The problem
Millions of people still have to choose between filling a prescription and paying for basics like food, housing, or utilities. As health care costs rise, patchwork drug coverage is driving inequality and pushing people deeper into crisis.
Canada needs a single-payer, public Pharmacare program that covers essential medications for everyone, delivered as part of our public health care system and grounded in the principles of the Canada Health Act—equity, accessibility, and universality.
Why it matters
Our health care system is under immense strain. Without expanding it to include prescription drugs, it risks failing to meet the rising demands of an aging population, higher rates of chronic illness, and a growing mental health crisis.
Right now:
- Coverage is fragmented and unfair. Whether you can afford your medications depends on your job, your province, your age, or your income level. Many people have no drug coverage at all.
- People are still choosing between medicine and necessities. One in five adults in Canada report not having the insurance they need to cover medication costs, and many are forced to choose between essential medications and basic necessities like food or rent.
- Pharmacare is partial and patchy. The first phase of national Pharmacare only covers certain contraception and diabetes medications, and so far only four jurisdictions—Manitoba, British Columbia, Prince Edward Island, and Yukon—have signed bilateral agreements.
The latest federal budget did not allocate any new money to expand Pharmacare beyond these initial agreements. The original $1.5 billion over five years announced in 2024 is already largely spoken for by the first wave of deals, and Budget 2025 added no additional funding for new national Pharmacare agreements.
That means there is currently no dedicated federal funding stream to bring the remaining provinces and territories into the program, even though most Canadians still don’t have access to national Pharmacare coverage. With four jurisdictions using most of the existing pot, and no new money set aside in the latest budget, there is a real risk that Pharmacare stalls as a limited pilot instead of becoming a universal program.
Without a strong public push, Pharmacare risks being quietly capped instead of expanded. Without public Pharmacare, there is no real universal health care.
What we’re calling for
Canada needs a single-payer, public Pharmacare program that is permanent, fully funded, and firmly embedded in our public system.
1. Implement single-payer Pharmacare as part of public health care
- Establish single-payer Pharmacare as an integral part of Canada’s public health care system—alongside mental health, long-term care, home care, dental care, and virtual care.
- Design the program to reflect the Canada Health Act principles of equity, accessibility, and universality, so everyone can access necessary medicines regardless of income, employment, or postal code.
2. Keep Pharmacare public, permanent, and fully funded
- Ensure that Pharmacare is publicly delivered and not-for-profit, not handed over to private insurers or for-profit providers.
- Make the program permanent, embedded in and compliant with the Canada Health Act, and fully funded so it can grow with need and withstand political change.
3. Increase federal health transfers to support Pharmacare and expanded care
- Increase the Canada Health Transfer so that the federal share of public health care costs reaches 35% immediately, with a plan to reach 50% of expenditures over time.
- Tie increased transfers to expanded public health care spending, including Pharmacare, and ensure money cannot be diverted to privatized or for-profit delivery.
4. Enforce the Canada Health Act and stop privatization
- Strengthen enforcement of the Canada Health Act to stop privatization and extra-billing in areas like prescriptions, where private interests are pushing further into care.
- Oppose and challenge all forms of health care privatization and instead strongly advocate for public solutions that expand and protect public coverage.
5. Work with allies to win and defend Pharmacare
- Work with health care advocates and allies across the country to protect and strengthen public health care as Pharmacare and other services are brought in.
- Build a broad coalition of unions, patient groups, anti-poverty organizations, seniors’ groups, and community advocates to keep Pharmacare on the agenda and defend it once it’s in place.
