HAMILTON -- A re-elected Liberal government would introduce a national pharmacare program, Justin Trudeau promised Monday -- though he wouldn't say how much it would cost or when it would take full effect.
Speaking in Hamilton, Ont., Trudeau said a Liberal government would invest $6 billion as a "down payment" towards implementing pharmacare, ensuring everyone has access to a family doctor, and improving mental-health services and palliative care.
The Liberal plan involves implementing a national list of drugs to be covered by the program and establishing a Canada Drug Agency to make the purchasing of medication more efficient and affordable for all Canadians.
The promise largely follows the recommendations of a blue-chip panel led by former Ontario health minister Eric Hoskins that laid out a path to establishing a national pharmacare system over the next decade.
Hoskins's report pegged the cost to the public treasury of starting such a program at $3.5 billion in 2022, rising to $15.3 billion each year by the time the program is fully operational in 2027.
Trudeau, however, did not say what the final bill for his plan would be, when he expected to have it in place, or how he expected to reach an agreement with provincial premiers with whom he is often at odds.
"We know that for people who have to take pills every day, the cost of medications represents a terrible financial barrier," Trudeau said during an event at a health-sciences centre.
"Under a re-elected Liberal government, we will work hard every day to make sure no Canadian has to choose between staying healthy and putting food on the table."
The pledge follows a similar commitment from the New Democrats, who are proposing to spend $10 billion a year to ensure that all necessary medication and medical devices are free at the point of care starting in 2020.
Yet both the Liberal and NDP promises are contingent on negotiations with the provinces, which are directly in charge of delivering public health care.
Trudeau acknowledged the fact Monday even as he sought to attack the Conservatives by repeatedly asking whom Canadians wanted to negotiate with Ontario Premier Doug Ford: Conservative Leader Andrew Scheer or Trudeau.
"Who do you want standing up for you?" Trudeau asked during the campaign event, which started with a full attack on Ford's record in office since 2018. "Who do you want negotiating with Doug Ford when it comes to your health care?"
Health-care negotiations between Ottawa and the provinces have traditionally been extremely fractious, and Trudeau faced questions about why Ford would want to work with him given his clear attack on the Ontario premier.
Trudeau pointed to his government's having produced a new health accord over 2016 and 2017 as proof that a re-elected Liberal government would be able to lead a new round of such talks.
At the time, Ford had not yet been elected, and there were seven Liberal premiers across the country. Right now there are two, as many conservative premiers have recently been elected.
Three years ago, provinces and territories were angry when the Liberals cut the annual increase in all-purpose health-care transfers from six per cent to three per cent and instead sought to add more money targeted at home care and mental-health services.
After the provinces together roundly rejected the offer, each signed onto the plan one by one. Manitoba was the last to agree to the new terms this past April.
Following Trudeau's announcement, the NDP released a statement quoting the Liberal leader as saying before the election that he would not force pharmacare or child care on provinces that did not want them.
The party suggested it showed Trudeau would end up bowing to "big corporations and Doug Ford" and not push through pharmacare for all Canadians.
The New Democrats also criticized the Liberals for not doing more to reduce the cost of medications while in power. Drug prices in Canada are the third-highest among members of the club of 36 rich countries known as the Organization for Economic Co-operation and Development.
The Conservatives, meanwhile, criticized Trudeau for not ruling out a ban on workplace drug-benefit programs once a national pharmacare program was operational, and attacked the Liberals for promising pharmacare in the 1997 and 2004 elections and not delivering.
Both the Canadian Medical Association and the Canadian Federation of Nurses Unions issued separate statements saying they welcomed the Liberals' commitment to increase health care funding and move toward a national pharmacare program.
Trudeau's speech on Monday at Hamilton's McMaster University was briefly interrupted by a handful of protesters, who sought to drown out his announcement by repeatedly yelling anti-pipeline slogans. They were escorted from the room without an acknowledgment from the Liberal leader.
Trudeau is spending a second straight day touring key ridings in Ontario, which have bounced from party to party over the years and are key to the leader's re-election hopes.
A handful of protesters were among the supporters who gathered to greet Trudeau outside a deli and bakery in nearby Stoney Creek, including a man wearing a yellow vest and carrying a megaphone who directed a long stream of insults at the Liberal leader. Trudeau did not address them as he greeted the much larger group dressed in Liberal red, who enthusiastically cheered him as he entered the store alongside the local Liberal candidate, incumbent Bob Bratina.
Trudeau received a warm welcome at a whistlestop in Niagara Falls, which is left without an incumbent after the departure of longtime Conservative MP Rob Nicholson. The Tory candidate there is Tony Baldinelli, a communications manager for the Niagara Parks Commission who was once an assistant to Nicholson; the Liberals are running Andrea Kaiser, a former local councillor and member of the family that co-founded the Inniskillin winery.
This report by The Canadian Press was first published Sept. 23, 2019.
