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The 13 premiers representing Canada’s provinces and territories met for two days in Saskatoon where they debated increasing trade between provinces, boosting immigration and addressing climate change while accelerating new energy projects.

JONATHAN HAYWARD/The Canadian Press

Canada’s premiers want the option to opt out of any federal pharmacare program and keep the additional money Ottawa would otherwise spend on drugs in their provinces, they announced after a two-day summit in Saskatchewan.

The federal Liberals and New Democrats are expected to campaign in the fall election on promises to create a system of universal pharmacare, which would upend the way Canadians have purchased their drugs for decades. A federal advisory body concluded earlier this year that a national, single-payer program in which drugs cost people very little is the only way to close wide gaps in Canada’s current patchwork of drug coverage.

The 13 premiers representing Canada’s provinces and territories met for two days in Saskatoon where they debated increasing trade between provinces, boosting immigration and addressing climate change while accelerating new energy projects.

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In a letter to Prime Minister Justin Trudeau and the leaders of the main federal political parties, sent on Thursday after the Council of the Federation meeting, the premiers asked for a number of commitments, including an opt out to any new national pharmacare program. They did not specify what they would do with the money that Ottawa would otherwise spend on drugs.

“This is the biggest issue at the table,” B.C. Premier John Horgan told reporters about a move toward Canadawide pharmacare. “We have a very comprehensive pharmacare program in British Columbia. We would be delighted to have a national pharmacare plan, but show me the money.”

He warned that the province would not accept a new federal pharmacare program that provides coverage for fewer drugs than B.C.’s existing programs. All provinces offer a mix of programs that cover the cost of many drugs for low-income people and subsidize extremely expensive drugs for all.

The premiers also asked Ottawa to increase annual health transfers by 5.2 per cent annually, an amount Ontario Premier Doug Ford warned might be insufficient to cover his province’s growing health-care needs. The federal government has reduced its annual increase to health transfers to about 4 per cent in recent years.

A federal advisory council chaired by former Ontario health minister Eric Hoskins called in June for the creation of a national drug agency, which would negotiate drug purchases centrally and decide which drugs will be covered. The national plan could cost up to $15.3-billion annually by 2027.

Alberta Premier Jason Kenney said he has not decided yet whether his province would look to opt out of any proposed federal program, citing a lack of details on the plans expected from the Liberals and the NDP. At the same time, he called on Ottawa to show more respect for provincial jurisdiction.

“My main focus would be to encourage any federal party to respect provincial jurisdiction in the delivery of health services. We’re the ones closest to our citizens, we know what their needs are. And that applies to any additional federal funding for pharmaceuticals,” Mr. Kenney said.

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The relationship between Mr. Trudeau and Alberta’s Premier has been strained. The province is challenging in court the federal government’s decision to impose a carbon tax on Alberta and Mr. Kenney has taken repeated aim at new regulations from the Trudeau government on resource projects.

“I would hope the federal government would show much more respect for the provinces that deliver these services,” Mr. Kenney said of pharmacare.

The Liberals did not respond to a request for comment, however the NDP said in a statement that its plan would answer the needs of provinces. “We are confident that we will be able to show the provinces that it is to their benefit to opt in because our plan will give everyone in their province access to the medication they need at no extra cost,” the party said.

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