Dr. Pargat Singh Bhurji
Health care in Canada is delivered through a publicly funded Health Care system, which is mostly free at the point of use and has most services provided by private entities. It is guided by the provisions of the Canadian Health Act of 1984, which came in to effect by Vision & Lobbying of Tommy Douglas .The government assures the quality of care through federal standards. The government does not participate in day-to-day care or collect any information about an individual’s health, which remains confidential between a person and his or her physician. Canada’s provincially based Medicare systems are cost-effective partly because of their administrative simplicity. In each province, each doctor handles the insurance claim against the provincial insurer. There is no need for the person who accesses health care to be involved in billing and reclaim. Private health expenditure accounts for 30% of health care financing.
The Canada Health Act does not cover prescription drugs, home care or long-term care, prescription glasses or dental care, which means most Canadians pay out-of-pocket for these services
There are several other countries providing Universal Health Care Such as Singapore, Hong Kong, Switzerland, Australia, New Zealand, Ireland, Mauritius, Denmark & Chile. All these countries also have a National Medication or Pharmacare program, it is only Canada which has a Universal health care but no a Universal Pharmacare.
Demand appears to be growing for a national Pharmacare plan covering prescription drugs costs for all Canadians. And no wonder. High prices are forcing a troubling number of households to avoid filling prescriptions, and even more are resorting to steps such as skipping doses or splitting pills in an effort to make medicine last longer.
It’s evidence that thousands of Canadians are risking aggravated illness and needless suffering because they can’t afford the rising price of drugs. That’s a troubling gap in our health system. And it shouldn’t have to be this way.
A study released earlier this Year, The Future of Drug Coverage in Canada, makes a compelling case for expanding our universal public health care system to include the cost of prescription medicines.
Not only would a national Pharmacare program ensure that all Canadians have access to drugs they need, it would save billions of dollars. Authored by six health policy experts, the study was published by the Pharmaceutical Policy Research Collaboration at the University of British Columbia.
“Full implementation by 2020 is both desirable and feasible,” researchers concluded. “Canada has been waiting for pharmacare since the 1960s.”
The provinces are aware of what’s needed and Ontario Health Minister Eric Hoskins, in particular, has been pressing hard to put Pharmacare on the national agenda. What’s lacking is bold federal leadership.
Canadians appear strongly supportive. A recent poll by the Angus Reid Institute found that more than 90 per cent of
Canadians back the concept of Pharmacare.
The Survey also revealed that more than one-in-five Canadians say that they themselves or someone in their household resorted to saving money this past year by not buying drugs ordered by a doctor or by skimping on doses. That’s a prescription for ill health.
The existing system is ridiculously expensive for all concerned, including governments. Other countries achieve lower drug costs by purchasing medicine through a single, national buyer of pharmaceuticals. Canada, in contrast, funds drugs through a hodgepodge of private plans and disjointed federal, provincial and territorial systems that still leave many people paying out-of-pocket.
It’s estimated that one-in-five households spend $500 or more on prescription medicine annually. And about 7 per cent pay more than $1,000 each year.
This occurs because many Canadians aren’t covered by workplace drug insurance plans. And those who are commonly face extra charges such as deductibles and prescription co-payments.
Pharmacare is the answer. Potential savings from bulk-buying through a single system are substantial. The study’s authors cited the example of Lipitor. A year’s supply of this brand name cholesterol-lowering drug costs at least $811 in Canada, according to the report. In New Zealand, where a public authority negotiates prices for the entire country, it’s $15. “In terms of drug prices, Canada’s multi-payer system is among the most expensive in the world,” they conclude.
Various studies have pegged Canada-wide savings from national Pharmacare at between $4 billion and $11 billion per year, depending on how the program is structured. That’s based on savings seen internationally.
Canada is, in fact, the only country with a universal health care system that doesn’t also cover the cost of prescription medicine.
Administration costs represent another burden. Authors of the report note that every public and private drug plan operating in this country spends money on revenue collection, claims management and other bureaucratic functions. Savings from ending this duplication alone were valued at between $1 billion and $2 billion.
The March Issue of Canadian Medical Association Journal researchers say the extra total cost to government of providing universal Pharmacare could range as high as $5.4 billion a year, but would likely be about $1 billion, depending on exactly how much can be saved through bulk purchases of medications and other measures.
At the same time, it would save the private sector the $8.2 billion annually it spends on prescription drugs, mainly through employee health plans.
Saving ‘billions of dollars’
“When we did the analysis, we were, at first, a little bit surprised,” said study author Steven Morgan, a professor of health policy at the University of British Columbia in Vancouver. “Wow. Canada can really save billions of dollars by covering everybody for virtually every drug? And then we started
The strongest argument for Pharmacare, however, doesn’t concern the money it would save. It’s about giving all Canadians fair and equitable access to medicines they need — drugs that work to keep them healthy, ease their pain, and save their lives. Until that’s done the promise of Canada’s publicly-funded health care system will remain only partially delivered.
With the Recent Election the main Issue being Economy, we should also focus on Need for A Universal Pharmacare, which in Reality is a do able thing.
Dr Pargat Singh Bhurji, MD, FRCP (C)
Consultant Pediatrician, Surrey BC