The Grand Plan of Obfuscation: A Guest Post

In response to Saturday's post about the increasing momentum of the neoliberal creep evident in the Trudeau government, frequent commentator BM offered his detailed take on this sorry situation:

It's all part of the Grand Plan of Obfuscation.

Put in a haphazard system of Pharmacare, so that no citizen knows what is covered and by whom. Allow the private sector like Morneau Sheppell to set up systems to track every citizen to make sure they're covered by the eclectic mix of public and private schemes for pills, because it's so complicated, and thus skim off management fees for their "services".

Big Pharma rejoices. Not having a national scheme means nobody is going to bargain for cheap pill prices on a national scale. So drug prices stay high, and the financial corporatists skim off the cream for services rendered tracking all the mush with ZERO value-added for anyone but themselves. All the public has to do is pay over the odds for all the shenanigans, while the politicians issue glib statements as to how they've helped everyone. It'll all cost more overall than what we have now, you can be sure.

Then, at Bay Street banquets, the corporatists will toast each other as to how well they sold the citizenry that piece of goods. The talking will of course be in business code and jargon, the obfuscation of our age. Financial mags will feature glowing articles on how some "genius" spotted a service "missing" from the "market", and worked out a scheme to profit from it. All hail a new "business" Titan! And if you believe all that guff, you'll believe the BS from corporate media on war reporting too.

These business people strike me as the lowest of human life forms, sucking and siphoning money into their pockets from the masses, while maintaining what they have helped society out, but in reality being parasites on the body politic. There is no shame left for those people. They believe their own lies, and act all patrician like Morneau, a man so apparently ill-informed and dim-witted, he'd never heard of business divestiture for holding public office, or if he had, regarded himself as so honest, ethics policies simply didn't apply to him.

Does anyone trust Bell and their ripoff cell phone and cable/internet plans? How about the banks? - Nah, they don't try and flog useless services to little old ladies over the phone, do they? Upstanding corporate citizens, the lot of 'em. The execs claim the moral high ground - "That's not our company policy!" Meanwhile, they incentivize middle management with bonuses to get more and more business, and leave that rapacious class to work out the details on the QT, while issuing highly moral company "policy", and tut-tutting their lowest-ranked employees' behaviour. Then doing bugger all to change things. It's all utter and complete bollocks from beginning to end.

Is anyone honest these days? I find precious little evidence of it. Everyone is trying to rip off everyone else just to make a living. It didn't use to be so obviously bent. But big business with the federal government in their pockets seem intent on ruining the ethics of the average citizen by lying, innuendo and complex ripoff schemes like National Pharma, and allowing it to be just obvious enough that we all turn into scheming thieves ourselves because it's the norm. You can't trust anyone these days - we're all stealthily trained to be greedy. Everyone is out for their own advantage.

A population ruined like this has no empathy, couldn't care less about anyone else, and if you expect them to really care about the environment, well good luck. Thus the brain dead cheer lower "taxes" as if it were some sort of universal truism, and society gradually turns into sh*t, with no hope of altruism whatsoever.

Star Readers Are Not Impressed

Star readers can spot a corrupt policy process when they see one, an acuity they make known as they opine on Bill Morneau's pharmacare plans:

Morneau’s unwise decision to backtrack pharmacare, Walkom, March 2

Every parent knows this: If you aren’t really going to take your kids to the zoo, don’t mention it at all.

When we heard details included in the Liberal’s budget this week, we were delighted. That evening’s conversation around our dining-room table with our adult children was animated and optimistic. One of the most exciting elements in the budget was the announcement of the government’s commitment to pharmacare.

Then, came Finance Minister Bill Morneau’s near-immediate dialing back: not a “plan” exactly, more of a “strategy,” and other weasely sounding words. What a colossal disappointment.

I reluctantly excused the Liberal’s backtrack from their promise to reform our electoral system. Please don’t let the pharmacare “promise” go the same way. We need to hear their clarification and recommitment — and soon. Just be straight with us. Are we going to the zoo or aren’t we?

Jeannie Mackintosh, St. Catherines, Ont.

I was even encouraged by the enlistment of former Ontario health minister Eric Hoskins, whose provincial government recently implemented a long-overdue pharmacare program, albeit one only covering residents under age 25. It was a start and I hoped that coverage would increase eventually to provide coverage for all.

My feelings of elation and hope were soon dashed when Finance Minister Bill Morneau announced it wouldn’t be universal but would amount to a patchwork of coverage, with some people included in the government plan and others not.

This is unacceptable. We don’t need some mish-mash of a program. Let’s do it right and make a universal plan and, as the research indicated, the overall cost to health care should see a reduction. Perhaps Australia’s government could advise how best to meet this goal.

Norah Downey, Midland, Ont.

Drug-policy experts were stunned. Canada is the only advanced country with a medicare system that lacks pharmacare. Canadians spend so much on drugs because we don’t have a pharmacare program: drug prices are too high and too many intermediaries like insurance companies and benefit consultants drain money from the system.

Morneau’s approach would leave all that waste in place. The obstacle is that every dollar wasted is somebody’s income and the affected industries — drug manufacturers, drug insurers and drug benefits managers — fight back.

The minister effectively pointed to a potential conflict of interest and then restricted the mandate of the advisory council. I hope the minister will step back and let the council do its work.

Kim Jarvi, Toronto

The Neoliberal Creep - An Update

I'm not sure what I find more offensive. Is it the fact that Bill Morneau, despite all that he has said about his limited vision regarding pharmacare, is apparently lying when he now says he is open to all ideas regarding a national drug-coverage program? Or is it that he holds the Canadian people in such contempt that he thinks we are either too stupid or too inattentive to see through his dissembling?

Finance Minister Bill Morneau now says he’s “agnostic” on proposals for a pharmacare plan after criticism that he was trying to dial back ambitions for a new program to ensure Canadians get the prescription drugs they need.

Morneau said Friday that he’s not seeking to prejudge the outcome of a newly created advisory council that will be looking at the idea or dampen the scope of their recommendations.

“What’s really clear to us is we need to get expert advice on how to do this best,” Morneau said during a visit to Montreal to discuss the budget measures.

What might account for his faux 'come to Jesus' reversal? Could it be that he has outraged influential groups?

... the Canadian Federation of Nurses, Canadian Doctors for Medicare and the Canadian Labour Congress [have written] an open letter to Prime Minister Justin Trudeau demanding Morneau be removed from the file.

They said Morneau has already decided it will not be a universal “plan” that covers all workers — to the detriment of Canadians, and the benefit of insurance and pharmaceutical companies, and, they suggested, Morneau Shepell.

They said it contradicts “overwhelming evidence” on the need for a universal program and undermines the work of Hoskins’ council before it begins.

“It is our hope that insurance industry and pharmaceutical industry interests will not play a role in the implementation of universal public pharmacare,” the letter to Trudeau stated.

Some will say we should not prejudge the process, and that we must give Morneau and his team a chance to get things right. To take such a position, in my view, would be to harbor a political naivete that I am incapable of.

More realistic, to me, is to see the truth of this entire charade, the truth made known when Mr. Morneau, in a moment of carelessness, let his mask slip, revealing what lies beneath - a living, breathing, neoliberal creep.

The Neoliberal Creep

The above title epitomizes both the direction of the entire Trudeau government and the character of specific high-profile individuals within it, most notably Finance Minister Bill Morneau and International Development Minister Marie-Claude Bibeau. The latter two are using their offices, not to promote the public good, but to do the bidding of their corporate masters.



Let's start with Morneau and what has to be one of the most rapid turnarounds/reversals I have ever witnessed in politics. On Monday, I was delighted to learn that Ontario Health Minister Eric Hoskins had resigned his post to head an Ottawa study into pharmacare, a universal program covering drug costs for all, a feature of all countries with universal health care save Canada. Then, less than two days later, Morneau 'clarified' his intention (doubtless after hearing from the pharmaceutical and private insurance companies) that

a new national pharmacare program will be "fiscally responsible" and designed to fill in gaps, not provide prescription drugs for Canadians already covered by existing plans.

Why the walkback/misdirection? Well, part of the allure of real pharmacare is the fact that bulk-buying of drugs means massive savings. This, however, does not sit well with the powerful pharmaceutical industry.

Traditionally, they have threatened to stop manufacturing drugs in jurisdictions that engage aggressively in bulk buying.

Consequently, Morneau is now facing conflict of interest accusations on the pharmacare file.

The Canadian Federation of Nurses, Canadian Doctors for Medicare and the Canadian Labour Congress wrote an open letter to Prime Minister Justin Trudeau demanding Morneau be removed from the file.

They said he has already decided it will not be a universal “plan” that covers all workers, merely a “strategy” to fill in the gaps for those who currently don’t have coverage — to the detriment of Canadians, and the benefit of insurance and pharmaceutical companies, and, they suggested, Morneau Shepell.

They said it contradicts “overwhelming evidence” on the need for a universal program and undermines the work of Hoskins’ council before it begins.


“It is our hope that insurance industry and pharmaceutical industry interests will not play a role in the implementation of universal public pharmacare,” the letter to Trudeau states.

Moneau's cowardice has earned the scorn of The Toronto Star:

...the projected savings that have made comprehensive drug coverage such a popular proposal in policy circles depend in large part upon the program’s universality. Most of the savings created by a pharmacare program would be achieved through the bulk-buying of drugs and the elimination of bureaucracies – potential benefits at least partly forgone by the sort of means-tested approach that Morneau is hinting at.

Morneau doesn’t really mean “fiscally responsible.” He means politically palatable. With no plan to return to a balanced budget, the finance minister wants nothing to do with the inevitable initial costs of such a project, even if avoiding these means forgoing enormous long-term savings.

Increasingly, the Trudeau government is proving itself to be a massive disappointment to progressives in Canada who, unlike some, demand substance, not just the vapid photo-ops that are coming to define this government.

In Part 2, I will look at International Development Minister Marie-Claude Bibeau's plans to cut the private sector in for a piece of the foreign aid action.

Only A Start

A bane of the neoliberal agenda but salvation to countless Canadians, the vision of a national pharmacare program has made a baby step toward realization.

The federal government has joined Canadian provinces and territories in a bulk-buying drug program that aims to lower the cost of prescription medications.

Health Minister Jane Philpott says drug plans administered by the federal government will unite with the provincial and territorial pan-Canadian Pharmaceutical Alliance, which negotiates to lower prices on brand name and generic drugs.

Philpott says in a statement that combining the negotiating power of federal, provincial and territorial governments achieves greater savings for all publicly funded drug programs, increases access to drug-treatment options and improves consistency of pricing across Canada.

While this development is most welcome news, (after all, the Alliance did save buyers $490 million last year) it can only be viewed as an interim measure on the seemingly endless journey toward a national drug plan that would save countless lives and billions of dollars currently being spent inefficiently by both government and private citizens; indeed, many of the latter can ill afford the costly prescriptions that could keep them out of hospital or worse.

A recent column by The Star's Martin Regg Cohn casts the problem into sharp relief:

[I]f we had grappled with prescription drugs the way advanced West European countries have, we would be saving billions of dollars a year by now. Canada is second only to the U.S. in per capita spending on prescription drugs, well ahead of European countries.

In fact, Canada keeps paying the price for a wasteful, inefficient, inequitable, fragmented system that leaves every patient to fend for himself or herself — unless he or she has a company drug benefit plan, gets welfare, or qualifies for seniors’ subsidies. If you’re working poor, or merely working precariously (as many young people are today, jumping from job to job or flitting from contract to contract, never qualifying for benefits coverage) ... tough luck.

While we are rightfully proud of our healthcare system, one that stands in sharp contrast to that of the United States, we have tended to ignore the fact that ours is the only Western publicly-funded system that doesn't have a pharmacare component. This grave deficiency has even been acknowledged and deplored by the right-leaning C.D Howe Institute which, in a recent study, drew the following conclusion:

It is clearly time to rethink pharmacare in Canada. Though the immediate effect of expanding public drug coverage would be an increase in government expenditures, this would likely be more than offset by savings to patients, employers, unions, and individuals who purchase stand-alone private drug coverage, producing a net cost reduction for Canada as a whole.

As pointed out in a Star editorial, the burden of paying for prescription medicines can be very heavy for some individuals:

It’s estimated that one household in five spends $500 or more on prescription drugs each year, and 7 per cent pay more than $1,000 annually. Those unable to pay often go without medicine. And even people covered by workplace drug insurance plans are typically stuck with costly deductibles and co-payments.

It is to be hoped that with the termination of the Harper regime, Canada has left behind its official contempt for evidence-based decision-making. Compelling research clearly tells us that the time is right for finally initiating pharmacare for all of us.

More On Pharmacare

The other day I wrote about an article in the Globe that called into question support for the notion of a national pharmacare program that would see drugs paid for by the government as a fitting and necessary complement to our universal healthcare. I examined the methodology and bias involved in the author's claims that people are not really keen on such a program.

In my view, what 'the people' want is rarely a consideration in public policy-making, unless there are crass political gains to be made. It is one of the reasons I like to read letters to the editor, which offer a more direct insight into people's views on issues. I am therefore reproducing three letters from today's Star on the topic of national drug coverage, two of which support the notions for economic, social and reasons:

Pharmacare to fill the gap, Editorial July 19

The demand for a national plan covering prescription drug costs in Canada has now turned into a flood – with our citizens’ backing for the pharmacare concept rising to over 90 per cent.

Studies published in leading journals indicate that medications save lives by keeping people healthy and that Canada would be saving around $9 billion annually by instituting a national pharmacare plan covering prescription drugs costs – and resorting to logical initiatives such as bulk-buying of drugs.

Despite the weight of evidence, and the push provided by provinces such as Ontario, bold federal leadership in this area has been lacking thus far. We are the only country globally that does not cover the cost of prescription medicine despite Canada’s well established and very successful universal health care system.

It is hoped that the upcoming federal elections will spur heated debates about the need for pharmacare to cover the cost of prescription medicine for Canadians, leading to healthy outcomes for patients and taxpayers alike.

It is time for our federal government to get started – as the key to success in this key health-care area is staring in Canada’s face. Stephen Harper would do well to heed Mark Twain’s sage advice: “The secret of getting ahead is getting started.”

Rudy Fernandes, Mississauga

Surely this study could have picked a better example than Lipitor at “more than $811 a year.” Generic forms of Lipitor and other statin drugs have been available for several years at about $125 for a year’s supply.

If this misrepresentation is the best example that the Pharmacare2020 study can find, what are we to make of the rest of its conclusions? If in fact there are further bulk discounts available, it would be best accomplished through provincial cooperation in the buying process, not by introducing another wasteful level of bureaucracy at the federal level.

This is just another veiled attempt to shake more dollars out of the federal government for something that is the responsibility of the provinces – the delivery of health care services.

Don Mustill, Markham

Thanks for drawing attention to yet another well researched study, Pharmacare 2020, that demonstrates that a national pharmacare plan covering drug costs for all Canadians is not only sorely needed but is economically feasible. All that remains is political will.

Perhaps if we all asked candidates who come knocking on our doors in the coming federal election what their party will do for the millions of Canadians who do not have their prescriptions dispensed for financial reasons, the message might get through.

Bill Wensley, Cobourg

A Tale To Frighten Children (And Uninformed Canadians)

Well, the Globe and Mail is up to its usual agenda of promoting the neocon vision. Not content to let Canadians ruminate on ideas unimpeded by thinly-disguised corporate ideology and scaremongering, it is attempting to sow doubt about a plan that would potentially benefit all Canadians, national pharmacare, whose time has surely come.

For a small primer on the concept, you could check out a post I wrote about two years ago, or conduct a Google search, which will yield some compelling links, including this one:

Canada is the only industrialized country with universal health insurance that does not offer universal prescription drug coverage, and statistics show one in 10 Canadians cannot afford to pay for their medications.

From an economic viewpoint, there is a compelling case to be made for pharmacare. Consider this report, entitled Pharmacare 2020 — The Future of Drug Coverage in Canada, an analysis of which conducted by The Star yielded these conclusions:

Not only would a national pharmacare program ensure that all Canadians have access to drugs they need, it would save billions of dollars. Authored by six health policy experts, the study was published by the Pharmaceutical Policy Research Collaboration at the University of British Columbia.

Pharmacare is the answer. Potential savings from bulk-buying through a single system are substantial. The study’s authors cited the example of Lipitor. A year’s supply of this brand name cholesterol-lowering drug costs at least $811 in Canada, according to the report. In New Zealand, where a public authority negotiates prices for the entire country, it’s $15. “In terms of drug prices, Canada’s multi-payer system is among the most expensive in the world,” they conclude.

Because the arguments in favour of a universal drug plan are compelling, and because it is enjoying a certain momentum, the reactionary right is now starting a smear campaign to undermine enthusiasm, one based on manipulative polling, lies, and half-truths.

Entitled The risks that come with a national pharmacare program, the author of this Globe article, Yanick Labrie (more about him shortly), refers to a recent Angus Reid poll which

found that 91 per cent of Canadians support “the concept of a national ‘pharmacare’ in Canada, that would provide universal access to prescription drugs ...” But they may not be ready to pick up the tab. The survey also found that 70 per cent are against increasing the GST to 6 per cent – from the current 5 per cent – to pay for the program. If you’re not willing to pay for something you want, that may be a sign you don’t really want it that badly.

What Labrie omits here is also the finding that the majority would prefer that it be paid through an increase in corporate taxes, a not unreasonable preference, in my view.

Next, the writer warns of what we might be giving up if we embrace pharmacare:

Canadians should be wary of replacing our mixed system with something like what exists in the U.K. or New Zealand. Socializing a larger part of drug spending through a single-payer pharmacare plan would give more power to government and its bureaucrats to make decisions on behalf of the insured. Policies that restrict access to new medicines would be applied across the board and would penalize all Canadians in the same way.

The implication that this would be tantamount to allowing a 'death-panel' bureaucrat to determine your fate is clearly there. What Labrie doesn't mention is that the decisions on adding new drugs to provincial drug formularies are already made for costly drugs, most of which are not covered by private plans anyway. The case of the cystic fibrosis drug Kalydeco is instructional in this regard. The final decision in that case saw Ontario deciding to fund it.

The above also demonstrates a strategy commonly used by the right: absolutism. There is nothing in any concept of pharmacare that I have ever read that would preclude any of us from still carrying private insurance. Yet read the following assertion by Labrie:

According to a recent online survey conducted by Abacus Data for the Canadian Pharmacists Association, 80 per cent of respondents support the idea of a national prescription-drug program. But only 31 per cent favour replacing our current mixed public-private systems, managed by the provinces, with a national, government-run pharmacare monopoly.

Monopoly? Who said anything about a monopoly? As well, take a look at the Abacus online survey he refers to.

A patently manipulative push poll commissioned by pharmacists, consider the biases built into the following questions:

While many Canadians want enhanced access to medications, many Canadians are also concerned about the cost of a national pharmacare program, losing their private drug plans, and the ability of governments to administrate drug plans effectively.

Which approach to pharmacare comes closest to your view?

The result?

Overall, a plurality of Canadians believed that pharmacare should only cover those Canadians who are not currently covered through some other existing government or private plan.

Here's another:

To what extent are you concerned about the following issues related to a national pharmacare program?

Replacing your current private prescription drug plan with a public plan that would have fewer choices

Increased cost to governments if patients use more prescription drugs than they do now

The ability of governments to administer the plan efficiently and effectively

The result?

Although Canadians were supportive of the proposed national pharmacare plan, most said they would be concerned if a national pharmacare program replaced their current plan with a public plan that had fewer options, if it increased costs to governments because patients use more prescription drugs than they do now, and of the ability of governments to administer the plan efficiently and effectively.

I could go on, but I would encourage you to visit the poll results to see more of the questions asked that guarantee the results the pharmacists sought.

I promised at the start that I would say more about the author of this article, Yanick Labrie, who is described as an economist at the Montreal Economic Institute. A visit to the website will tell you all you need to know about its ideological and economic leanings, as will as a list of present and former executive members, which includes former Harper favourite Maxime Bernier and right-wing commentator and analyst Tasha Kheiriddin. The vice president is currently Jasmin Guénette, former director of public affairs who came back after spending two years at the Institute for Humane Studies in Virginia, an organization that can most charitably be described as an American libertarian outfit.

By all means, let us have a national debate about pharmacare. But let it be an honest one that leaves aside the demagoguery and distortions that currently abound on this issue.

A Timely Message Important To Everyone

The video that follows was made by Canadian Doctors For Medicare, who are advocating for a national pharmacare program, something that a country as rich as ours could well-afford. It is a logical and necessary extension of our national healthcare. In fact, according to an article in The National Post,

Canada is one of the few developed countries in the world without a universal pharmacare program, and we are the only country in the world with a universal medicare system that excludes prescription drugs (as if pharmaceuticals are not an essential element of medical treatment). Each year, a staggering 10% of Canadians cannot fill a prescription due to financial reasons.

Instead of a consistent and uniform standard throughout the country, Canada has a patchwork of provincial programmes that may or may not meet people's needs. During the 12 years I lived in Manitoba in the 70's and 80's, for example, I enjoyed its pharmacare coverage which, at the time, as I recall, had a standard deductible of only $80. While things have changed somewhat in the interim, with the deductible now a percentage of family income, it is far superior to what other Canadian jurisdictions offer.

A sharp contrast is found in Ontario, where I now live; only people over 65 qualify for general coverage. Other groups, depending upon their level of poverty or their special needs, can access some coverage through other programmes.

For a breakdown of what is available in the other provinces and the Territories, click here.



That we do not have a national program offering universal access should be a source of shame. Perhaps if we are ever fortunate enough to elect a government that cares more about the well-being of its citizens than it does about bloated corporate profits, things will change.