Enough of the delays, Canada, it’s time for universal pharmacare
In the intensive care unit, a child recovers from a diabetic coma brought on by dangerously high blood sugar after stopping his insulin injections.
A young woman lies restrained on a psychiatric ward after quitting her antidepressants then attempting to take her own life.
A middle-aged man listens to his doctor tell him he’ll need multiple medications so he doesn’t suffer another heart attack, but he knows he’ll never fill his prescriptions.
Potentially life-saving medicine was prescribed to each of these patients, yet the patients didn’t take it. Why? They couldn’t afford it.
And they’re not alone: One in 10 Canadians don’t fill their prescriptions due to cost constraints. But these patients’ troubles, and millions of others like them, could be avoided altogether — with the introduction of universal pharmacare.
Canada’s Health Act (1985) guides us “to facilitate reasonable access to health services without financial or other barriers,” yet the best health-care practitioners, diagnostics and treatment plans mean nothing if you can’t afford to implement them.
As a doctor, it breaks my heart to watch these stories unfold, first-hand; frustrated and saddened, I begrudgingly prescribe inferior treatments since more effective ones are cost-prohibitive for patients. As a Canadian, I am outraged that our so-called world-class health system falls short for so many.
In 2018, Ontario is moving ahead at a provincial level with a plan called OHIP+ to foot the bill for many essential medicines for those under the age of 25. This complements other public programs that help cover the costs of prescription drugs.
However, it still leaves many patients and provinces unprotected — and Ontario taxpayers are footing the $465-million bill.
But why introduce this limited provincial coverage, rather than universal pharmacare for all Canadians? Is it too expensive? No. Universal pharmacare would save money.
Think about what we’re already spending: Canadian taxpayers fund federal plans for the military, RCMP, veterans, First Nations and Inuit, inmates and some new refugees. At a provincial level, we also contribute to our individual provincial and territorial plans (13 in total), which cover patients with disabilities and those over the age of 65. Given that seniors typically have higher usage with 30 per cent taking five or more prescription drugs, the final tally is already a hefty bill.
Weigh these costs against the savings appreciated under a national universal plan.
Firstly, our collective buying power as a nation allows us to negotiate better prices for pharmaceuticals.
Secondly, expensive brand-name medications can be broadly substituted with more cost-effective generics.
Finally, amalgamating our multitude of federal and provincial plans into a single payer, publicly administered system offers significant reductions in overhead and administration fees.
Together, these savings across public and private sectors amount to billions of dollars.
Perhaps the government isn’t aware of these savings? No again. A Parliamentary Budget Officer report presented to the House of Commons in September confirmed that a universal plan would reduce pharmacare spending by $4.2 billion.
Unrealized savings will likely be gained through preventing further illness and hospitalization. And, value can’t be placed on lives saved and human suffering avoided. Yet, our government wavers and Canadians remain unprotected.
OHIP+ is a small step forward, but not a smart one. It will increase, rather than decrease, overall spending on pharmacare. Value for money spent is lessened because we’re unable to reap the cost savings that are realized under a national plan. And, most importantly, it still excludes marginalized groups in Ontario, plus millions of other Canadians.
So enough with the excuses. No more delays. It’s time to act now and do what’s best for all of Canada: implement universal pharmacare.