National Pharmacare: A Discussion with Chris Bonnett

Video Summary

Roger Thorpe, President of Thorpe Benefits, and Chris Bonnett discuss national pharmacare in Canada. Chris, with extensive experience in the insurance industry and academic research on universal drug insurance, provides insights on the potential implementation and challenges of a national pharmacare program. They discuss the main issues to be solved, barriers to implementation, cost considerations, and potential recommendations for the government. Key points include: Chris Bonnet explains that national pharmacare aims to ensure universal and comprehensive access to prescription drugs for all Canadians. He notes that the main barriers are political will, public attention, and cost. The program has been proposed multiple times since the end of World War II but has never been implemented. They discuss the Parliamentary Budget Office (PBO) report on pharmacare costs, with Chris highlighting potential flaws in the assumptions, such as immediate price reductions and the exclusion of private payer community costs. He emphasizes that all models should be taken with a grain of salt and viewed as a starting point for conversation. Chris recommends a shared cost model between governments, employers, and some out-of-pocket expenses for individuals. He suggests formalizing the existing structure while ensuring universal coverage and national standards for formulary and out-of-pocket costs. He also proposes involving various stakeholders in the governance of the drug program. Both speakers agree that the implementation of national pharmacare is complex and requires more time and study. They emphasize the need for patience from the government and greater engagement from employers in considering the implications for their businesses and employees.

Chapters

Introduction and background of Chris Bonnett

Roger Thorpe introduces Chris Bonnett, who provides his background in the insurance industry, including underwriting, reinsurance, sales, and product development. Chris mentions his academic pursuits, including a doctoral thesis on universal drug insurance in Canada.

Purpose and barriers of national pharmacare

Chris explains that national pharmacare aims to ensure universal and comprehensive access to prescription drugs for all Canadians. He identifies the main barriers as political will, lack of public attention due to competing issues, and cost concerns. Bonnet notes that the idea of a national drug insurance plan has been proposed multiple times since the end of World War II.

Analysis of the Parliamentary Budget Office (PBO) report

Chris discusses the PBO report on pharmacare costs, highlighting potential flaws in its assumptions. He points out issues with the assumed formulary, federal-provincial cooperation, and projected price reductions. Bonnet emphasizes that the model’s savings projections may not be realistic and that it ignores the private payer community in its estimates.

Recommendations for implementing national pharmacare

Chris Bonnett recommends a shared cost model between governments, employers, and some out-of-pocket expenses for individuals. He suggests formalizing the existing structure while ensuring universal coverage and national standards for formulary and out-of-pocket costs. Bonnett also proposes involving various stakeholders in the governance of the drug program and potentially requiring employers to provide coverage to part-timers.

Conclusion and call for patience

Roger Thorpe and Chris Bonnett conclude that implementing national pharmacare is complex and requires more time and study. They emphasize the need for patience from the government and greater engagement from employers in considering the implications for their businesses and employees.