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?