Social Policy in Ontario

We’re doctors. This is the glaring hole we see in our national health care conversation

Posted on October 3, 2024 in Health Debates

Source: TheStar.com — Authors: Iris Gorfinkel and Joel Lexchin

TheStar.com – Opinion/Contributors
Oct. 3, 2024.   Iris Gorfinkel and Joel Lexchin.

“Nearly 60 per cent of Canadians with diabetes reported failing to adhere to their prescribed therapies due to affordability issues related to their medications, devices and supplies,” write  Iris Gorfinkel and Joel Lexchin

While much has been said about the added public costs of universal pharmacare, there’s been far too little emphasis on the other costs continually paid from not having prescription drugs covered.

The groundwork for a national pharmacare program is expected in the coming weeks in Bill C-64. It’s six pages are now in its final legislative leg, but its importance to the health of Canadians cannot be understated.

Health Minister Mark Holland called it a “pilot project” with its initial focus on drugs for diabetes and contraceptives. If passed, it will mark a milestone in Canada’s universal health care at a time when trust in public health care delivery has reached an all-time low.

What potentially blocks its path forward is a highly influential report penned by the Parliamentary Budget Office (PBO) last year. It pegged the annual cost of a comprehensive Pharmacare program at $11.2 billion over what’s currently publicly spent, although total public, private and out-of-pocket spending would go down by $2.2 billion, mostly owing to bulk buying of prescription drugs.

What the PBO’s report neglected to consider — let alone include — were the money and heartbreak saved by fewer clinic and hospital services and deaths resulting from access to affordable medications.

Nearly 60 per cent of Canadians with diabetes reported failing to adhere to their prescribed therapies due to affordability issues related to their medications, devices and supplies. Unaffordability triggers an expensive cascade of damage to nerves and blood vessels that can lead to heart attacks, stroke, kidney failure and blindness, each of which in turn triggers more visits to the emergency room and hospitalizations and raises the likelihood of prematurely dying.

Pharmacare’s potential savings from making diabetes treatment freely available are even greater with the addition of contraceptives. When contraception isn’t freely available, it results in unwanted and unexpected pregnancies with profound psychological, physical and financial consequences. Nearly half of all pregnancies in Canada are unintended. Unplanned pregnancy forces women to confront abortion, consider allowing their babies to be adopted, or raising a child without the necessary financial, physical, and emotional support. Each of these is costly to not only the health care system, but also to public assistance programs as well.

The report fails to mention — let alone tries to tabulate — the human costs of unaffordable medications. Unaffordable drugs reduce the overall quality of life and take a toll on both physical and mental health; 7.5 million Canadians lack drug coverage because the cost too often competes with basics like rent and food.

Eliminating out-of-pocket costs for medications used to treat diabetes, cardiovascular disease and chronic respiratory conditions would result in 220,000 fewer ER visits and 90,000 less hospital stays annually, saving the health care system $1.2 billion a year.

These savings weren’t just overlooked, they went without mention in the Parliamentary Budget Office’s report. Its laser focus instead was aimed solely at the cost savings from lower prescription drug prices alone.

Unaffordable drugs invoke worry, helplessness and dread and creates a potentially damaging dependency. Granted, it’s difficult to assign a savings to the emotional costs currently being paid, but it’s intellectually dishonest to not even mention them.

Every other OECD country offering universal health care coverage includes prescription drugs. The reasons why they do so are crystal clear — to prevent the physical, emotional and societal harms that directly result from unaffordable drugs. Ignoring these multiple benefits minimizes the greatest gifts that universal drug coverage offers.

The cost savings from Pharmacare go well beyond having a unified Canadian power at the bargaining table when purchasing medications and having lower drug prices. Universal drug coverage is beneficial to mental, physical and societal health in a far greater number of ways that shouldn’t be ignored or dismissed.

Iris Gorfinkel is a family physician and clinical researcher. Joel Lexchin is professor emeritus at the School of Health Policy and Management at York University.

https://www.thestar.com/opinion/contributors/were-doctors-this-is-the-glaring-hole-we-see-in-our-national-health-care-conversation/article_a2413f36-7ffe-11ef-8b0a-874363f5b6d4.html?source=newsletter&utm_content=a12&utm_source=ts_nl&utm_medium=email&utm_email=0C810E7AE4E7C3CEB3816076F6F9881B&utm_campaign=top_3161

Tags: disabilities, featured, Health, ideology, mental Health, pharmaceutical, poverty, standard of living

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