- what do you call it when it's not single
Speaker:payer? Multi-payer? Mixed or public-private. Yeah. It's so melty. Dual pair. They refer
Speaker:to it as dual pair. That's their... Dual pair, okay. Yeah, although it's really like tens
Speaker:of thousands of pairs because you have so many different plans. Yeah, I can't like see the
Speaker:liberals kind of having... That would just be a little bit messy. So I expect folks to hear
Speaker:about this on the campaign trail and the conservatives to try to make it a way... Any issues that
Speaker:arise from pharmacare a bit of a wedge issue. the way that they're trying to do with dental.
Speaker:But I think the important part there that you're talking about rolling it out to as many people
Speaker:as possible is, although it's two categories of drugs, there are a lot of people and families
Speaker:impacted by diabetes. And I think everyone can understand why it's so important to have that
Speaker:medication. But it's impossible to measure the amount of people that would take advantage
Speaker:of the free contraception. So we might have numbers on people who use it or of the age
Speaker:that one would use it. But I think that the cost of contraception has been a deterrent,
Speaker:you know, an immeasurable factor in a lot more. Cause I've seen a lot of people kind of, and
Speaker:this is what happens when you have rollouts like this or means testing, it pits people
Speaker:against one another on a level. So there's people who have... drugs they can't afford and they
Speaker:want a reason to include their drug and maybe not birth control, right? Like why is birth
Speaker:control so important? So I know why it's so important. Do you wanna like reflect on that?
Speaker:And because right wing or left wing, there's a lot of people out there that need contraception
Speaker:that would have better lives if they could control the amount of births. that they had to experience,
Speaker:or pregnancies rather, that they had to experience? Yeah, I mean, it's a cost barrier for a lot
Speaker:of women, I think especially lower income women, and especially for things like IUDs, which
Speaker:are included in the list of things that will be covered under this PharmaCare plan. The
Speaker:cost barrier is pretty substantial. So yeah, having access to those more effective, less
Speaker:likely to fail forms of birth control is huge. The government cited, I think, a figure of
Speaker:like nine million women and other people who need contraceptives that would benefit from
Speaker:this. So I think, yeah, I think it's going to affect a lot of people and I think diabetes
Speaker:likewise, there's tons of people who have diabetes and I think people will understand pretty easily
Speaker:why this is necessary. But I think... You're talking about a dynamic of like this kind of
Speaker:negative solidarity that we often, working class people often get into, right? Where it's like,
Speaker:how come he has it so fucking good? What about me? You know, he should be suffering like I
Speaker:am. Right? Like that's kind of like, and you see it all the time, public sector versus private
Speaker:sector workers and stuff. And I think also people, it's easy to look at birth control as not life
Speaker:saving, even though it is. It definitely is for many, many people, not just to prevent
Speaker:a pregnancy, but. for issues that they have with their health, they use the birth control
Speaker:pill, I could go on it. We have, but it's one of those easy ones where you could just be
Speaker:like, literally this medication keeps me breathing and it's not covered, but something that a
Speaker:condom could do. This is a real kind of uneducated mentality that's out there, but yeah, it's
Speaker:definitely reminiscent of the same things that we find reasons to punch across instead of
Speaker:up. Yeah, but what's been interesting, and I think is a dynamic that works in the opposite
Speaker:direction, is you have some patient groups, and even ones that get some money from the
Speaker:pharmaceuticals, have been coming out. I don't know how cynical maybe they're trying to get
Speaker:inside the policy process by doing this, but they've been saying, well, we should be next.
Speaker:Cancer drugs need to be next, or drugs for heart disease should be next, and so on. And so it's
Speaker:like... And of course, like, yeah, there's a program there that's changing people's lives
Speaker:and giving them much better access to their medicines without having to pay huge amounts
Speaker:out of pocket. It's like, of course, you want to get on board and most people don't care,
Speaker:you know, like about the politics of the of the program. They just see that this is something
Speaker:that is better and that could make things better for them. So, yeah, I think that's something
Speaker:that, you know, like in the immediate aftermath of the introduction of the bill, there was
Speaker:a number of like. radio national kind of call-in shows. And a lot of people were pretty clear-eyed
Speaker:about it. They were just like, yeah, I know this isn't gonna do anything for me, but I'm
Speaker:still really happy and I hope this program expands. And I think that's the kind of dynamic that
Speaker:is positive, the kind of positive solidarity that people see happening and that we're gonna
Speaker:try to encourage as much as possible from here on out. Because I think that's how we can.
Speaker:win things and I think yeah we're used to kind of you know the Ontario experience that you're
Speaker:referring to where we kind of have this hail mary gains that are thrown at us by a failing
Speaker:government and then they get snatched away just as quickly but there are other instances where
Speaker:things have been built up and you know if people are organized enough they can fight to keep
Speaker:them and even expand them. We just got to do the work I don't know it's tough. but we gotta
Speaker:do it. What is the work then for people listening that want their healthcare drugs covered or
Speaker:they understand the importance of this program and the timeframe in which they need to operate
Speaker:in? What should they be doing other than staying in touch with the Council of Canadians? Yeah,
Speaker:I think, you know. We've been working to have people get out and do canvassing. We're kind
Speaker:of like, we didn't expect to get this far, quite frankly. I love the honesty. Yeah, no, no.
Speaker:Because considering what we're up against, right? I was pretty prepared to just write a very
Speaker:angry analysis post being like, this legislation is crap. And then it's like, whoa, okay, it's
Speaker:actually not crap. It's actually, you know, in line as weaknesses and stuff, but it's in
Speaker:line with what we were campaigning for. So that was a big surprise. But yeah, I mean, I think
Speaker:we're in a phase now where we're trying to build closer relationships with the groups that have
Speaker:been fighting for contraceptives and reproductive health. and reaching out to groups of people
Speaker:who in the diabetes community who aren't being funded because some of the bigger groups are
Speaker:being funded by the pharmaceutical industry, but there are kind of networks and groups of
Speaker:people. That's some shady shit. Yeah. Oh, it's shady as hell. I mean, you can't imagine how
Speaker:shady... They're like tenant rights groups being funded by the landlords. It is exactly that.
Speaker:Oh, that's another episode, Nick. That has such cringe worthiness. But I love the idea of building
Speaker:a wider coalition, because quite often folks try to reinvent the wheel or do that work that's
Speaker:really already been done, meaning organizing around a health issue or whatever it is that's
Speaker:completely tied to what you're advocating for. That's really where folks start to make grounds,
Speaker:because... Yeah, resources can be tight, so people power is important. I mean, and I think,
Speaker:I think like at an individual level, like, I mean, yeah, it's tough to do things individually.
Speaker:I think in general, you know, if you're not gonna join the Council of Canadians, join another
Speaker:group that's campaigning on pharmacare. I think it's important. You need to get, have organizations
Speaker:and you need to get together with people in your community. So we're trying to facilitate
Speaker:that and work with as many groups of people as possible, either through our chapters or
Speaker:even in places where we don't have chapters. But I think, you know, also just talking to
Speaker:people like, you know, probably everybody knows, has maybe people in their family or in close
Speaker:friends who have diabetes, just like, you know, if you educate yourself a bit about the bill
Speaker:and talk to them and see if they know that this is coming and talk to them about it. Because
Speaker:like I think some of the polling I've seen is like 50% of people don't even know like anything
Speaker:about the pharmacare legislation, right? And, you know, had this experience. shortly after
Speaker:the legislation dropped where We got a we got an op-ed in the Toronto Star kind of laying
Speaker:out why we thought this was this was good And it was a victory against Big Pharma and the
Speaker:insurance companies and I wanted to go buy it and I happened to be in Toronto In a kind of
Speaker:north part of Toronto. I can't remember the name It was it wasn't North York But it was
Speaker:not far from there and I just went to all the all the corner stores I was gonna say Dippin'
Speaker:Earths the corner stores in the area trying to get a paper, trying to get a Toronto star.
Speaker:And like nobody had newspapers, you know. We call them convenience stores. Convenience stores,
Speaker:there you go. It's not always on the corner. Yeah, and I went to like three of them and
Speaker:I asked them and they were like, oh no, people don't read the newspaper. It's just like, yeah.
Speaker:It's behind a paywall for me. I never see the, I'm up in the boonies here, North America,
Speaker:Toronto, but, aw. So you still don't have a copy of that? I did, I got a copy. Do I have
Speaker:a copy? Yeah, I got a copy. I actually. But your point was we don't, we just watch CP24
Speaker:here in Ontario. I think it's on in the hospital waiting rooms for us. So we're there a long
Speaker:time. That's where we're supposed to get our news. Yeah. So, so yeah. So there's, there's
Speaker:a lot of, you know, just like basic education of like people within your family. If you happen
Speaker:to be, you know, know more about this issue, just like ask around and share, share stuff.
Speaker:Yeah. I actually got this. It's very silly. I got this copy, paper copy of the Toronto
Speaker:Star out of the garbage of a shopper's drug mart. Because I got one the day after. I was
Speaker:like, do you have yesterday's paper? And they're like, well it's in the garbage. I don't care.
Speaker:I'll take every copy. That's so funny you say that too because I totally get it. Santiago,
Speaker:our producer, he's got a piece coming out for Humber. They do a magazine every year. And
Speaker:I'm like a mom, I feel like I'm just like, you make sure you get me a good copy, not a crease
Speaker:copy. Don't fold it and put it in your bag. Maybe get another copy. Don't forget to get
Speaker:your parents a copy. And he's like, oh no, I know, I know. And you know, we're excited for
Speaker:its release. It matters. It's not silly. It's important. Thank you, Nick, for coming on and
Speaker:for doing this advocacy work. It's a bit of a grind, but we will link, folks. to your campaigns,
Speaker:the op-ed you've referenced, and a whole bunch of the work that you folks are doing. And yeah,
Speaker:folks can check out Council of Canadians, not for Canadians, I made that mistake at the beginning
Speaker:of the episode, this is much better, of Canadians. And also you mentioned Health Coalitions, we've
Speaker:interviewed members from the Ontario Health Coalition. but they're also in a lot of small
Speaker:towns too, including the big cities. But if you can't find a chapter for the Council of
Speaker:Canadians, that is definitely another way that you can push back against this, you know, private
Speaker:industry lobbying and be part of the good guys. But thank you, Nick, for coming on the show
Speaker:too and brightening my view of PharmaCare, because like anything that comes out of this Casa deal,
Speaker:I just, you know, Heavy bias. I don't want to believe anybody in government anymore. And
Speaker:so sometimes I need a calm head to show me those bright spots, the things that are worth fighting
Speaker:for there. Yeah, well, glad to be a hopeful voice. That is a wrap on another episode of
Speaker:Blueprints of Disruption. Thank you for joining us. Also a very big thank you to the producer
Speaker:of our show, Santiago Helu-Quintero. Blueprints of Disruption is an independent production
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