QUARTERLY MAGAZINE JUNE 2018 The health issue 200+ MENTAL HEALTH SPECIALISTS 50+ TOWNS & CITIES Mental health ACROSS ONTARIO MATTERS 20+ YEARS OF EXPERIENCE We partner with organizations to develop and deliver customized mental health and wellness programs. NO WAITING LISTS Our specialized mental health programs Mental health and wellness programs can include: we have developed include: • Psychological and mental health • Gradual return to work + counselling services (Cognability™) 30 LANGUAGES • Initial screening assessment • Post-residential addictions and triaging treatment Continuing Care • Thorough psychological • Community mental wellness assessments strategy and continuum building FEE • Comprehensive treatment planning • Employment and Wellness COVERAGE program for individuals with • Case management BY THIRD PARTY addictions INSURANCE • Tailoring a partnering organization’s mental health programming for sustainable support CONTACT US TODAY TO LEARN MORE ABOUT ALL OF THE SERVICES WE OFFER TOLL FREE: • General Counselling • Rehabilitation Services 1-888-245-5516 • Psychological Assessments (MVA & WSIB) www.daltonassociates.ca • Autism and Behavioural Services • Corporate and Government Services [email protected] CONTENTS JUNE 2018 | THE HEALTH ISSUE Streamlining Canada’s healthcare system for the 21st century 09 Could Pharmacare become the defining policy issue in 2019? 01 Debating decriminalization Treating drug use as a health issue 13 Ontario’s OHIP+ Canada’s new food labels leaving a A microcosm for a national plan 05 bitter taste with some stakeholders 15 CONTENTS EDITOR & PUBLISHER James Baxter EDITORS Catharine Fulton Emily Kennedy Holly Lake Peter Robb WRITERS Janice Dickson Kyle Duggan Rachel Gilmore Kelsey Johnson Kathryn May Kady O’Malley Kirsten Smith Sarah Turnbull Marieke Walsh CONTRIBUTORS The Regulatory Black Hole of Russell Williams & John Muscedere Chris Simpson Sperm Donation 21 Jennifer Zwicker & Stephanie Dunn PHOTOGRAPHER Matthew Usherwood DIGITAL & DESIGN A national seniors Sarah West strategy needs to 27 BUSINESS TEAM Heather Bakken account for complexity John Butterfield Emily Emberson in the aging process Callie Sanderson Yamina Tsalamlal IPOLITICSINTEL Danelia B. Bolivar (Executive Editor) Marguerite Marlin (Deputy Editor) Kirby Bucciero How to solve Canada’s Irina Cristescu wait time problem 29 Felixe Denson James Gragg-Reilly Codie Mitchell Sarah Nixon Charlie Pinkerton Curtis Rafter Vincent Rocheleau Olivia da Silva Kevin Smith Who’s in charge here? The tangled web of 33 201-17 York Street Ottawa, ON K1N 5S7 Canada disability governance Office: 613-789-2772 and policy in Canada ipolitics.ca | [email protected] iPolitics is Canada’s top digital source for independent, up-to-the-minute coverage of Canadian politics and the business of government. Could Pharmacare become the defining policy issue in 2019? Get ready for the politics of pharmacare. BY KYLE DUGGAN JUNE 2018 IPOLITICS MAGAZINE 01 COULD PHARMACARE BECOME THE DEFINING POLICY ISSUE IN 2019? he next federal election will be full of debate about Conservative insider Geoff Norquay agrees pharmacare is the idea of a national single-payer program that will going to be a “pretty big issue.” cover the drug costs of Canadians. T He noted the idea has been around for several election It could be the “defining” issue of the 2019 campaign. cycles but the recent endorsement from a House of At the very least it will be the ground for a battle royal Commons committee and the NDP trying to draw a “line in between the Liberals and the NDP for centre-left voters. the sand” on the political turf it had staked out suggest it will play largely in 2019. Although it’s not clear yet exactly what the Liberal government is cooking up for 2019, insiders are sure the “The Liberals are in mortal combat with the NDP for the issue is primed for political prominence. centre-left vote,” the principal at Earnscliffe said. NDP insider Robin MacLachlan is ready. The House of Commons health committee recommended in April that the federal government should implement a “I think pharmacare could very well be the defining issue universal, single public-payer prescription drug coverage from the policy standpoint in the next election – at least program – days ahead of the Liberals adopting a in the battle for progressive voters that helped elected pharmacare policy at their annual convention in Halifax. Justin Trudeau’s liberals to a majority government,” the vice principal at Summa Strategies said. “This will be The partisan brawling over the issue this past year a battle between the Liberals and the NDP to position culminated shortly after budget day in late February, when, themselves as the party that can actually implement what as part of a concerted NDP question period onslaught, would be in my view the fulfillment of Tommy Douglas’s finance critic Peter Julian charged that the Liberal ‘medicare for all.’” government was “sabotaging” and “vandalizing” the NDP’s C M A H E A L T H SUMMIT 02 IPOLITICS MAGAZINE JUNE 2018 COULD PHARMACARE BECOME THE DEFINING POLICY ISSUE IN 2019? idea, not just stealing it – because the finance minister Pension Plan enhancements, In this case, the parties proposed a system that would be means tested (he has talked about CPP enhancements in the last election, and since said he’s open to hearing from experts what the best there were a lot of skeptics who didn’t think the federal approach would be). government could get the provinces on board. But Liberal insider Rob Silver says no political party “owns” “This government has a record of actually having delivered a specific policy idea. on it,” he said. “You own an idea in politics to the extent that voters UBC professor Steve Morgan, a health economist and associate your political party with that idea,” he said. prominent advocate for a national system, said that the stars might be aligned for the kind of major federal- “There is no reason in fact to believe that Mr. Jagmeet provincial agreement on pharmacare. Singh is synonymous as Mr. Pharmacare. They need to get over themselves and make a case to Canadians on But such a deal could have a narrow window of time, why they are in the best position to to implement it, and depending on what happens in provincial elections this it’s up to the Liberal Party – if they decide to proceed with year. (At time of publication, Ontario had not yet gone to pharmacare – to convince Canadians.” the polls). Silver said while it could could a platform plank for the Based on the Parliamentary Budget Officer’s cost Liberals, elections never turn on just one issue. estimates, he said, a pharmacare sales pitch would be relatively easy for a party to campaign on. It would cost Shachi Kurl, executive director of the Angus Reid Institute, a total of about $19 billion a year. But the provinces said it’s probably too early to figure out if it’s a ballot box and territories already spend some $12.5 billion of that issue. Although past polling her firm has done suggested meaning the feds would only need to put up about $6 there’s strong support for a pharmacare program that billion. would provide relief from prescription costs. And he said it would be tough for the Liberals not to run “These are not issues that are going to hold necessarily on it after the party’s high-profile resolution calling for riding by riding. This is one of those overarching issues pharmacare passed in Halifax this spring. that does cut across political lines,” she said. MacLachlan said he “fully expects” the Liberals to run “Is there an advantage for either the NDP or the Liberals on pharmacare in 2019, but not promise it beforehand on that front when so many people support it, does it because “they want it to be the carrot that they hold out actually become a ballot issue or a ballot question? Hard there for progressive voters to vote for the Liberals rather to say. Sometimes these issues tend to not necessarily than the NDP.” turn the electorate when so many people are on one side of it. Party politics is one thing, the federal government is also examining policy options behind the scenes. “It’s a little like healthcare,” she said. “People say healthcare is at the top of their list of issues consistently, On budget day this year, former Ontario Health Minister but we have yet to see a federal election that’s decided on Dr. Eric Hoskins, a key figure in Ontario’s OHIP+ universal healthcare.” drug coverage for those under 25, was named head of the Advisory Council on the Implementation of National While the NDP and Liberals battle, the Conservatives, Pharmacare. Norquay said, are free to ask critical questions about costs to industry and the consequences of making complex That council is expected to report to the ministers of changes, noting the government’s propensity to botch health and finance by spring 2019. major projects like the beleaguered Phoenix pay system. One key question that’s surrounded Hoskins’ panel “The problem is that you cannot unscramble the eggs is whether it will have to start from scratch by asking that you crack,” he said. “The challenge is that moving to whether pharmacare is a good idea in the first place, and universal coverage with a single-payer (system) would be whether it should be universal single payer system. hugely complex.” Although there have been a few small signs to suggest To achieve universal coverage under a single-payer that it’s leaning in that direction. Some read into the system, the provinces and territories would need to name of the council which includes the key word be “significantly on-side with the federal government,” “implementation.” Norquay said, which means the new system would need A parliamentary petition sponsored by a Liberal MP also to be “as good as what they (the provinces) have now.” called for implementation of a universal pharmacare plan Although Silver said a good analogy might be the Canada “in this 42nd Parliament.” JUNE 2018 IPOLITICS MAGAZINE 03 COULD PHARMACARE BECOME THE DEFINING POLICY ISSUE IN 2019? But Morgan said Hoskins’ appointment bodes well because he’s demonstrated in the past he can rally provinces around a given issue, at least with the country’s health ministers.