- Pharmacare will save tax dollars and your own out-of-pocket cash too.
- The current inequitable patch-work drug system is more expensive than national Pharmacare will ever be.
- Stephen Harper will have squandered $70-$100 billion since taking office by neglecting to introduce Pharmacare; 1/10 to 1/6 of the federal debt (not the deficit).
In Canada 10% or over 3.5 million people have no or inadequate drug insurance, a scenario eerily reminiscent of the US. With the prevalence of chronic disease in Canada for people over 20 at 60% of the population, that means a lot of people who need prescriptions simply don’t get them or pay a lot out-of-pocket to access necessary treatment.
I am one of those people. I have lifelong severe asthma (a lung disease that cannot be prevented), but I was lucky enough to find a group plan. Nevertheless, it’s not a great plan. With my insurance premiums, high co-pay and new biologics, my outlay for insurance and co-pays can approach $10,000 per year. Every. Single. Year.
Yet, this inequity in the current system was originally to be addressed when Medicare was created as Pharmacare was meant to be an integral part of the comprehensive Canadian Health System as originally envisioned. But through political malaise and ideological roadblocks, this idea was left to wither and die, despite the obvious benefits to patients and the economy.
For years successive federal governments have dithered, either accepting the tired mythos about unsustainable costs to avoid taking action or simply ignoring the problem entirely.
Whether through ineptness, ignorance or deceit, nothing has been done and millions suffer from this broken system.
But, it doesn’t have to be this way:
First you need to understand the distinction between how much we spend on drugs themselves versus how much we spend to ACCESS those drugs.
First, the retail value of the drugs purchased by Canadians in 2012/13 was about $22 billion.
But, to access those drugs we paid $10 billion for private drug insurance premiums (think of them as private taxes), $3 billion for private drug insurance premiums paid by the government (sounds crazy, right?), $1 billion for tax subsidies for these private plans, $10 billion for direct government purchase of publicly funded drugs, and $5 billion on direct out-of-pocket purchase and co-payments.
That totals $29 billion leaving a whopping $7 billion difference which is – by and large – profit to insurance companies.
When you add up all the amount of money that goes into the system, what is the logical conclusion of this very simple inquiry? There is – in fact – currently more than enough money to run a national first-dollar coverage Pharmacare programme without increasing overall tax. Moreover, research shows that this is just the tip of the iceberg, there are many other positive benefits to introducing national Pharmacare, such that its introduction will lead to even bigger savings.
Contrary to what many politicians might tell you, the public sector is – by far – more efficient with health care dollar administration than the private sector, so we would see a bigger plan covering more people, but with more efficient administration than we see with the inefficient private plans.
And yes, we will have to cover more people who were previously uninsured or underinsured. It’s been estimated that the additional cost of treating citizens previously unable to access pharmaceutical care would be in the range of $1 billion. However, this would be offset by the reduction in cost due to improved medication adherence. If people aren’t scrimping on prescriptions, it means saved dollars in other forms of medical treatment, including the most expensive one: hospitalization. This has been estimated to range between $1 billion for straight medical cost saving to as much as $9 billion if you include improved labour productivity.
The real question is why we have let federal politicians and pundits pull the wool over our eyes for so long. Introducing national Pharmacare will not add to the tax burden, will save money and free up funds for other parts of the economy, improve health outcomes and the health of the population and, finally, stop the increasing fragmentation of the health care system.