Democracy Gone Astray

Democracy, being a human construct, needs to be thought of as directionality rather than an object. As such, to understand it requires not so much a description of existing structures and/or other related phenomena but a declaration of intentionality.
This blog aims at creating labeled lists of published infringements of such intentionality, of points in time where democracy strays from its intended directionality. In addition to outright infringements, this blog also collects important contemporary information and/or discussions that impact our socio-political landscape.

All the posts here were published in the electronic media – main-stream as well as fringe, and maintain links to the original texts.

[NOTE: Due to changes I haven't caught on time in the blogging software, all of the 'Original Article' links were nullified between September 11, 2012 and December 11, 2012. My apologies.]

Friday, January 20, 2012

The Case for a National Pharmacare Program

When one in 10 Canadians can't afford their prescriptions, the country can't afford not to bring drugs under Medicare.


One of my patients is a taxi driver in Toronto. He supports his wife and two kids. He works hard to get by, and much of this hard work goes to pay for his diabetes medications. Sometimes he can’t make ends meet and has to skip his prescriptions. There are several patients like him in my practice, and in the practices of most other family doctors.

It’s a familiar story in Canada, where one out of every 10 patients who is prescribed a drug cannot afford to take it as prescribed, according to a new study by researchers at the University of British Columbia and the University of Toronto. These are often prescription medications that have been proven to be highly effective at extending and improving life.

This figure alone may sound benign, but consider this scenario: One in 10 cancer patients aren’t given life-saving surgeries because they can’t afford them. If this were the case, there would be front-page media coverage and an ensuing national outcry. Why, then, are we not outraged about the discrepancies in access to life-saving prescription drugs?




Related: Our Surprisingly Expensive Pharmaceuticals




One of the reasons we don’t pay more attention to the fact that 10 per cent of us can’t afford prescription drugs is that people without drug coverage don’t have a powerful and well-financed lobby behind them. Typically, the people who can’t afford their medications are working hard at low-paying, non-unionized jobs. In most provinces, the elderly and those who are extremely poor have their medications paid for by government. Those with stable employment usually have private health insurance. It’s the taxi drivers, nannies, and restaurant employees who often fall through the cracks.

This new study confirms that those who can’t afford to pay have lower-than-average incomes, and are less likely to have third-party insurance. The combination of these risk factors has a significant impact: More than one-third of people who have low incomes and lack insurance will skip a prescription.

Missed prescriptions ultimately lead to more visits to the doctor and the emergency room, with more acute, more complex, and more expensive health needs.

Providing prescription drugs for free is not only the right thing to do, but also makes economic sense in many situations. A small cost outlay can sometimes prevent higher costs in the future. A recent study in the New England Journal of Medicine showed that providing medications free of charge to heart-attack patients resulted in more people taking needed medications and having fewer complications. This benefit was free: Despite paying for prescription drugs, the health insurer’s overall costs did not increase, because patient outcomes improved.




Related: Can Obamacare Work for Canada?




While many say we cannot afford to bring prescription drugs into Medicare, the evidence shows exactly the opposite: We can’t afford not to. A national pharmacare program would save money and improve economic efficiency. In fact, a study published last year suggested that a national pharmacare program with rigorous review processes and more aggressive price negotiations could generate savings of up to $10.7 billion on prescription drugs.

Other countries are negotiating prices and reviewing prescription drugs much more effectively than we are. Canada’s annual growth in drug spending in the past decade was seven per cent a year, more than double the OECD annual average of three per cent.

Canada’s private insurance companies do not negotiate as aggressively as governments, if at all. Private insurers pay $383 million more per year in higher prices for generics relative to what the public plans pay, and they receive generous tax subsidies.

Just as we decided in the 1960s that everyone should have access to physicians and hospitals, we should decide today that everyone should have access to life-saving prescription drugs. A taxi driver like my patient should not have to choose between taking diabetes medication and putting food on the table.

Original Article
Source: the Mark 

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