November 6, 2017
We have all been prescribed medication at one point or another in our lives. Many of us know how much insurance costs. Some of us know just how much medication can cost if it is not covered by, or is only partially covered by insurance. There have been talks on whether or not Canada’s medicare system should include coverage for medication. I, along with many others firmly believe that medication coverage should be included. How can we say that our healthcare system is “universally accessible” if there are those of us who cannot afford the necessary medication required?
The major reasons the government has not moved to cover medication through Medicare are the practical considerations and logistical challenges that would be encountered. One challenge that would be faced is the need to create a national “evidence-based formulary” (a formulary is a list of medications that are acceptable to prescribe.) Another challenge would be that “prices and supply contracts need to be negotiated”. And, finally, the cost of medications would be covered through public plans (most likely leading to an increase in taxes). However, I would consider these challenges small when compared to the benefits that this coverage would offer us Canadians.
Before calling for a reform of medication coverage it is important to understand the current system. Any medication received by a patient while they are in a hospital is completely covered by Medicare. Only a small portion of the medication received through the fulfillment of a prescription at a local pharmacy is covered. The public plans that are offered vary from province to province and their coverage is based on a variety of factors such as income or age.
These public plans only cover 42% of the overall costs of medication within Canada. Private insurance covers 36% of medication costs, but this insurance is not required to be carried by employers (except in Quebec where an employer is required to provide insurance to “eligible employees”). Most private insurance is gained through extended work benefits (these insurances are usually only seen in employees who are full-time and employed in larger institutions).
The costs associated with the current medication system are disproportionately affecting those of a lower income. Cost can be a major barrier for some of us in attaining our necessary medication – the above report shows that one in ten Canadians is unable to take their essential medications due to the associated costs. It has been shown that those of us without insurance are less likely to fill prescriptions than those with insurance, and even for those of us with insurance the small costs associated with medication (such as dispensing fees) can prevent some of us from being able to afford these necessary medications.
When people do not see an instant benefit from taking a preventive medication (like a medication that decreases the probability of having a stroke) they frequently elect to stop using that medication when confronted with the costs. But, when they do this they often end up using other health services. This tends to cost the Medicare system more than the medication ever would have. This exact issue is estimated to cost the healthcare system between $1 billion and $9 billion annually.
One of the major arguments against medication being covered through Medicare is that it will cost Canadians more than it would save them. However, a simple examination of the numbers will show this to be false. In 2015, Canadians filled roughly 568.4 million prescriptions in pharmacies throughout the country, with a total price tag of $10.8 billion. Of these prescriptions only 377.5 million were covered under the public plans, contributing only $4.27 billion to the total price. Adding essential medication coverage to our medicare system would only cost the government roughly $1.23 billion a year. However, it would save consumers $4.27 billion a year by eliminating the need to pay for private insurance costs.
The issue which leads to this cost discrepancy is that each province has many different private insurances and public plans that pay for medication. But, many of these insurances/plans still have immediate costs through “deductibles, co-payments, and co-insurances.
When other countries that cover medication or charge their people very little or nothing, were compared it was determined that if Canada were to provide this coverage it would lead to an increase in performance in all “key pharmacare policy goals”. When considering these countries, it was also determined that their citizens have better access to medication and “greater financial protection” at a notably decreased cost compared to our provinces.
By covering medication in Medicare we will be increasing the equality of our healthcare system and ensuring that price is not a barrier to fellow Canadians when filling prescriptions for necessary medications. Adding this coverage will lead to us Canadians saving billions of dollars every single year, whereas the government only need pay a billion and a half.
So, I ask the government to take a step toward equality and universality and cover every Canadians medication through Medicare.