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.
