In 2007 we attended SOS Medicare II, a high-profile national conference in Regina looking at the unfinished Medicare agenda.
Tommy Douglas’ original vision for Medicare extended far beyond what we have in Canada today. Once the envy of the world, our Medicare system is now wanting compared to other developed nations which have a much broader scope of public coverage.
Canada is drawing closer to the United States than Europe in the percentage of our health care system that remains totally private. The evidence is clear – the U.S. system is the most costly in the world and fails to deliver good population-based health outcomes. We spend far less than our neighbours to the south, live longer and have a much better infant mortality rate. If we want a truly more sustainable health care system, then perhaps it is time to start looking at expanding public coverage instead of delisting more services.
This year Pharmacare – public coverage for prescription drugs – is getting particular attention due to increased interest by the provinces. Canada is an outlier among developed nations for our lack of a universal Pharmacare program. While Conservatives would scoff at the cost of such a program, the reality is Canadians would stand to save substantially on health care costs with its introduction.
In February we were in Vancouver for Pharmacare 2020, a two-day event that involved a cross-section of patient advocates, pharmaceutical companies, insurance providers, academics and labour. (Read our stories here.)
UBC’s Michael Law with Saskatchewan health policy analyst Steven Lewis.
VANCOUVER – Canada’s Medicare system stops the minute a doctor writes a prescription.
On the second day of Pharmacare 2020, the talk turned to how we get to a quality system that will leave no Canadian behind, that will be efficient, accountable, and evidence-based.
Saskatoon health policy analyst Steven Lewis says leaving drug coverage out at the dawn of Medicare was an accident of history. If we were to create a pharmacare program from scratch, the task would be much easier. The problem is how do we transition from the house we built for ourselves to the one we want to live in?
Another audience participant astutely remarked that from the 30,000 foot level there is a great degree of consensus, but getting closer to the ground is going to be more difficult.
Lewis is blunt about the reasons why – a public pharmacare system would create winners and losers. Doctors would be the winners – a public pharmacare system would better mirror their existing practices. It would be more difficult for retail pharmacists who may need to define what their role is within the health system. Should they be remunerated as the owners or employees of a retail outlet, or should they join the mainstream of health professions and get remunerated based on the service they render to the public?
Jim Keon and Jody Shkrobot protect their turf during Pharmacare 2020 in Vancouver.
VANCOUVER – Almost 10 per cent of Canadians never fill their drug prescriptions. They can’t afford it.
We’re here in Vancouver for a unique forum to discuss what every major national health care system review over the last 50 years has recommended – the need for a national pharmacare program. We can no longer ignore the fact that universal access to prescription drugs is a necessary part of any modern health system. Canada is an outlier on the international stage – most countries have some form of universal pharmacare coverage for its citizens. Given the collective wealth of our nation, this is a major embarrassment. As one participant in Pharmacare 2020 noted, we have yet to enter the 21st century when it comes to drugs.
How different our health system might look should we have followed Justice Emmett M. Hall’s recommendations in 1964 that Canada move to a national pharmacare system with a $1 deductible on prescription drugs. Since then we have had the National Health Forum (1994-97) The Romanow Commission (2002) and the recent National Pharmaceutical Strategy which failed to come to any agreement on the objective of providing the basic minimum of catastrophic drug coverage. Seems the provinces could not agree not to bankrupt very ill citizens who are faced with steep drug costs.
It’s not like we are saving the public treasury money.
UBC professor Steve Morgan has been writing a series of excellent BLOGs on Healthy Debate this month about the need for Pharmacare in Canada.
As Morgan stated last November, our Medicare system stops the minute a doctor writes a prescription.
While organized labour has been reasonably successful in getting pharmaceutical coverage for their members, one in ten Canadians do not fill prescriptions due to cost. This is much higher than many of the countries and health care systems we frequently compare ourselves (with the exception of the United States). The impact is often felt as symptoms get worse without medication and the patient makes greater use of the public health system as a result.
Morgan is among the organizers of a national symposium at the end of February in Vancouver on the subject, arguing that Canada pays a significant premium for drugs by not moving to a universal model.
“We are probably the only country in the world that offers a universal healthcare system of financing that excludes prescription drugs,” he said in November.
If we moved to the Pharmacare system Germany has, for example, Canadians would collectively save $4 billion in drug costs. If we moved to the UK model, the savings would be on the order of $10 billion. If the government is serious about sustainability of health care, this should be a wake up call.
To watch Morgan’s 10-minute speech from last November, click on the window below. Also included is one of the excellent short videos posted in the run up to Morgan’s Vancouver symposium later this winter. The link to Healthy Debate is also on our blogroll to the right.