Why Canada needs a national pharmacare program
TheGlobeandMail.com – Globe Debate
Oct. 14 2014. Eric Hoskins
Dr. Eric Hoskins is Ontario’s Minister of Health and Long-Term Care
It was as a practising physician, not as Health Minister, that I first realized our country’s need for a national pharmacare program.
In treating my patients, I became acutely aware that some of them wouldn’t fully benefit from universal health coverage in our country. Why? Because with every reach into my sample drawer, I knew there was a struggling mom who wouldn’t fill her child’s prescription because she simply couldn’t afford it.
The fact that some families are forced to make such decisions is beyond troubling. It’s also not the norm among our peers: Canada remains the only industrialized country with universal health insurance but no national pharmacare policy for its citizens.
How real is this gap in coverage? The most comprehensive study estimates one in ten Canadians can’t fill their prescriptions because of the cost. And the financial burden of paying for prescription drugs is shared, as almost a fifth of Canadian spending is ‘out-of-pocket’. Just as access to a family doctor or emergency department is crucial, access to drugs is essential for a truly responsive and sustainable health care system.
And while we need drug coverage to see better performance in our health system, pharmacare also speaks to the Canadian values of fairness and equity. This is why I raised the need for such a national program at this month’s Health Ministers meeting with every province and territory at the table – and we can do more as a nation.
Over the past several years, Ontario and the other provinces and territories have embarked on a successful joint initiative to improve access to drugs. Together, we’ve created a pan-Canadian cancer drug review process to ensure equitable access to new medications. We’ve also made significant progress in getting better prices for new, life-saving drugs by negotiating as a bulk buyer with drug companies through the Pan-Canadian Pharmaceutical Alliance – an initiative that will now have a permanent office hosted in Ontario through our ministry.
All of this has made sound economic sense as we address the high costs of prescription drugs in our country. Right now, despite our best efforts, Canada and the provincial/territorial governments pay more for medications than most other Western countries. To help frame the inflated prices we pay, there may be no better analogy than asking yourself if you’d pay $60 bucks for a cup of coffee at Tim Horton’s? We’d certainly all scoff at that number, but compared to other countries, this is the value gap Canadians face when it comes to drug prices.
As this will require a collective effort, I was heartened by federal Health Minister Rona Ambrose’s commitment at this month’s meeting to initiate discussions regarding the possibility of a national pharmacare program. Ontario has been asked to lead these discussions, and I am determined to continue the conversation. But we need our partners in Ottawa.
The federal government needs to join the provinces and territories by committing itself to a national pharmacare program that would provide access to prescription drugs for all Canadians. A recently released report, A Roadmap to a Rational Pharmacare Policy in Canada, figures that such a national approach would lead to potential savings of up to $11.4-billion every year. In addition to the economic benefits, pharmacare would help ensure access to essential prescribed medications, particularly for those who are most in need and least able to pay. It is the natural next step in the evolution of Canada’s most revered symbol – universal health care.
What better way to celebrate Canada’s 150th birthday in 2017 than by delivering better access to prescription drugs through a national pharmacare program. Ontario is ready to take a leading role in making this a reality.
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Letter to the Editor
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National Pharmacare Program, Universal Health Coverage, and National Prescription Coverage we have heard it all before.
Maybe when the economy is balanced, when the economy is stronger, when the next election promise arises or when the next politician states I believe this should exist, but it is out of my hands. Only when the public screams it is needed, once again it is ignored by politicians who have the power in changing policy to make this issue a reality. Excuses upon excuses have survived the 50 years that a National Pharmacare program has been trying to emerge and make the lives of Canadians healthier. If Canadians could afford prescriptions for ailments before it turns chronic or even a deadly condition, this alone could save both governments a lot of money. Preventative is always better, if we create a stronger and healthier population in Canada they will be able to return and stay in the workforce lessening the burden upon sick benefits such as the Canada Disability Pension Program. We as Canadians have a strong healthcare system; it would work to our advantage if Canadians were not becoming ill due to misuse, not filling, or avoidance of medications. Personally, I am one who reduces dosages of medication because I am not sure when the next round of prescriptions will be attained.
Canada’s healthcare system is a source of great national pride for man, yet a large component of a complete healthcare system remains inaccessible to many Canadians. Canada’s lack of a universal pharma care program prevents many patients from fully benefiting from our universal health coverage simply because many Canadians cannot afford the astronomical costs of prescriptions. Despite their being a growing call for a national strategy to combat this issue and fill the significant gap in healthcare, our current federal government remains the biggest roadblock to creating a national pharmacare program. In 2004 a national pharmaceutical plan was one of the objectives of the Health Accord, however when the Harper Government came into power, commitment to this strategy was abandoned. More recently Harper has walked away from the 2014 Health Accord and is leaving the responsibility of healthcare and subsequently pharmacare to the provinces. Additionally Harper has gone on record saying he will not introduce any federal programs on matters of provincial jurisdiction, i.e. healthcare (Born & Dhalla, 2011). Harper and his conservative’s commitment to reducing the deficit and dismantling social programs are effectively erasing any hope of instituting a national pharmaceutical strategy. While Canadian’s health falters due to financial hardships and the increasing costs of prescription drugs it is clear that Harper’s government refuses to respond to the needs of the people and implement fair and equal pharmacare.
I fully believe in the necessity of providing some form of pharmaceutical aid at a federal level. Canada should be applauded in the effort of maintaining a universal healthcare system, which is not a right given to citizens of many other countries. Currently, Canadians can receive emergency medical attention, diagnosis and consultations from a variety of medical professionals with minimal to no cost and this is nothing short of commendable. That being said, there is a large gap in the ability to access healthcare when only half the care is considered a right. Though a Canadian can be assessed, diagnosed and even have some treatments covered; any further pharmaceuticals needed are to be financed off the taxpayers’ dollars. This can be extremely problematic for the vast amounts of citizens that do not have drug coverage plans. Speaking from personal experience, I was extremely fortunate that throughout my life I have had coverage under my mother’s work benefits. At one point in my life, I was diagnosed with a severe eye infection, which could have permanently affected my vision, if it not had been for my mother’s pharmaceutical plan. This plan provided coverage for all the necessary medications, which I would not have been able to afford on my own. Sadly, within the next few months, I will be too old to be covered under my mother’s health plan. I am facing the scary reality of no longer being able to afford current prescriptions, let alone what medications may be needed in the future. I too will join many Canadians facing this terrifying reality. It is time that Canadians recognize that there is a sizeable gap in our access to healthcare. Medications and pharmaceuticals are as much a right to healthcare as it is to visit a doctor or a hospital. To some Canadians, medications are needed to maintain quality of life and no citizen should ever be denied that right.