In October 2024, Canada approved a law that made all birth control free. People said it was a historic gesture that would improve lives. A...
In October 2024, Canada approved a law that made all birth control free. People said it was a historic gesture that would improve lives.
At the time, Justin Trudeau was the prime minister. He said that the bill's passage was "real progress." The left-wing New Democratic Party said they were responsible for getting Trudeau's governing Liberals to go through with it. The bill didn't simply cover birth control; it also made diabetes medication free and set up a legislative basis for a national pharmacare plan that might cover all prescription drugs in the future.
"We dreamed of making sure that our health care system included medications. "Pharmacare is now the law of the land," said Jagmeet Singh, who was the leader of the NDP at the time.
The bill seemed to show how far Canada has come since Donald Trump was re-elected just a few weeks before it went into effect, and two years after the US Supreme Court took away all constitutional rights to abortion.
But almost a year later, the promise has not come true. In Canada, birth control is still not free. Only three of the ten provinces and one territory had deals in place. The biggest ones, British Columbia and Manitoba, previously had free birth control. Trudeau and Singh are no longer in charge, and current prime minister Mark Carney seldom ever talks about reproductive rights. Instead, he talks about Trump, tariffs, and how Canada can be economically stable.
After all the high-minded talk, many people are still wondering what occurred. Angel Foster, a health sciences professor at the University of Ottawa who studies women's health, said, "It's strange that we haven't had more immediate and enthusiastic uptake of the pharmacare plan." "People have been asking for [free birth control] for a long time."
Not having power as a governor
The Pharmacare Act, which set aside $1.5 billion over five years for its first phase, was the outcome of talks between the Liberals and the NDP. The NDP had made pharmacare a top priority in 2022 to keep the minority government in power.
Singh sounded triumphant during a press conference last October, but he also hinted at future problems.
The 10 provinces and four territories in Canada are in charge of providing healthcare, according to the country's constitution. Each of them needs to make an agreement with the federal government in order to get federal money.
Singh told the administration to act quickly and sign deals with the provinces, even though they might not want to do so for financial or ideological reasons.
Singh added, "I'm worried because we know that Conservative premiers don't want people to be able to get free birth control." "This pharmacare we've gotten is something that could be so great, but it's very fragile."
He went on to say, "You can't wait or drag your feet, Justin Trudeau."
But most provinces and territories still haven't signed anything. People who research health policy in Canada think that the situation shows how little authority the federal government has over the country's healthcare.
Katherine Boothe, an associate professor at McMaster University in Ontario who studies health policy and public pharmaceutical programming, says that one problem is that Canadian politicians have long been afraid that universal pharmacare would lead to runaway costs.
"It's a very strange thing, but it shows up early in Canada," she said of the anxiety that pharmacare costs will keep going up. "And I think the fact that it shows up so early and so often is what makes it so powerful today."
People who support birth control say that it saves money because it means fewer abortions, which the government has to pay for. The Journal of Obstetrics and Gynaecology Canada published study in 2015 that shows the most recent data available. It says that unintended pregnancies in Canada cost roughly $320 million a year.
All three countries—UK, France, and Australia—have universal healthcare and some type of pharmacare. In the UK, people pay £9.90 for each prescription, but some things are always free, such birth control and drugs for people who are already in the hospital. In France, everyone is covered, although they have to pay a little amount for specific services. Children, individuals with low incomes, or persons with a major chronic condition are not required to pay anything. Australia has its Pharmaceutical Benefits Scheme, which pays for most prescriptions and lets people spend no more than AU$31.60 per prescription.
Canada is very different from the others. In the industrialized world, Canadians pay the second highest prices for prescriptions, behind only the US. People have to pay for their own prescription drugs unless they have coverage through their job, private insurance, or a patchwork of provincial or territory drug funding systems that may be based on income, age, or both.
According to 2016 data from the Lancet, nearly one in five Canadians pay for their own pharmaceuticals, which adds up to about $30 billion for 600 million prescriptions. Oral birth control costs approximately $300 a year, while IUDs, which work for five years, cost about $500.
Sexual health activists warn that those who don't have insurance for birth control may not use it because they need to pay for food or rent. Several studies in Canada show that the expense of birth control is the biggest reason why people don't take it, especially in low-income families. Debbie Owusu-Akyeeah, who is in charge of policy and advocacy at Action Canada for Sexual Health and Rights, an Ottawa-based advocacy group, stated that some women are choosing the cheapest birth control instead of the one that works best for them.
"That's where people are at: 'I can't afford this pill, but maybe I'll just get condoms... at least I can pay my bills,'" she said.