The UK’s John Abraham on a panel with Carleton University’s Marc Andre Gagnon.
10 things we learned from last week’s Ottawa conference on drug coverage hosted by the Canadian Health Coalition and Carleton University:
1. The University of British Columbia’s Steven Morgan noted that if Canada were to adopt the UK’s public drug plan without any changes, it would “be enough to pay for universal Pharmacare in Canada at current rates. We would not have to increase taxes.” Carleton University’s Marc Andre Gagnon says Canada could save $10.7 billion on pharmaceutical costs with a universal drug plan. The question is not can we afford universal drug coverage, but can we afford not to?
2. We’ve reported in several posts on how Canada and the U.S. are outliers when it comes to a universal drug plan for our citizens. This has been the case for a very long time. The international panel noted many countries adopted universal access to prescriptions shortly after World War II. France adopted its social insurance system in 1945 while Britain was a few years behind in starting the National Health System in 1948, quickly adding prescriptions to it in 1952. More recent Scotland, Wales and Northern Ireland abolished all prescription charges, whereas England charges about 5 per cent co-pay on the cost of drugs in its Pharmacare program.
3. New Zealand has among the lowest drug costs in the world. They do this by placing a cap on total drug spending and making pharmaceutical companies bid on a share of that pie. The drawback is it does tend to slow the speed in which expensive new drugs become available, but does succeed in providing universal access to needed medications. There is a small co-pay of about $5 per prescription. There is no co-pay after 20 prescriptions are filled annually. There is practically no private coverage for pharmaceuticals in New Zealand. According to Matthew Brougham, former CEO of PHARMAC, New Zealand has been able to limit the increase in drug pricing over the last decade to 3 per cent per year compared to 9-10 per cent increases worldwide. While Canadian politicians claim they cannot afford to introduce Pharmacare, New Zealand adopted such a system precisely because the country was in dire economic circumstances.
4. The lack of universal drug coverage in Canada has not been for want of evidence or trying. Dr. Joel Lexchin of York University noted in his opening remarks that the Hall Commission recommended it in 1964, the National Health Forum did so in 1997, and it is now policy for both the federal Liberals and NDP. Lexchin says Canada’s Pharmaceutical policy resembles the U.S. health care system – some private coverage, some public, and a lot of people who have nothing. “This is not a pie in the sky scheme,” he said, noting Saskatchewan formerly had universal drug coverage.
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Tagged Barbara Martinez, Canadian Health Coalition, Jeff Connell, Joel Lexchin, John Abraham, Marc-Andre Gagnon, Marie Claude Premont, Matthew Brougham, Pharmacare Program, Rethinking Drug Coverage, Steve Morgan, Walter Robinson
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.
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Tagged Arthur Fabbio Jr., Barbara Walman, David Henry, Diane McArthur, Jim, Jody Shkrobot, Keon, Marc-Andre Gagnon, Michael Law, Pharmacare 2020, Steve Morgan, Vancouver Pharmacare Conference
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.