title: Universal prescription drug coverage in Canada: Long-promised yet undelivered.
abstract: Canada's universal public healthcare system is unique among developed countries insofar as it does not include universal coverage of prescription drugs. Universal, public coverage of prescription drugs has been recommended by major national commissions in Canada dating back to the 1960s. It has not, however, been implemented. In this article, we extend research on the failure of early proposals for universal drug coverage in Canada to explain failures of calls for reform over the past 20 years. We describe the confluence of barriers to reform stemming from Canadian policy institutions, ideas held by federal policy-makers, and electoral incentives for necessary reforms. Though universal "pharmacare" is once again on the policy agenda in Canada, arguably at higher levels of policy discourse than ever before, the frequently recommended option of universal, public coverage of prescription drugs remains unlikely to be implemented without political leadership necessary to overcome these policy barriers.
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada. steve.morgan@ubc.ca.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Morgan
authors.affiliation: Department of Political Science, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Boothe
mesh_terms: D002170:Canada; D006291:Health Policy; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D009313:National Health Programs; D055553:Prescription Drugs / Q000191:economics*; D019472:Universal Health Insurance
chemical_list: D055553:Prescription Drugs