Any proposed national program must be designed and implemented in partnership with provinces and territories, as provinces and territories have experience and expertise in delivering pharmacare services to Canadians and are accountable for these services. Premiers reiterated that any national pharmacare program must respect the following principles:
- Improving access through removing cost barriers for patients should be the focus;
- Development should be based on the best available evidence about potential benefits, risks, costs, and reliability of supply;
- Provinces and territories must retain responsibility for the design and delivery of public drug coverage; and
- Federal pharmacare funding must be long-term, secure, flexible and fully offset present and future cost pressures experienced by provinces and territories.
Over the years provinces and territories have made significant investments in their own drug plans that deliver high quality coverage and services to their citizens. The federal government must ensure that any national pharmacare program does not penalize any jurisdiction for investments it has made to improve drug coverage for its citizens. Premiers emphasized that a national pharmacare program requires the federal government to provide funding that fully offsets the present and future incremental cost pressures experienced by provinces and territories.
Premiers also reiterated their support for the principle of asymmetrical federalism and that any jurisdiction that wishes to maintain full control over drug insurance should have the right to opt out unconditionally, with full financial compensation, should the federal government participate financially in the establishment of a national pharmacare plan. Quebec has already indicated its intention to follow that path and all provinces and territories reserve the right to do the same.
Mental Health and Addictions
Mental illness and addictions affect all Canadians at some time, whether it be personally or through family, friends, or colleagues. Culturally-appropriate and patient-centred care is the basis of delivering appropriate mental health and addictions recovery services to patients across Canada. Premiers discussed the delivery of services through the continuum of care from: prevention, screening, community services and early intervention to harm reduction enhanced treatment for those who need it, and longer-term follow-up and recovery programming. All aspects of the continuum of care are critical to addressing mental health and addictions crises in Canada. Premiers urged the federal government to increase work on interdiction of illicit drugs at Canada’s ports and through the postal service, as well as stronger enforcement against traffickers.
Premiers discussed the unique challenges of delivering mental health services for those living in rural, agricultural, remote and northern communities, and noted the need to address housing shortages and homelessness to support sustainable mental health, address substance use challenges and support stabilization and addiction recovery.