Life Before Pharmacare
May 07, 2009
drug, healthcare, medicare, pharmacare
In late 2007, the Canadian Health Care Coalition (CHC) held a series of hearings in communities across Canada on the matter of Canadian’s experiences and insights with regard to the cost, effectiveness, appropriateness and availability of prescription drugs.
In conjunction with the Canadian Centre for Policy Alternatives, the CHC has now released a report on those findings. Entitled Life Before Pharmacare, it argues that Canada urgently needs a national drug plan and better management of pharmaceuticals in health care.
Canadians in general seem to think that everyone is taken care of in some way when it comes to prescription drugs, whether it be through provincial drug plans, social assistance, or employer benefit plans. But this is not the case. Many Canadians do not have any coverage at all, and those who do are facing extreme and ever-increasing costs. We have a system that is a patchwork of private and public plans that allows too many Canadians to fall through the gaps.
Many Canadians are without prescription drug coverage for a variety of reasons. Some simply cannot afford to pay for them because of their income. Others have found themselves out of work because of illness and too young to receive pension benefits that would have included coverage for drugs. Those with disabilities often have to choose between staying on income assistance or going back to work and losing their drug coverage.
Before Canada introduced Medicare in the 1960s, it was common to hear these same stories but in relation to access to physicians, hospitals, and medical treatment. In the years since, the role of pharmaceuticals in health care has expanded dramatically, and prescription drugs now play a key role in the management of our health. But prescription drugs are not included in Medicare, even though this was part of Tommy Douglas’s vision of a more comprehensive public healthcare system.
According to the report, prescription drug costs have risen exponentially over the last 10 years, increasing by an average of 11 percent per year. This is more than three times the rate of inflation. These continually rising costs provide challenges to our mix of public and private drug plans, as drug coverage is dependent on where one works. In Manitoba, only nine percent of the population qualifies for government reimbursement of drug costs, while in Quebec 43 percent qualify.
Although almost three-quarters of Canadians have private insurance coverage (normally through their employer), the rising cost of drugs translates into higher premiums and deductibles for claimants on work-based plans. Drugs now account for a whopping 70 – 80 percent of the cost of those benefit packages, and premiums are rising by 15 percent a year. Employers are pressing to contain costs, and healthcare benefits have become a major area of contention between unions and employers.
Not surprisingly, the report’s central recommendation is for a universal, public drug plan to reduce the more expensive patchwork of private and public plans that now exist. This plan would be cost-shared between federal and provincial governments and employers and administered by the provinces. The other recommendations include the creation of a national formulary to cover the cost of all essential drugs and a national strategy to obtain reductions in drug prices through bulk purchasing.
It is perfectly clear that the time came long ago for prescription drugs to be moved from the sidelines of Canada’s healthcare system and to be integrated with the primary health care and with other aspects of the health care system.
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