Are we there yet?

In the wake of the Liberals 2024 Budget, we pulled Nik Barry-Shaw into the studio to unpack what it all means for the long fight for Pharmacare in Canada. Nik is a campaigner with the Council of Canadians.

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Resources:

• Follow Nik Barry-Shaw on Twitter (X)
• Toronto Star (paywall) Op-Ed: Pharmacare
• Pharmacare now – The Council of Canadians

Greetings friends. My name is Jess McLean and I'm here to provide you with some blueprints

of disruption. This weekly podcast is dedicated to amplifying the work of activists, examining

power structures and sharing the success stories from the grassroots. Through these discussions,

we hope to provide folks with the tools and the inspiration they need to start to dismantle

capitalism, decolonize our spaces and bring about the political revolution that we know

we need. Welcome Nick. Can you introduce yourself to our audience, please? Sure. My name is Nick

Berry Shaw. I'm the trade and privatization campaigner with the Council of Canadians. But

these days, my job title is probably more like a pharmacare campaigner. Trade and privatization.

That's a lot to unpack there alone. I know we came here to talk about pharmacare, but it

was like, oh, snap. The Council of Canadians, for folks who have no idea. What that is. Can

you give us the coolest notes? Yeah, the Council of Canadians was founded back in 1985, mainly

as a kind of a left nationalist organization opposed to free trade. And it was very much

in that kind of left nationalist mold. Certainly the person affiliated with the council that

people would know the best would be Maude Barlow, who was the chairperson for many, many years

and played it. a kind of pivotal role in the fight against free trade in the late 80s and

then against NAFTA and against the trade agreements like the MAI and the FTAA for those of that

generation for whom those acronyms mean something. These kind of free trade deals that were being

drafted by corporations in the years when history was supposed to have ended and they were just

going to kind of steamroll over everybody. And so the council played a pretty important role.

in organizing and mobilizing Canadians in those various fights in the 80s, late 80s, 90s, and

into the 2000s. And since then, you know, trade continues to be an important part of what the

Council does, but also fighting against especially healthcare privatization and fighting for the

expansion of the public healthcare system has always been a key element of what the Council

is about. And... So yeah, I think in general we are one of the few like genuinely membership-based

and membership-funded organizations out there that have a national reach. We get 92% of our

funding from our members, from donations. We have, I believe, 42 chapters across the country.

And certainly for me as someone coming to this from... from Montreal, I'm based in Montreal,

I grew up in Montreal, done, lived my whole life in Montreal, and so being involved in

kind of the radical left in Montreal, and I'm sure it's the case in many other places, it's

mostly rooted in universities, in larger cities, and often you don't have much reach outside

of those places, and so the council is very different in that regard, because we have chapters

in smaller and mid-sized towns, like... all across the country. And so as an organizer,

that's been really fascinating and interesting to be able to kind of be planning and working

on campaigns that have a different kind of scope than what I've been familiar with in previous

work. This is like totally off topic and I wasn't gonna bring it up, but the four Canadians in

the name makes me cringe, just like I'm a staunch. anti-nationalist. And I understand in the context

of the free trade and the way that, especially the CAW or the auto workers were being controlled

by an American union without their best interests. And so this left it, but you said the term,

so I have to talk about it. Right. I was like, you can't drop leftist nationalist without

maybe unpacking a little bit so folks understand because anything nationalist now, especially

with the word Canadian in it. has a real different flavor to it, if you know what I'm saying,

right? It kind of comes. Yes, it does. And so I wonder, does it still have a really nationalist

focus, or do you wanna maybe address what I've just thrown at you? No, no, I totally get that.

Yeah, the Council of Canadians, it's right there in the name. There have definitely been discussions

within the organization, within the membership about changing the name. I think those discussions

are always complicated, so we've stuck with what we have. I think ideologically, the organization

has kind of moved a substantial distance away from left nationalism. It's not as important

a part of our rhetoric, of our ideology, and so on, but I think at the same time, it's still

important for a good number of our members and supporters. But I think, yeah, like if you

follow... you know, the kind of trajectory of like what Maude Barlow was saying, you know,

and what she's done, you know, to the council's credit. I mean, I've only been working with

the council for like two years now, but I think you could kind of trace an arc where the council

kind of evolved out of a kind of more basic left nationalism where everyone from Maude

Barlow to Mel Watkins to Paul Martin, which... blew me away when I was reading. It was like

they were part of the founding group, you know, so it was a very like broad, and I would say

not actually that left nationalism in some ways at the beginning. And moved in a much more

internationalist direction, you know, various campaigns around water, which has been really

important for the council over the last, you know, decades. I've done a lot of work with

First Nations communities around these things. When what's a wet and was happening those shortly

before I joined the organization. I know the council was fairly involved in is happening.

Is happening. Well, yeah, there's ongoing, but when the rail blockades and stuff, when it

was at its peak, the council was fairly involved in that. I understand. And so, yeah, I think,

I think the name, I think, yeah, still poses a problem for some people. Yeah, I think it's

just kind of a. gut reaction for me at this point, even when I dig deep, it's just like

when I read it. Anytime someone uses the rhetoric actually of four Canadians when they're talking

about federal policy worries me because your citizenship actually isn't dependent on a lot

of federal programs, nor should it be, right? And so that's kind of politician talk, but

we don't wanna get too far off topic. We do really wanna unpack pharmacare and... the legislation

that recently passed, which, you know, arguably definitely a victory for those who've been

advocating for pharmacare, which has not seen any movement in a very, very long time, despite

many election promises by the victor. It's not like we were banking on a single party to win

there. The liberals have promised this for a long, long time. And so back in... Late February,

early, anyway, not that long ago, you wrote a piece, what I would describe as a victory

piece, a celebratory piece with cautionary tales. Definitely not like the NDP tweets that are

coming out today that have me raging where they're just claiming they've delivered pharmacare

and dental care and winter protection and all of these things that have just been delivered

to us today. It's far more complex than that. So I'm glad you're here to kind of get people.

to understand the legislation, and then we'll talk about the budget a little bit, and what

that means for PharmaCare, plus all kinds of goodies in between. But what excited you about

the legislation for PharmaCare, because there was a lot of ways it could have gone. I think,

yeah, first I should just say that the legislation has been introduced, but it hasn't been passed.

So now it's in second reading. I mean, I'm learning about all the arcane of parliamentary procedure

by working on this campaign, but it's gonna go to the committee and then it's gonna go

to third reading in the Senate. And so it'll probably get passed sometime like in the fall

of 2024. I think that's probably like an optimistic timeline, but the legislation that's been introduced.

Bill C-64, I think, is a victory for, you know, the Council of Canadians and for our allies

and the Canadian Health Coalition, the unions like the CLC that have been, you know, fighting

for this for many, many years, and a lot of the patient advocates and other organizations

that have been fighting for this stuff for a long time. And I think... what we were particularly

happy to see in there was first of all, it didn't have any out-of-pocket costs, right? So it's

what's called first dollar coverage in the legislation. So it means that when you go to the pharmacy

and you're getting medications that are covered by this national plan, you're going to get

them with your health card. You're not going to be paying with a credit card. And I think

that's- Michelle, I'd like to forward for a second. It's a good line. He said that to us.

It's a good line. I think we should rip it off. It's a good line. Find a different way to deliver

that. No, no, I think we should totally appropriate the... You're reclaiming it? ..the sloganeering

of the right when they come with a good one.

And in this case, it is actually true. I mean, I think the thing about Doug Ford is like,

yeah, that's how it should be, but it ain't what's going on with his healthcare privatization

schemes. quite the opposite. But so that was important. So the fact that there's no out

of pocket costs, I think that was very important. The fact that it's universal is huge, meaning

that everyone covers everybody. It doesn't cover only, the system we have now is this public-private

patchwork. Some people have workplace plans. Some people are covered by... public plans

that are run by the provinces, and some people have no coverage at all, and there's wildly

different levels of coverage. Sometimes you have a big copayment, sometimes you have a

huge deductible, so you basically don't get any money back before you pay huge amounts

out of pocket. And so it's a mess, and there's lots of people who not only fall through the

cracks, but a lot of people who, even with the coverage that they have, can't afford their

meds. This is like the means testing we talk a lot about on the show that really gets me

pissed off when means testing is introduced to any aspect of healthcare. It's a huge problem

because also income levels are really hard to gauge. They lack nuance, family size, cost

of living increases, or whether you're in an urban or rural setting, none of that seems

to matter. It's just a really arcane way to deliver something that everybody should have.

then it makes barriers too, right? Then there's paperwork and other steps that even if you

do qualify, you don't, because you don't understand or don't complete the process correctly. So

that absolutely is an important point for me too, because it's been the dental care. I mean,

I'm not even gonna talk about it, but. No, no, it's actually important to talk about dental

care because that was- Now you're gonna get us all wrong left. That was what, yeah. But

that was what the insurance industry, and that's what Big Pharma really wanted. Like if you

read their lobbying briefs that they were submitting to the Ministry of Health. For PharmaCare.

That's what they wanted for PharmaCare. For PharmaCare, they're kinda like in their inter-industry

meeting, because Pharma and the insurers are constantly meeting and convening strategy sessions

and thinking of how they can shape PharmaCare legislation. They were doing that even before

the Supply and Confidence Agreement kind of put PharmaCare back on the political agenda.

So they were gunning for something that would be basically a dental care style, means tested,

only covers the uninsured, or you have income cutoffs and so on. None of that, right? And

I think that's really hugely important. And it was a big defeat for the insurers. And if

you look at what their main lobbying industry association was saying afterwards, they were

saying, we have serious concerns, they're really upset with the... It felt like the government

hadn't listened to them and they'd been lobbying the health ministry like crazy in the lead

up. So, you know, I think that the universality is key because it really does entrench the

principles that, you know, make our public healthcare system so widely loved and so effective in

the pharmacare as it's gonna roll out going forward. Let's talk about that industry lobbying

a bit because although this was surprising that it didn't seem to take any of their input,

some of their lobbying has been very successful within the ministry, within the cabinet. The

Breach did a great article, we'll link in our show notes. You guys opened up about that in

your statement where heavy, heavy pressure. I don't think folks realize the amount of layers

of lobbying that are involved. Nick touched on it. being pharma and insurance companies

colluding and working together. We're talking about like entire teams of highly paid professionals

that spend their entire time and effort trying to pressure governments in different ways,

kind of like Nick does, but for evil, you know, and much bigger teams with a lot fancier offices,

I imagine. I hope because your money should be going elsewhere. But you know what I mean?

On top of that, they have think tanks and other kinds of policy type groups that do that work

for them or that they create themselves sometimes. It's just so much and they're usually quite

successful. So although I'm always very skeptical of any legislation passed these days, like

I, there are these pluses are really big considering. but you call them they a lot. Can we name some names?

Like we love to talk about blah blah, like when we're talking about other issues, we know who to really go after. Who are the biggest players in Canada

that are pushing for lesser pharma care? Yeah, that would be, I mean, there's the big name pharmaceutical corporations

like Pfizer, like Johnson & Johnson, like GSK, GlaxoSmithKline, AbV. You know, there's a fairly long list of them.

I've been compiling the list. I didn't want to hear that. I just need one. I have to focus

my answers. Oh, there's too many. And they have so many resources behind them. So I've been

tracking. They haven't even gotten into the insurers yet. No, no. So that's pharma. And

then they have their industry body, which is called Innovative Medicines Canada. And that

sort of is, you know, regroups all of these brand name drug manufacturers in Canada. And...

You know, the CEO of Innovative Medicines Canada is routinely recognized as one of the most

influential lobbyists on the Hill. And then on the insurance side, we have really like

three big insurers in Canada. We have Manulife, Canada Life, and Sun Life. Those are like the

big three. Another one that kind of stands out, because I've been going through the lobbying

data for a while now, is Greenshield Canada. which is surprising because it's close to some

of the union movement. They work a lot with Unifor and a lot of unions have their insurance

plans with Green Shields because it's technically a nonprofit, but they are part along with the

big three insurers. They actively participate in the industry lobbying group called the CLEA,

which is a very unfortunate acronym, Canadian Life and Health Insurance Association. So,

They are very involved and they've been lobbying as much as some of these really big players

that have like 10, 20 times the revenues. And so again, this is something I haven't, like

this pure speculation on my part, but I'm like, how the hell is this like small insurance company

that's supposedly nonprofit playing such a big role in fighting public single-payer pharma

care? They have run paid, like sponsored content. in the Globe and Mail. They did a day-long

seminar hosted by André Picard that they sponsored. They have done a pilot project that they announced

saying, you know, don't do a universal system. We're going to show you how to just do pharma

care for, you know, for the poorest of the poor. Oh, we know what that would look like. Yeah.

So. really and but presenting it as like this you know of course we care about the struggling

you know low-income workers and those are the people that we're doing this for and don't

do a universal thing that's just giving money to wealthy people so really bizarre kind of

class politics masking what is obviously an industry agenda so i'm like i know we know

that they've been funded by a pharmaceutical company we don't know which one right Because

it was anonymous and no one's done any digging I haven't had time to do any digging on that

but like obviously they're working hand in glove, right? Obviously like they're punching above

their weight because somebody is giving them money And so those are the really the two kind

of Those are the players on the two sides on the insurance side and the firm aside And yeah,

I mean we're up against a lot of money a lot of money a lot of yeah a lot of capitalist

power for sure, I don't like Have you ever seen the movie Thank You for Smoking? I haven't,

sounds good though. It follows the life of a lobbyist for the tobacco industry. He dines

with the head lobbyist for the firearms industry. And I think pharmaceuticals, I can't remember

what, but they were like three vices, I can't remember. And... You might appreciate it now

having to do what you do, but it does give me the impression it's just like one person lobbying

on behalf of all of these huge things. And that's really not what it's like now. I mean, maybe

it was in the 80s, but that is a huge conglomerate forced to be up against a member funded organization.

I imagine there's probably not a lot of groups dedicating massive amounts of resources to

grassroots, pharmacare organizing. And there's just so many issues to fight for. And yeah.

Yeah. I mean, this is an issue that the council has been pushing for in various ways since

2000. But going into, I guess shortly after the supply and confidence deal was signed,

and we were even working on a campaign on pharmacare before that. But with the supply and confidence

agreement, we were like, okay. This is an actual opportunity. We have a chance to fight for

something here. We know the liberals are very weak and they've only gotten weaker. They're

depending on the NDP to prop them up and they've made this formal commitment to pass legislation,

to bring legislation on pharmacare. And so, yeah, let's try to concentrate our energies

on that and let's try to. raise the temperature as much as possible. Let's try to be strategic.

So we did a lot of like mapping of writings and looking at who the MPs were that were really

on the bubble on the liberal side, looking at who's in cabinet and who is probably gonna

lose the next election. So like, you know, that versus like an MP in the Anglophone part of

Montreal. It's like, you know, they're not- Who doesn't need to listen to anybody. Yeah,

they don't need to listen to anybody. Except to whoever funds his election. Exactly, yeah.

I mean, they probably don't even need funding for their election. They're just going to get

a... The war chest is full. You're right. Yeah. So we did a lot of that kind of pre-planning

for the campaign. And yeah, I mean, I think it made sense. And I'm pretty happy with what

we've been able to achieve. I don't think it's, you know, immodest to say that we've been playing

an outsized role because we put the time in and we've been trying to, you know, doing a

lot of work. I think one of the orientations that we actually learned... in part from the

pharma industry itself was the importance of patient voices. And so making connections with

people who have diabetes, people who have a kid with a rare disease, you know, people who

have been through the struggle themselves, right, who have found themselves confronted with these

ridiculously high drug costs and in many cases have paid for it not only with out of pocket

but with their health, right. and who can speak to that of just how dire the need is for PharmaCare.

And so we've built relationships with a number of people like that who could be spokespeople.

And we organized an 18 city tour, PharmaCare kind of town halls, where we made sure to give

these people kind of a platform to speak out alongside experts. And yeah, and I think that

was sort of, we were in part drawing inspiration from the Machiavellian. kind of workings of

big pharma, right? Because they understand who their worst enemy is, right? They understand

that like the thing that is kryptonite for them is like people like Aaron Little, this woman

from Port Elgin, Ontario, whose daughter has a rare disease and a pharma company came along

and bought the rights to her drug and basically jacked up the price 3000% and was asking families

of kids with this rare... kidney disease to pay $300,000 a year to keep their kid alive,

basically. And what they do is they give money to the patients to advocate on their behalf.

So there are all these pharma-funded patient groups out there that pharma has basically

co-opted to get them to go out there and say, look, we need the provincial government to

cover this on their plan. we need insurers, private insurers to cover this. Because as

soon as you're charging hundreds of thousands of dollars for a drug, there's no actual market

for that, right? Like there's no one, no one has that kind of money to like, to pay for

the drugs. But so they use those patient voices to basically push their commercial interests.

And I think to neutralize criticism from these groups. But there's a ton of people, you know,

people like Erin Little who are out there. And in her case, to her credit, they tried to buy

her off. And she said, you know, fuck you. Like this is outrageous. This is bigger than me.

Yeah. And this is bigger than me. And she had a social conscience about it and was like,

yeah, you know, like she, she had people donating her money because, you know, she, and as she

put it, she was like, yeah, my daughter is this cute little blonde girl. So of course people

want to run GoFundMaze for her. But if like, if I was black, if my daughter was black, like

would they be doing that? You know? So, you know- It does leave a lot up to chance, right?

Or privilege. Yeah. Yeah, exactly. And so meeting and connecting with people like that and bringing

them into the campaign, in some cases people like Bill Swan, another patient advocate from

Nova Scotia who's been working on this stuff since the 80s, has COPD, ended up in hospital

as a young man because he couldn't get a puffer, because he lost coverage after he aged out

of his father's plan. You know, and these people aren't special in the sense that this stuff

happens to people every day. It's just happening all the time. There was a poll that was done

recently, and it showed 22% of Canadian households have someone who hasn't been able to afford

their medication in the last year. Right? So that's... Even with that experience level being

high, there's still a lot of Canadians or people in Canada that don't realize how bad the lack

of coverage is. because there are some provinces that cover seniors, for example. And, you know,

if you're lucky, you could go your entire life without needing regular medication. You kind

of go from maybe your parents paying or being covered for medication. You kind of skirt through

if you're lucky and you don't need it. And you just assume everybody is in the same situation

and they'd be horrified to know that there are now some, like, chemotherapy drugs that aren't

covered by OHIT. Anybody in Ontario knows what's... being covered is less and less and less. But

that brings me to one of the critiques that I'm sure even you have about the legislation

being introduced and the rollout, only including two classifications of drugs to begin with.

Those folks need with diabetes, as well as contraception of a few different forms. To my understanding,

it's not just a birth control pill. nor is it just insulin, right? So they're kind of categories

of drugs. That doesn't even cover some of the folks that you were just talking about, right?

Or the people that I was talking about. So how can we look at that critically, but also hopefully?

I think, yeah, I mean, I think it's a foot in the door. You know, we have a foothold kind

of towards... bigger program because the legislation does lay out a process for expanding it to

a bigger list of essential medicines, which most people who've looked at essential medicines,

it's usually like the kind of drugs that your family doctor, if you're lucky enough to have

one, will prescribe you. These are the most commonly prescribed drugs. So there is that

in the legislation, which is positive. But yeah, it started very small. And I think this is

partly the revenge of Big Pharma and the insurance industry is, you know, I'm sure that this is

something that the liberals, when they have those meetings with those lobbyists, they're

telling them, they're like, don't worry, we're going to give the people this much and no further,

you know. And even, I mean, you can hear it, right? Like, as soon as the legislation dropped,

as soon as it was introduced, Mark Holland, the liberal health minister, went out there

and said, you know, I'm not ideological. I'm not sure if we should continue with a public

single payer system, right? Even though report after report has shown that it's cheaper, it

provides better coverage, it will save us billions of dollars on drug costs. He still thinks we

don't have enough data. He says this is a proof of concept. We're doing a pilot project, right?

And we're going to see. And the example he cited as an interesting kind of alternative to what

we have been pushing for and what the NDP... to its credit had been pushing for in the negotiations.

Public single-payer pharmacare, the alternative is PEI. And PEI has a deal with the federal

government where they basically give a bunch of money to the provincial health plan, which

is fine. I mean, the federal government should be investing more in healthcare, but crucially,

it's not single-payer. And the importance of... a program being single payer is that if you

cover everybody and you have the federal government negotiating on everyone's behalf, you're able

to negotiate down the price of these drugs, right? And that's what big pharma does not

want to see. For so many reasons. That's what they're fighting tooth and nail. Because you

look when the announcement that we were going to have pharmacare legislation coming. came

out with the Supply and Conference Agreement back in March, 2022. I'm only imagining the

reaction. So you guys, your wheels started turning, but these folks are always thinking about Farbakar

already. They must've been like, oh shit. But that's the interesting thing is their response

was, we're pleased to hear this. And we hope that the federal government will go forward

and strengthen our public-private system, right? And so it's kind of weird because like, it

took me a while to understand this because it's like, why the... why the hell does Big Pharma

Care, who's paying? They just want the highest price for their jobs. That's a red flag, right?

Their response is a big red flag. That's the problem is they don't want a single payer public

system, because then they're gonna be in the same situation that they're in with virtually

every other country with a developed healthcare system other than the US, where you have some

kind of universal Pharma Care system and where the government negotiates centrally with these

pharmaceutical companies. and get significantly lower prices, right? In Canada, we're paying

the second highest prices in the world now. We were third for a long time. Now we've passed,

I believe it was Germany. And so we're second only to the US. We're paying the second highest

prices. And we have tons of people who don't have insurance. And we have tons of people

who are covered by, you know, really, yeah, really patchy, really inadequate in public

insurance or private insurance. So, you know, that's what they're fighting against, right?

And so they've always taken this outward stance of, you know, okay, yes, pharmacare, but work

within the existing system. And don't, you know, they try to claim that it's gonna blow up everything

else if we do this single payer system. So, OK, I want to go back. Now it's time to talk

about the budget. So I want to. Because my ears went up when you spoke about revenge from the

industry, you know, in this kind of delayed. rollout because the announcement was for 1.5

billion. Like that was the number that was always not always floated out but as part of these

budget announcements that we got teasers for. But then we find out it's actually over five

years with like less than 60 million for its first year and you folks have done the work

you've done the math you're telling us that it's about three billion to cover these to

drugs. So because when the announcement came, they asked Jogmeet Singh about it and he was

skeptical even then. He seemed to know that there would be lacking funds in the budget.

There was not much said about it at the time, but it was part of his initial announcement,

like not to really expect much in the 2024 budget itself. And to me, that was just like another

red flag. the reaction of the industry that you're talking about there plus the budget

announcements, the details. You want to react to all that now. The foundation is still there,

but there's a real risk that it's not adequate enough for longevity. Is that? Yeah, there's,

I think it's weird because I'm learning the nuances of budget process as we go. So there

is a possibility to kind of like up the amount of funding that is there for PharmaCare as

things go along. But it's definitely concerning. Like they should be announcing loud and clear,

you know, the federal government should be announcing loud and clear to the provinces that this is

going to be fully funded, that they're going to, you know, cover a significant chunk if

not all of the cost. I mean, like, you know... $3 billion on the federal budget of, I think

480 billion or something, it's like 0.6%. You know, it's a rounding error in the federal

budget. They could easily, easily tomorrow just cover the whole thing, right? And so the very

fact that we're having- I'm sure you could find some of those in there. Like, can we have that?

Like, is that possible? Anything that falls from the table, can you kind of beef up pharmacare

a little bit? Yeah, I think I was looking at like, when they announced that they were gonna

have the- federal civil service cut back on outside consultants and international travel.

I think like the annual savings from that were something like five billion over three years

or something. I mean, it's just like they're spending that much money just on external consultants

and fucking flying people to conferences. Because I'll tell you what to do. I'll do it for free

because I'm so pissed off about everything, you know, just yeah. That must have been frustrating

because like when you, when I read your article back from February, and rightfully so, you

know, it was really celebratory. And you deserved a moment, but then I feel like I get, I get

frustrated. Usually I blame the NDP and I focus my rage there because the messaging sometimes,

and I'm... I'm bad for this. Like I know we should celebrate any victories because we don't

get very many. I understand the importance for the psyche, but I feel like that's just like

not my job. So I apologize for everyone out there who feels like I just, I shit on every

victory, but I feel like there's always gotta be someone in the room that's going, we gotta

keep going. Please keep going. Like, please do not applaud these people. Like, please,

like, please just look at them like Oliver and be like, can I please have some more? Like,

but. but in a much more assertive way, right? Like at a time where your foot should be on

the gas, when that foot is in the doors is not when you kind of lean back, it's when you push

forward really aggressively to get in and make it stay there. Because we know the liberals

aren't gonna win the next election unless something crazy happens. And we know that the conservatives

want nothing to do with pharmacare, let alone a single payer. So, There's two risks, right,

that I want to focus on because you gotta mitigate them somehow. The provinces could be a barrier,

right? They're, the rollout has complications there with getting them to agree, especially

with this paltry sum, as well as the threat of the conservatives if it's not implemented.

I've mentioned this before, but it's really important. Kathleen Wynne did this to us in

Ontario, so folks should remember. We got all this great labor legislation, but she only

introduced it when she knew she was about to lose an election. So it was—it might have been

an attempt to win that election, but I think, like, the writing was on the wall. It was just

to kind of placate the movements, I think, to get them to pull back a little bit and almost

all of it. I think all of it. I would be hard pressed to think of one bit of that bill, including

the minimum wage that got canceled, that remained, and they knew it wouldn't because a lot of

it had delayed rollouts or only applied to a small target group at the beginning. And so

no one really missed it when they axed it, except the minimum wage. That really should have pissed

people off. And it did. You know what I'm saying? If something is entrenched, it's delivered

to as many people as possible, it becomes way more difficult to come in and rip it away from

them. That becomes a real political liability for people. But if it's just this piecemeal

thing that's not working, dental care is gone. They're not gonna be able to save that from

the conservatives, because it's a fucking mess. And people will probably applaud them because

of the bad media around it. So what can we do to farm a care now?

Like, what's your plan of attack now that you've got this budget? I think you mentioned the

provinces and I think, yeah, that's sort of, is one of the elements of the legislation that

is a double-edged sword, right? So it's good in the sense that it's not like dental care,

it's actually a public program that will be administered publicly. So like Dental Care,

they got Sun Life to be the company that is administering, they basically took out a plan,

you know, with Sun Life for all of the people who meet the criteria that they set out, which

is crazy complicated. For a universal program, it makes sense, and they're running it through

provincial drug plans, and it kind of works like the health transfer where it's like the

feds give you this money and you basically have to level up the coverage that you offer people

to be. They have to, yeah. Because some of the health transfers have not a lot of strengths.

Again this is one of the weaknesses of the legislation is it's very clear for diabetes drugs and for

contraceptives that it has to be first dollar, it has to know out of pocket costs, it has

to cover everybody. And then it says, okay, and then we're going to expand to essential

medicines within a year of passing it, which will, chances are, happen. after the October

2025 election, unfortunately, but it'll be coming. But there it's a little, there's a bit of gray

area, right? And so if you read what like the insurance industry people are saying, or the

pharmaceutical funded think tanks, they're like, okay, yeah, well, next phases will be not universal,

will be not single pair, will, you know, and so they're angling for that. So that's something.

That's so hard to imagine. What a complicated mess that you'd have two sets of drugs on one

and then a whole different system set up for the other. That seems like valuable and expensive.

I think the real end game, the immediate goal for us from here till the federal election

is, can we get as many provinces as possible to sign on? and have as many people across

the country as possible receiving their contraceptives, receiving their diabetes drug for free through

their health card, you know, and can we make that happen before October 2025? Because if

this is still a program that is just on paper, you know, there's nothing easier for a future

Polio government to walk in and just tear it up, you know. So, okay, pharmacare is done.

Taking away people's access to insulin, to their diabetes drugs, to their free contraceptives,

it's going to be harder. I'm not saying, I mean, Polio could do it, but it's going to be harder.

And we'll, you know, I think we'll face that fight when we get there, if we get there. But

I think the priority right now is to have as many provinces get on board and roll this out.

We know a number of them are already favorable. I mean, the obvious ones being BC and Manitoba.

where the NDP is in power provincially. Doug Ford says he needs to see some details and

the usual suspects, Alberta and Quebec, what is their deal? I mean, before they even see

any details, they're like, no, fuck you, feds. Yeah, I mean, Quebec. We love being a thorn

in your side, take that. Quebec is a foregone conclusion. I mean, I guess for Daniel Smith's

UCP government too, been doing some digging on this because there are some lobbyists who

have been hired by Shoppers, which is owned by Loblaws, and they have been lobbying the

provincial government on PharmaCare, the Alberta government on PharmaCare. I'm like, you have

to clarify it, because that asshole was the first person to meet with Ford when he won,

so they're everywhere. They're everywhere. And so yeah, we've focused pretty much exclusively

on the insurance companies and Big Pharma through this campaign, but... I mean, there's just

so much legitimate rage against law laws, and they're clearly playing a role in pushing provinces

to kind of to fight back or reject the national pharma care plan that I think, yeah, we're

going to be we're going to be digging more into that and putting out some research soon on

that. I feel like at this rate, Shoppers Drug Mart is going to be the single. provider of

medication for Ontarians. I mean, they had that deal with manual life that they had to, I think,

retract because people got so pissed off, but it just gives people an idea of how entrenched.

We've talked about Gail and Weston even in private clinics, medical clinics, and buying the real

estate that's underneath them, as well as our groceries and rental units. So the sway within

government, as you can imagine, is massive. So that's just like another layer your opponents,

but... It's interesting, because when Galen Weston and the Loblaws people get called to

testify, and they say, why are your food prices so damn high? And they say, oh, our profits

are coming from pharmaceuticals. Don't worry. Nick is sitting over there giving him the finger.

Yeah, we fucking know. No, thanks. And everyone's supposed to be relieved at their grocery store.

Oh, well, it's not here. It's when I go get my medication that they're really fucking me.

And... Or when I need money at the bank, they're getting my fees there. Because yeah, like that

was some sort of out for them. They're so disconnected from why we hate them. But let them remain

oblivious. And that's the kind of thing, like the deal that they signed with Manulife was

basically they were going to funnel everyone who has a plan with Manulife into their stores.

And if we move towards a universal public single pair where people were covered no matter where

they are and no matter what kind of job they have, that would be impossible. Those deals

would not be on the table for law laws. And they would also probably face scrutiny for

the kinds of dispensing fees they're charging at their pharmacies because the federal government

will be involved in that too. So, yeah, they have some interests that in seeing this national

pharmacare project fail. See, I know everyone's talking about housing a lot. I mean, everybody,

well, we are because we can't afford it, but politicians are using housing as a real hot

button issue. But when you talk about the level of lobbying that's involved with the pharmacare

and that one lobbyist for the innovative medicines of Canada being like the most influential person

on the Hill, I can only imagine there's gonna be a lot centered on this and... a lot riding

on it for these lobbyists. Their money is clearly going to be in one camp here. I know they like

to hedge their bets, which is great, and they still will. But they'll have a real incentive

here to get the conservatives to win, because the liberals I don't think are any position

to back out of this or even to go back to a multi- what do you call it when it's not single

payer? Multi-payer? Mixed or public-private. Yeah. It's so melty. Dual pair. They refer

to it as dual pair. That's their... Dual pair, okay. Yeah, although it's really like tens

of thousands of pairs because you have so many different plans. Yeah, I can't like see the

liberals kind of having... That would just be a little bit messy. So I expect folks to hear

about this on the campaign trail and the conservatives to try to make it a way... Any issues that

arise from pharmacare a bit of a wedge issue. the way that they're trying to do with dental.

But I think the important part there that you're talking about rolling it out to as many people

as possible is, although it's two categories of drugs, there are a lot of people and families

impacted by diabetes. And I think everyone can understand why it's so important to have that

medication. But it's impossible to measure the amount of people that would take advantage

of the free contraception. So we might have numbers on people who use it or of the age

that one would use it. But I think that the cost of contraception has been a deterrent,

you know, an immeasurable factor in a lot more. Cause I've seen a lot of people kind of, and

this is what happens when you have rollouts like this or means testing, it pits people

against one another on a level. So there's people who have... drugs they can't afford and they

want a reason to include their drug and maybe not birth control, right? Like why is birth

control so important? So I know why it's so important. Do you wanna like reflect on that?

And because right wing or left wing, there's a lot of people out there that need contraception

that would have better lives if they could control the amount of births. that they had to experience,

or pregnancies rather, that they had to experience? Yeah, I mean, it's a cost barrier for a lot

of women, I think especially lower income women, and especially for things like IUDs, which

are included in the list of things that will be covered under this PharmaCare plan. The

cost barrier is pretty substantial. So yeah, having access to those more effective, less

likely to fail forms of birth control is huge. The government cited, I think, a figure of

like nine million women and other people who need contraceptives that would benefit from

this. So I think, yeah, I think it's going to affect a lot of people and I think diabetes

likewise, there's tons of people who have diabetes and I think people will understand pretty easily

why this is necessary. But I think... You're talking about a dynamic of like this kind of

negative solidarity that we often, working class people often get into, right? Where it's like,

how come he has it so fucking good? What about me? You know, he should be suffering like I

am. Right? Like that's kind of like, and you see it all the time, public sector versus private

sector workers and stuff. And I think also people, it's easy to look at birth control as not life

saving, even though it is. It definitely is for many, many people, not just to prevent

a pregnancy, but. for issues that they have with their health, they use the birth control

pill, I could go on it. We have, but it's one of those easy ones where you could just be

like, literally this medication keeps me breathing and it's not covered, but something that a

condom could do. This is a real kind of uneducated mentality that's out there, but yeah, it's

definitely reminiscent of the same things that we find reasons to punch across instead of

up. Yeah, but what's been interesting, and I think is a dynamic that works in the opposite

direction, is you have some patient groups, and even ones that get some money from the

pharmaceuticals, have been coming out. I don't know how cynical maybe they're trying to get

inside the policy process by doing this, but they've been saying, well, we should be next.

Cancer drugs need to be next, or drugs for heart disease should be next, and so on. And so it's

like... And of course, like, yeah, there's a program there that's changing people's lives

and giving them much better access to their medicines without having to pay huge amounts

out of pocket. It's like, of course, you want to get on board and most people don't care,

you know, like about the politics of the of the program. They just see that this is something

that is better and that could make things better for them. So, yeah, I think that's something

that, you know, like in the immediate aftermath of the introduction of the bill, there was

a number of like. radio national kind of call-in shows. And a lot of people were pretty clear-eyed

about it. They were just like, yeah, I know this isn't gonna do anything for me, but I'm

still really happy and I hope this program expands. And I think that's the kind of dynamic that

is positive, the kind of positive solidarity that people see happening and that we're gonna

try to encourage as much as possible from here on out. Because I think that's how we can.

win things and I think yeah we're used to kind of you know the Ontario experience that you're

referring to where we kind of have this hail mary gains that are thrown at us by a failing

government and then they get snatched away just as quickly but there are other instances where

things have been built up and you know if people are organized enough they can fight to keep

them and even expand them. We just got to do the work I don't know it's tough. but we gotta

do it. What is the work then for people listening that want their healthcare drugs covered or

they understand the importance of this program and the timeframe in which they need to operate

in? What should they be doing other than staying in touch with the Council of Canadians? Yeah,

I think, you know. We've been working to have people get out and do canvassing. We're kind

of like, we didn't expect to get this far, quite frankly. I love the honesty. Yeah, no, no.

Because considering what we're up against, right? I was pretty prepared to just write a very

angry analysis post being like, this legislation is crap. And then it's like, whoa, okay, it's

actually not crap. It's actually, you know, in line as weaknesses and stuff, but it's in

line with what we were campaigning for. So that was a big surprise. But yeah, I mean, I think

we're in a phase now where we're trying to build closer relationships with the groups that have

been fighting for contraceptives and reproductive health. and reaching out to groups of people

who in the diabetes community who aren't being funded because some of the bigger groups are

being funded by the pharmaceutical industry, but there are kind of networks and groups of

people. That's some shady shit. Yeah. Oh, it's shady as hell. I mean, you can't imagine how

shady... They're like tenant rights groups being funded by the landlords. It is exactly that.

Oh, that's another episode, Nick. That has such cringe worthiness. But I love the idea of building

a wider coalition, because quite often folks try to reinvent the wheel or do that work that's

really already been done, meaning organizing around a health issue or whatever it is that's

completely tied to what you're advocating for. That's really where folks start to make grounds,

because... Yeah, resources can be tight, so people power is important. I mean, and I think,

I think like at an individual level, like, I mean, yeah, it's tough to do things individually.

I think in general, you know, if you're not gonna join the Council of Canadians, join another

group that's campaigning on pharmacare. I think it's important. You need to get, have organizations

and you need to get together with people in your community. So we're trying to facilitate

that and work with as many groups of people as possible, either through our chapters or

even in places where we don't have chapters. But I think, you know, also just talking to

people like, you know, probably everybody knows, has maybe people in their family or in close

friends who have diabetes, just like, you know, if you educate yourself a bit about the bill

and talk to them and see if they know that this is coming and talk to them about it. Because

like I think some of the polling I've seen is like 50% of people don't even know like anything

about the pharmacare legislation, right? And, you know, had this experience. shortly after

the legislation dropped where We got a we got an op-ed in the Toronto Star kind of laying

out why we thought this was this was good And it was a victory against Big Pharma and the

insurance companies and I wanted to go buy it and I happened to be in Toronto In a kind of

north part of Toronto. I can't remember the name It was it wasn't North York But it was

not far from there and I just went to all the all the corner stores I was gonna say Dippin'

Earths the corner stores in the area trying to get a paper, trying to get a Toronto star.

And like nobody had newspapers, you know. We call them convenience stores. Convenience stores,

there you go. It's not always on the corner. Yeah, and I went to like three of them and

I asked them and they were like, oh no, people don't read the newspaper. It's just like, yeah.

It's behind a paywall for me. I never see the, I'm up in the boonies here, North America,

Toronto, but, aw. So you still don't have a copy of that? I did, I got a copy. Do I have

a copy? Yeah, I got a copy. I actually. But your point was we don't, we just watch CP24

here in Ontario. I think it's on in the hospital waiting rooms for us. So we're there a long

time. That's where we're supposed to get our news. Yeah. So, so yeah. So there's, there's

a lot of, you know, just like basic education of like people within your family. If you happen

to be, you know, know more about this issue, just like ask around and share, share stuff.

Yeah. I actually got this. It's very silly. I got this copy, paper copy of the Toronto

Star out of the garbage of a shopper's drug mart. Because I got one the day after. I was

like, do you have yesterday's paper? And they're like, well it's in the garbage. I don't care.

I'll take every copy. That's so funny you say that too because I totally get it. Santiago,

our producer, he's got a piece coming out for Humber. They do a magazine every year. And

I'm like a mom, I feel like I'm just like, you make sure you get me a good copy, not a crease

copy. Don't fold it and put it in your bag. Maybe get another copy. Don't forget to get

your parents a copy. And he's like, oh no, I know, I know. And you know, we're excited for

its release. It matters. It's not silly. It's important. Thank you, Nick, for coming on and

for doing this advocacy work. It's a bit of a grind, but we will link, folks. to your campaigns,

the op-ed you've referenced, and a whole bunch of the work that you folks are doing. And yeah,

folks can check out Council of Canadians, not for Canadians, I made that mistake at the beginning

of the episode, this is much better, of Canadians. And also you mentioned Health Coalitions, we've

interviewed members from the Ontario Health Coalition. but they're also in a lot of small

towns too, including the big cities. But if you can't find a chapter for the Council of

Canadians, that is definitely another way that you can push back against this, you know, private

industry lobbying and be part of the good guys. But thank you, Nick, for coming on the show

too and brightening my view of PharmaCare, because like anything that comes out of this Casa deal,

I just, you know, Heavy bias. I don't want to believe anybody in government anymore. And

so sometimes I need a calm head to show me those bright spots, the things that are worth fighting

for there. Yeah, well, glad to be a hopeful voice. That is a wrap on another episode of

Blueprints of Disruption. Thank you for joining us. Also a very big thank you to the producer

of our show, Santiago Helu-Quintero. Blueprints of Disruption is an independent production

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