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Oshawa joins push for universal pharmacare program

Posted: October 16, 2015

(October 16, 2015)

By: Reka Szekely, Oshawa This Week

Growing health-care coalition argues Canada needs a universal pharmacare program to compliment medicare

OSHAWA — Canada is the only country with a universal health-care program but no pharmacare and a growing coalition in the health sector is arguing that it doesn’t make sense to cover the cost of doctors’ visits and then leave patients struggling to pay for their prescriptions.

Dr. Danyaal Raza is a board member of Canadian Doctors for Medicare. He’s also a family physician at St. Michael’s Hospital with an academic appointment in the department of family and community medicine at the University of Toronto.

He points out that according to one study, one in five Canadian families can’t afford their medications.

“If you’re poor enough or if you’re old enough there is some public coverage but most people have to rely on private care that’s linked to their job,” he said.

The problem, of course, is that for many Canadians, their jobs no longer offer a drug benefit program. That includes people who work part-time or full-time in the retail and service sector as well as people who are self-employed.

“It’s a huge gap in the health-care system,” said Dr. Raza.

Dr. Raza said he routinely asks patients if they have drug coverage because that will affect the access to care that they have.

“I remember I had a patient who had an incurable illness and he had a little bit of savings, but the savings were too much to qualify for the means-tested plans but it wasn’t enough to cover for all of his drugs,” he said, adding he’s heard stories of diabetes patients skipping or rationing their medication due to costs.

Canadian Doctors for Medicare brought the issue to Oshawa council in September with medical student Yuchen Li among the group speaking to local politicians. He pointed out Canada has the second highest per capita drug expenditure rate among developed countries, trailing only the United States.

The difference, he said, is due to the bulk buying power of countries with pharmacare programs. For example, the cholesterol drug atorvastatin — known by the brand name Lipitor — costs Canadians roughly $800 per year but as little as $15 per year for people in New Zealand where the government uses its bulk buying power.

A study published in the Canadian Medical Association Journal found that a universal public drug program would reduce spending on prescription drugs in Canada by $7.3 billion with costs to the private sector dropping by $8.2 billion while costs for the government would rise by $1 billion.

Natalie Mehra, executive director of the Ontario Healthcare Coalition, an organization that lobbies to strengthen public health-care in Canada, said that even people who have workplace drug plans are under pressure.

“Every year when unions bargain they’re faced with more and more of a push to take cuts and bigger co-payments and reductions in the scope of benefit coverage,” she said. “Plans that used to pay 100 per cent now pay 80 per cent … it’s harder and harder to get those plans to cover a range of services.”

In some cases, said Ms. Mehra, patients have to fight with their drug companies to get covered for expensive medications.

“I remember hearing from a woman who had cancer and she had to fight for every new drug she was on to get coverage from her insurance company and in the meantime she had to pay for them herself,” said Ms. Mehra, adding that the woman was forced to get loans to cover her medication.

Ontario residents who do not have a drug benefit plan can sign up for the Trillium Drug Program, but Ms. Mehra said many don’t know about the opt-in program or they struggle to pay the deductibles.

She points out the program is not available across the country.

“Even in Ontario with the Trillium Drug Program, people face a lot of hardship paying for drugs and public health-care was created to prevent that kind of suffering,” said Ms. Mehra.

Ontario Minister of Health Eric Hoskins has also argued for a national pharmacare program.

Though not a headline-grabbing issue, pharmacare is on the national radar with both the Green Party and NDP endorsing a national pharmacare program.

“At least at the moment it’s not a ballot box issue, but we have two political parties that are talking about it and that’s encouraging,” said Dr. Raza.

A broad range of groups have endorsed a pharmacare program including unions like Unifor and the Canadian Union of Public Employees; the Canadian Diabetes Association, the Registered Nurses of Ontario; the Canadian Association of Community Health Centres and numerous community health centres across Canada.

Dr. Raza, who spent three months at Lakeridge Health during his residency, says a pharmacare program could benefit the local economy.

“Oshawa is built on the industrial sector and when businesses can get a break by not having to pay for drug plans, it seems like good economic sense in addition to good medical sense,” he said.

Canadian Doctors for Medicare are trying to raise awareness by asking for endorsements for a national pharmacare program and in Oshawa, the idea was unanimously supported with several councillors talking about discussions with constituents who struggled to pay for their medications and at times cutback due to costs.

“It shows to me we can do better than we are today,” said Councillor Dan Carter.

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