With regards to US drug policy, Trump has said that he wants transparency in drug prices, importation of cheaper drugs, and negotiations for favorable prices on drugs covered by Medicare. He has also vowed to do battle against drug company lobbyists.
“If, under his watch, deregulation leads to faster approval of pharmaceutical drugs and cheaper drug prices because they're imported from countries such as India, there will be enormous pressure on Canada to follow the same path,” said Goldman.
As for Trump’s impact on US healthcare at large, Goldman believes that a complete repeal of Obamacare is unlikely given insufficient Republican control of the US Senate, the sheer complexity of the program, and the fact that such a move would cancel coverage for millions of Americans.
However, a Republican-controlled Congress could phase out a planned expansion of Medicaid coverage, denying healthcare to low-income Americans who are counting on its implementation. Trump has also gone on record approving Health Savings Accounts, which are tax-exempt personal healthcare expenditure funds that all Americans would contribute to.
Goldman expressed concern that should such reforms push through, a Canadian politician, likely provincial, might use the US as an example to argue for provinces to stop paying for healthcare and let the private sector pick up the slack.
“I could see an advocate of private health care in Canada setting up Health Savings Accounts for all citizens regardless of their ability to pay, and providing a means-tested cash infusion to those below a certain income level,” he said. “To get widespread buy-in and to ease the transition, there would likely be generous tax credits across most income groups.”
While some have recently argued for private providers to be given more influence in the Canadian healthcare system, Goldman is firmly against it.
“I believe that a publicly-funded health care system with the government as the provider of care is the most efficient and fairest system going,” he said. “However, we'd be mistaken to think Canada's health care system is immune to massive upheaval and an appetite for change.”
No European solution for Canadian healthcare problem, say academics
Trump’s criticism of Canadian healthcare triggers backlash
In a commentary piece, CBC columnist Dr. Brian Goldman speculated that health policy decisions made by Donald Trump during his presidency “could be enormous.”