Want a new drug (plan)

Canada is the only country in the world that offers universal public medical insurance, but doesn't cover prescription drug costs.  It makes no sense at all. Studies show that a substantial proportion of the people who are given prescriptions by their doctor don't get the prescription filled because they can't afford the cost. This means the public health plan has incurred the substantial cost of the doctor's time, without the patient receiving any benefit: after all, just sitting in front of a doctor never made anyone well again -- it's the drug he or she prescribes that does that.

Until a few years ago, it seemed as though the provinces, who each manage their own medical systems, were moving closer to providing prescription drug coverage.  Here in Ontario, for example, seniors have their costs covered, subject to a fairly small annual deductible (or "co-pay").  However, in the more straitened fiscal circumstances we've seen recently, progress on this front has stalled, and even shown signs of going into reverse.  In its last budget, Ontario proposed steps to make well-off seniors pay more, a move that is on hold for the time being only because of the difficulty of making the necessary adjustments to the income tax system.

Now we have the release of a major new report that shows that Canadians as a whole would benefit to the tune of several billion dollars if a nationwide, universal pharmacare system were to be set up.  The public sector would be on the hook for an additional $ 1 billion a year, in the researchers' estimation, but the savings for private health insurers would be many times greater. Savings would be achieved through bulk buying of drugs -- at the moment each provincial plan makes its own deals with the pharmaceutical companies -- and through greater reliance on generic drugs.

It seems like a no-brainer, and in any country other than Canada it probably would be. One obvious stumbling block is the Harper government, which has been relentlessly cutting health care standards ever since it came into office, and would be very unlikely to support any new spending in the field. Longer term, the fragmented provision of health care by individual provinces would pose an even bigger obstacle: the likelihood that the individual health fiefdoms would agree to the compromises and co-operation that a national scheme would require must be rated as very slim. Finally, of course, it's unlikely that the drug companies, already among the biggest lobbyists in the country,  will sit idly by and watch Canada set up a scheme whose effectiveness in effect relies on reducing their profits.

It will be interesting to see whether any of the major parties adopts a commitment to pharmacare as part of its platform for this year's election. There would seem to be a lot of votes in it.