Economy
Federal government estimates don’t reflect true costs of national pharmacare

From the Fraser Institute
By Grady Munro and Mackenzie Moir
By borrowing to fund national pharmacare, the government can temporarily conceal the direct cost to Canadians, but Canadians inevitably must pay for this spending through higher taxes—something polling on national pharmacare suggests is a deal-breaker for many.
According to a new report from the Parliamentary Budget Officer (PBO), the price tag for the Trudeau government’s national pharmacare program is already expected to exceed the government’s original estimate. And the program will likely continue to grow more expensive.
In mid-April, the government reported the “first phase” of national pharmacare would cost $1.5 billion over five years, starting in 2024/25. For this first phase, which would “expand and enhance” existing public coverage of contraception and diabetes medications, the federal government must negotiate with each province and territory regarding the implementation of national coverage.
Yet just one month after the federal government released its cost estimate, the PBO now reports that this phase of national pharmacare will cost $1.9 billion over five years. In other words, before Ottawa has negotiated any deals with the provinces, the expected costs of national pharmacare have already increased by approximately $400 million.
It should come as no surprise. Since February, when the government and the federal NDP struck their pharmacare deal, the government has failed to acknowledge the program’s true costs. By borrowing to fund national pharmacare, the government can temporarily conceal the direct cost to Canadians, but Canadians inevitably must pay for this spending through higher taxes—something polling on national pharmacare suggests is a deal-breaker for many.
It’s also important to remember this is the first phase of national pharmacare, and the Trudeau government likely plans to further expand coverage to a list of “essential prescription drugs and related products.” Consequently, according to previous PBO estimates, costs of the fully-implemented program may reach $13.4 billion in annual federal and provincial spending by 2027/28.
Crucially, the cost estimates by both the federal government and the PBO fail to account for how Canadians and insurance organizations might respond to national pharmacare.
For example, in their most recent estimates they assume that nobody already covered by some type of drug insurance plan (this was 81 per cent of Canadians in 2019) will switch to the new national plan, or that no public or private insurers will adjust or renegotiate their plans. For Canadians previously insured privately but switch to the national plan, pharmacare will shift some portion of the costs currently borne by private providers onto the federal government. This will further increase the program’s price tag, which again is ultimately paid by taxpayers.
As the Trudeau government continues to implement national pharmacare, Canadians should be aware that current cost estimates don’t accurately reflect the true costs of the program. A larger-than-expected bill for Canadians is more than likely.
Authors:
Economy
US strategy to broker peace in Congo and Rwanda – backed by rare earth minerals deal

MxM News
Quick Hit:
Senior Trump advisor Massad Boulos says the U.S. is brokering a peace deal between the Democratic Republic of the Congo (DRC) and Rwanda that will be paired with “Ukraine-style” mineral agreements to stabilize the war-torn region.
Key Details:
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The U.S. wants Congo and Rwanda to sign a peace treaty and, on the same day, finalize critical mineral supply deals with Washington. Boulos told Reuters that both deals are expected within two months.
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Rwanda’s side of the treaty involves halting support for M23 insurgents, while the DRC has pledged to address Rwanda’s concerns about the Hutu-dominated FDLR militant group.
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DRC President Tshisekedi has floated the idea of giving the U.S. exclusive access to Congolese minerals in exchange for help against M23. “Our partnership would provide the U.S. with a strategic advantage,” he wrote in a letter to President Trump.
Diving Deeper:
According to a Thursday report from Reuters, President Donald Trump’s administration is accelerating efforts to finalize a dual-track strategy in central Africa—pushing for a peace agreement between the Democratic Republic of the Congo and Rwanda, while simultaneously brokering “Ukraine-style” mineral deals with both nations.
Massad Boulos, Trump’s senior adviser on Africa, told Reuters that the administration expects the mineral agreement with Congo to be signed on the same day as the peace treaty, followed shortly by a separate deal with Rwanda. “The [agreement] with the DRC is at a much bigger scale, because it’s a much bigger country and it has much more resources,” Boulos explained, while noting Rwanda’s potential in refining and trading minerals is also significant.
The DRC and Rwanda have set a tight timetable, agreeing to exchange draft treaty proposals on May 2nd and finalize the accord by mid-May. Secretary of State Marco Rubio is scheduled to preside over the next round of negotiations in Washington.
Rwanda’s cooperation hinges on its withdrawal of support for M23 rebels, who have taken over key territories in eastern Congo. These insurgents have even paraded through captured towns alongside Rwandan troops, prompting international condemnation. In return, Congo has committed to addressing Rwanda’s longstanding concern over the presence of the FDLR—a militant group composed largely of Hutu fighters accused of plotting to overthrow Rwanda’s Tutsi-led government. The FDLR has been active in the region for years and remains a major point of contention.
The instability in eastern Congo—home to over a hundred armed groups—has prevented investors from tapping into the country’s vast mineral wealth. The DRC holds an estimated $24 trillion in untapped resources, including cobalt, copper, lithium, and tantalum, all essential for advanced electronics, renewable energy systems, and defense applications. Boulos emphasized that no deal will go forward unless the region is pacified: “Investors want security before they invest billions.”
Reports suggest M23 has seized control of major mining operations, funneling stolen minerals into Rwanda’s supply chain. Though the UN’s peacekeeping mission, MONUSCO, was designed to stabilize the region, it has been ineffective during this latest wave of violence. President Tshisekedi asked the mission to withdraw last year, and several countries—including South Africa, Malawi, and Tanzania—are now pulling their peacekeepers after M23 captured the regional capital of Goma in January.
Red Cross teams began evacuating trapped Congolese soldiers and their families from rebel-held areas on Wednesday. At least 17 UN peacekeepers have been killed so far this year.
In a March letter to President Trump, President Tshisekedi made his case for a strategic partnership, offering exclusive U.S. access to Congo’s mineral wealth in exchange for American support against the insurgency. “Your election has ushered in the golden age for America,” he wrote, describing the proposed deal as a “strategic advantage” for the United States.
Boulos, who has longstanding business ties in Africa, quickly visited the DRC following the letter and began working to finalize the terms of the proposed agreement.
Business
Overregulation is choking Canadian businesses, says the MEI

From the Montreal Economic Institute
The federal government’s growing regulatory burden on businesses is holding Canada back and must be urgently reviewed, argues a new publication from the MEI released this morning.
“Regulation creep is a real thing, and Ottawa has been fuelling it for decades,” says Krystle Wittevrongel, director of research at the MEI and coauthor of the Viewpoint. “Regulations are passed but rarely reviewed, making it burdensome to run a business, or even too costly to get started.”
Between 2006 and 2021, the number of federal regulatory requirements in Canada rose by 37 per cent, from 234,200 to 320,900. This is estimated to have reduced real GDP growth by 1.7 percentage points, employment growth by 1.3 percentage points, and labour productivity by 0.4 percentage points, according to recent Statistics Canada data.
Small businesses are disproportionately impacted by the proliferation of new regulations.
In 2024, firms with fewer than five employees pay over $10,200 per employee in regulatory and red tape compliance costs, compared to roughly $1,400 per employee for businesses with 100 or more employees, according to data from the Canadian Federation of Independent Business.
Overall, Canadian businesses spend 768 million hours a year on compliance, which is equivalent to almost 394,000 full-time jobs. The costs to the economy in 2024 alone were over $51.5 billion.
It is hardly surprising in this context that entrepreneurship in Canada is on the decline. In the year 2000, 3 out of every 1,000 Canadians started a business. By 2022, that rate had fallen to just 1.3, representing a nearly 57 per cent drop since 2000.
The impact of regulation in particular is real: had Ottawa maintained the number of regulations at 2006 levels, Canada would have seen about 10 per cent more business start-ups in 2021, according to Statistics Canada.
The MEI researcher proposes a practical way to reevaluate the necessity of these regulations, applying a model based on the Chrétien government’s 1995 Program Review.
In the 1990s, the federal government launched a review process aimed at reducing federal spending. Over the course of two years, it successfully eliminated $12 billion in federal spending, a reduction of 9.7 per cent, and restored fiscal balance.
A similar approach applied to regulations could help identify rules that are outdated, duplicative, or unjustified.
The publication outlines six key questions to evaluate existing or proposed regulations:
- What is the purpose of the regulation?
- Does it serve the public interest?
- What is the role of the federal government and is its intervention necessary?
- What is the expected economic cost of the regulation?
- Is there a less costly or intrusive way to solve the problem the regulation seeks to address?
- Is there a net benefit?
According to OECD projections, Canada is expected to experience the lowest GDP per capita growth among advanced economies through 2060.
“Canada has just lived through a decade marked by weak growth, stagnant wages, and declining prosperity,” says Ms. Wittevrongel. “If policymakers are serious about reversing this trend, they must start by asking whether existing regulations are doing more harm than good.”
The MEI Viewpoint is available here.
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The MEI is an independent public policy think tank with offices in Montreal, Ottawa, and Calgary. Through its publications, media appearances, and advisory services to policymakers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship.
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