There could be more trou­ble brew­ing for the NLPDP

The Compass - - EDITORIAL - So­cial Af­fairs Pat Cullen Pat Cullen is a jour­nal­ist and com­mu­nity vol­un­teer who lives in Car­bon­ear. She can be reached at 596-1505 or cullen.pat1@gmail.com.

What’s be­ing cut and what’s be­ing saved in the New­found­land and Labrador Pre­scrip­tion Drug Pro­gram (NLPDP) is con­fus­ing, but now ac­cord­ing to one Pro­gres­sive Con­ser­va­tive MHA we may not have been told the en­tire truth about th­ese cuts and sav­ings.

Steve Kent, a for­mer min­is­ter of health and com­mu­nity ser­vices, ex­pects ad­di­tional slashes to the pro­gram in the sup­ple­men­tal bud­get this fall. The NLPDP is tax-payer funded and used by the province’s poor­est.

“There is about a $7.7 mil­lion cut to the Health bud­get that the depart­ment is sim­ply ex­plain­ing as line by line sav­ings and op­er­a­tional sav­ings,” Kent wrote in a June 13 email. “This is a sig­nif­i­cant cut to the depart­ment’s bud­get and Min­is­ter Hag­gie re­fuses to ex­plain what’s be­ing im­pacted. I sus­pect that part of this amount rep­re­sents even fur­ther cuts to the Pre­scrip­tion Drug Pro­gram, and per­haps the Min­is­ter doesn’t want to talk about it. Why won’t the Lib­eral Gov­ern­ment tell us what they’re cut­ting? It’s pos­si­ble that they still don’t have a plan. Maybe we’ll learn more in bud­get #2 this fall.”

We know, to some de­gree, what the Lib­eral gov­ern­ment is cut­ting. The bud­get doc­u­ment shows the province plans to save $5.5 mil­lion a year by can­celling cov­er­age for most over­the-counter med­i­ca­tions and lim­it­ing test strips to in­di­gent di­a­bet­ics.

We also know that an ad­di­tional $3 mil­lion will be saved an­nu­ally through the elim­i­na­tion of the adult den­tal pro­gram for old-age pen­sion­ers re­ceiv­ing the guar­an­teed in­come sup­ple­ment and peo­ple earn­ing low wages. Ac­cord­ing to a CBC news re­port of April 21, if th­ese groups need fill­ings, ex­trac­tions or den­tures, they’re out-of-luck.

But there is a line in the bud­get es­ti­mates that’s al­ways been puz­zling. It shows that $137, 185,200 will be spent on drug sub­si­diza­tion in 2016-17 as com­pared to $149,322,400 in 2015-16. Over $12 mil­lion will be re­moved from the NLPDP in one year. More puz­zling is a state­ment by Health and Com­mu­nity Ser­vices Min­is­ter John Hag­gie that most of the $12 mil­lion will come from the re­duc­tion in di­a­betic test strips.

The re­duc­tions be­gin July 1. Hag­gie’s depart­ment ad­min­is­ters the NLPDP.

A May 27 email from the depart­ment said there would be “a re­duc­tion of $11M in ac­tual drug ex­pen­di­tures” to the pro­gram. Five mil­lion dol­lars was ex­plained in the can­cel­la­tion of over-the-counter drugs and the lim­i­ta­tion on test strips “(…$5 mil­lion in 2016-17, as re­duc­tions only ap­ply to part of this year)”. But there was an un­ex­plained “$6M for the net ef­fect of other changes to the pro­gram and the an­nu­al­iza­tion of pro­gram changes from 201516.”

Where the ad­di­tional $6 mil­lion in sav­ings was com­ing from, the depart­ment didn’t say. In a fol­lowup email of June 10, an ex­pla­na­tion for the $6 mil­lion was of­fered. “This fig­ure in­cludes a num­ber of changes in­clud­ing an in­crease in fund­ing for the Smok­ing Ces­sa­tion Pro­gram; trans­fer of fund­ing from the NLPDP to East­ern Health for the drugs Eprex and Aranesp; re­vi­sions to phar­macy com­pen­sa­tion; and the cost of an­nu­al­iz­ing changes to the pro­gram bud­get made in 201516,” the email read in part. (The drugs Eprex and Aranesp are used mainly to treat ane­mia caused by chemo­ther­apy or chronic kid­ney dis­ease).

As for the ad­di­tional $1 mil­lion or so re­ferred to by Hag­gie, a New Demo­cratic Party staffer who re­viewed the emails, said this ap­peared to en­tail sav­ings on com­puter work and an in­crease in new rev­enue.

But the en­tire mat­ter is dis­con­cert­ing. Nowhere in the emails was the elim­i­na­tion of the adult den­tal pro­gram for spe­cific groups men­tioned and John Hag­gie’s state­ment that the brunt of the $12 mil­lion would come from the re­duc­tion in test strips is non­sen­si­cal, par­tic­u­larly when a depart­ment email put the “NLPDP bud­get sav­ings for test strips for one full fis­cal year (at) $2.2 mil­lion.”

Most trou­bling of all is Steve Kent’s spec­u­la­tion that our most vul­ner­a­ble may well face fur­ther cuts to their drug plan in the fall be­cause of numbers buried in the bud­get which can be ma­nip­u­lated to their detri­ment. All over-the-counter med­i­ca­tions have been taken away from our un­der­priv­i­leged with the ex­cep­tion of head-lice treat­ments, ma­ter­nal vi­ta­mins and med­i­ca­tions for chil­dren in care. The only group not af­fected are those with cys­tic fi­bro­sis or growth hor­mone de­fi­ciency. Some di­a­bet­ics will see their test strips re­duced from the cur­rent 2,500 yearly to just 50well be­low the rec­om­men­da­tion of the Cana­dian Di­a­betes As­so­ci­a­tion.

Min­is­ter Hag­gie’s gov­ern­ment was elected with a re­sound­ing ma­jor­ity be­cause peo­ple trusted it to act in their best in­ter­est. And it is my spec­u­la­tion that many of th­ese peo­ple are heav­ily de­pen­dent on the NLPDP. They de­serve bet­ter. We all do. And we cer­tainly de­serve more clar­ity, more com­pe­tence, and more hon­esty from the gov­ern­ment to which such trust was given.

We cer­tainly de­serve more clar­ity, more com­pe­tence, and more hon­esty from the gov­ern­ment to which such trust was given.

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