Do we live in a democracy or a plutocracy? In End Times, Peter Turchin defines democracy as government “shaped by the collective will of common citizens” and plutocracy as government shaped by economic elites. The Pharmacare issue offers a revealing case study.
For decades, the majority of Canadians have wanted universal pharmacare as prescription drugs have eaten up a growing slice of health spending. Last year, the federal government passed the Pharmacare Act. At first glance, that looks like democracy in action. But is it?
Our collective will was for universal pharmacare covering everyone, regardless of income or private insurance. This model, recommended by the government’s own 2019 Advisory Council and four previous reports, would give Ottawa real power to negotiate lower prices and save billions. It’s a prescription for healthier finances and healthier citizens.
Yet Big Pharma resisted universal coverage because it threatened profits. They pushed for gap pharmacare, which preserves fragmented plans, high prices, and complex bureaucracy that confuses patients. Under gap coverage, the government lacks power to negotiate or unify drug policies. Turchin notes that in a plutocracy, the elite always get their way. Our case study is evidence we live in a plutocracy.
If we want policies shaped by people, we must strengthen our democracy. Adopting a proportional representation (PR) election system would dilute elite influence, boost accountability, and help deliver public priorities like universal pharmacare rather than watered-down, profit-protecting alternatives. PR is real reform, not a placebo. Learn more at FairVote.ca and/or CharterChallenge.ca.
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