Deciding Who Will Be Covered and Under What Conditions | National Pharmacare Online Consultation | Let's Talk Health

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Deciding Who Will Be Covered and Under What Conditions

3 months ago

Pharmacare is a system of health insurance that provides people with access to necessary prescription drugs. National pharmacare could be structured to cover the drug costs of all Canadians, regardless of their ability to pay (like Canada’s insurance coverage for doctor and hospital care). Alternatively, it could be ‘means-tested’ and provide coverage for individuals only when their drug costs exceed a certain percentage of their income.

Which approach do you think is preferable and why? Share your thoughts below:


Thank you for your interest in this consultation with the Advisory Council on the Implementation of National Pharmacare.

The online consultation is now closed, and written submissions are no longer being accepted. You can still keep in touch with us via email at pharmacare-assurancemedicaments@canada.ca.

Please stay tuned for the consultation report, which will be posted here and on the following website: www.canada.ca/pharmacare.

Sincerely,

Advisory Council on the Implementation of National Pharmacare

***************************************************************************

  • AnonKingston 17 days ago
    I am totally opposed to any suggestion that the principle of universality should be watered down. It is inevitable that sooner or later the conversation will shift to jealousy over aiding some portion of the population. And it just adds adminstrative costs unnecessarily. The ideological sway towards individual responsiblity will undermine accessibility. In a recent study of the Italian medical system which recently added private components, the EUC discovered that about 5% of the population displayed reduced accessibility. Keep it simple, just and get the full benefits of a pharmacare system that works for all.
  • pharmacaremama 17 days ago
    Because it's all in the same system as other forms of health care, it should be treated the same way - universally available. We are offloading primary health care into the community, and that means more drugs that I take at home vs. a nurse gives me in a hospital. If I get chemo in a hospital clinic vs. get a prescription for chemo medication that I take at home, why should that be differently funded?
  • sm-1994 17 days ago
    National Pharmacare should be sustainable while maintaining the best interest of the public. The key area that needs to be reviewed is Cancer care medication. Canadians in all provinces should have equal access to chemotherapy, both oral and IV, which is not the case at the moment. By creating national Pharmacare and doing Canada wide bulk drug purchasing we should be able to cut some costs.
  • Piccolino 17 days ago
    National Pharmacare should be a program that is administered publicly, through public insurance, and should provide universal coverage to all residents of Canada on similar terms and conditions, regardless of age, sex, income, occupation, or health status. It should cover a comprehensive, evidence-based formulary of drug products in keeping with the principles of comprehensiveness and appropriateness within the Canada Health Act and all medicines on this national formulary should be available without co-payments or deductibles for patients. National Pharmacare should be national in scope with provisions to ensure continuous coverage for residents who move within Canada.
  • hdub 18 days ago
    National pharmacare should be structured to cover drug costs of all Canadians in the same way that doctor and hospital care is covered. This will save individuals and employers the cost of private insurance offsetting any increase required for taxes.
  • Jayne 3 months ago
    My preference would be that prescription care, like medicare, would be universal and accessible for EVERYONE, and that the INCOME TAX system would be used to pay for it because income tax is the fairest way to recognize the difference in ability to pay (or not).
    Hide replies (25)
    • Dinah 2 months ago
      You are right to point out that medication coverage should be part of medicare, as it is in Britain!
      • dragon4104 about 2 months ago
        in Britain people are denied drugs that are too expensive as the system will not or cannot afford to pay for them
        • Dinah about 2 months ago
          Yes, I just saw another story on a little girl who can't get Orkambi for her CF on the BBC. It makes me so mad because I was part of the team that found the gene for CF here in Toronto. Why did we spend all that time and money on that research if the kids who have it are still not able to access the help they need?!?!?
          • maddog1950 about 2 months ago
            Maybe because the drug companies are greedy
          • NickelCity 19 days ago
            'Our' future Canadian model should make allowances for this. It is saddening that Manitoba is also dithering on it's decision on Orkambi!
        • Mia 30 days ago
          But I'd still rather MOST drugs were covered. Why throw it all out just because the most expensive ones aren't covered. There are generics of most drugs. Usually it is expensive, unproven drugs that are not covered. Besides I was just reading that with pharmacare universal; the government can purchase drugs much cheaper in bulk; and the savings make the drugs much more affordable. What's not to like.
          • NickelCity 19 days ago
            Bulk, bulk, bulk purchasing is the way to go. Why Provincial and federal health ministers don't get this is beyond my comprehension.
    • concernednewfoundlander 2 months ago
      I pay around $850 a year for private insurance. If my income tax increased by around the same amount (probably wouldn't go that high though) then I wouldn't notice. If it increased as a percentage of that year's earnings to fund this, it would be even more efficient.
      • Dinah 2 months ago
        I pay around $4400 per year for my plan. It does include dental care and other non-medication things, though. I agree that if income tax went up a reasonable amount, and a similar amount came off my plan monthly fee, I would be no worse off.
        • Lainey 2 months ago
          Yikes! What Province?Is this a Private or Public Plan?
          • Dinah 2 months ago
            Private. I carried on with the one that I had from work when I retired. I know a teacher who pays similarly.
            • tpayer about 2 months ago
              Teachers are like government workers. They get the best insurances and pensions.
              • Mia 30 days ago
                They pay for it. Strange how the 'public' thinks it's a handout. Because they pay collectively, and it's invested wisely, it makes very good plans; it also means the large group ( which they are) gets better rates. That's why that government collective pension idea is good; it would act the same way as teacher's pensions for all workers and supplement CPP; but then you'd have to agree to pay quite a chunk of a % from every cheque you earn, and you can never opt out. But it does pay out in the end. Wish I could have partaken of collective group plan investing like that.
              • Dinah 18 days ago
                Strong union! They have held strikes in the past to get to this place. We kids had to go without when my dad was on strike as a teacher. Not mad about this result at all!!
          • Dinah 2 months ago
            Sorry! Ontario.
            • Lainey 2 months ago
              Hi Dinah, I'm an Educational Assistant working in Edmonton, Alberta.I have heard for years that the Ontario Teachers Pension Plan was a solid gold Pension Plan. "The best in Canada!"
              • Dinah about 2 months ago
                It does seem to be pretty good. Because it is so large, it can invest better than you or I could do on our own. Same is true for the Hospitals of Ontario Pension Plan. My father was a teacher and took his pension when he was 55. He is now 87 and still collecting. Unfortunately, my parents declined the coverage he had brought along when he retired as they were still quite healthy in their late 50s and thought they were paying a lot each month for not too much. They changed their tune later, though, as they have both had to spend quite a lot on their teeth starting about 65. They still both have their own, however! The Ontario Seniors' plan covers the drugs for them, which is good as my dad is now diabetic.
              • gerbear11 about 2 months ago
                the Ontario TPP is great cause we pay though the nose while working - the % we put in has almost doubled in 30 years - it IS expensive but we get a reward at the end IF we survive
        • phamde about 2 months ago
          How many persons are covered for 4 400 $ ? Probably more than one. Dental care normally represents ~ 25 % of a health insurance program, medication ~50 %. Then what benefits other than medication are covered within that premium (health travel insurance, physiotherapy, etc., etc.) ? Let's make sure to compare costs for the same level of coverage.
          • Dinah about 2 months ago
            I realize this complicates things, but that figure is for only one person. Dental, drugs, semi-private hospital, glasses and other health devices, even 7 massages a year. Sorry, but you seem to know more than me about how to break that down cost-wise. And of course some people are more likely to use more of one benefit and less of another than the average.
      • victoriapharmacist 2 months ago
        Yes, and there is a third party there trying to make their margin as well (Pacific Blue Cross, Green Shield, etc etc).
    • TaxpayerJoe about 2 months ago
      The income tax system is not “fair”. EX: couple “A” where each spouse earns $60K per year , pays $28,600 in household income tax. yet a couple where one spouse earns $120K & the other $0 pays $35,000 in tax.Assume couple “A” has 4 kids, they could get $21,800 in Child benefit, but couple “B” who may be unable to have kids get $0. How is that fair?
      • Dinah about 2 months ago
        I'm with you on the couples thing. I would like couples to be taxed as a household, although I do see problems could easily arise in the details, especially these days when young couples have no security and may change who is earning what quite frequently. Those T1 forms may need some updating, but that is not the discussion here. The child tax benefit I am in favour of though. When my kids were younger, we lost the family allowance, and nothing replaced it for awhile. It is to make sure that the kids are properly taken care of, and I have no problem with that. Couples unable to have children can finally get infertility help on OHIP now I believe.
      • Mia 30 days ago
        And those couples who choose not to have kids. Not everyone wants kids, or want to subject themselves to infertility procedures, so the 'infertility help' is a moot point. They all pay into that pot that hands out those family allowance checks, pays for schools, maternity leaves, parental leaves, hockey rinks, parks and recreation programs for kids etc etc... Where's their benefits? I agree that it most definitely isn't fair.
    • Linus about 2 months ago
      All they need to do is raise your income tax to cover it and lower social assistance so they pay their share.
  • Janjan about 2 months ago
    Only for those who pay income tax
    Hide replies (4)
    • maddog1950 about 2 months ago
      that's where the tax act has to change. make the tax act simplfied, not these 40 page forms that need to be filled out each tax year. When I started filling out tax returns it was a 2 page document. Personal info on the front and earnings and expenses on the back. very few loop holes. very simple tax forms. " How much did you make last year" - "Please remit" :>( Just a joke from years gone by. :>)))
      • gophers about 2 months ago
        Can we also limit voting that way too? No government would be like that. Won't happen. Often, the people who might actually need the program the most - the truly poor, not complaining white middle class Canadians - are the ones who don't pay income tax.
        • maddog1950 about 1 month ago
          Middle class are the ones that pay the most of the tax revenues. The top 1% don't pay taxes. But we're getting off topic. This about pharmacy care, not the whole benefit packages that private insurance throws at you, parts they are included that will never be used
        • NickelCity 18 days ago
          Removed by moderator.
  • Gygeneral about 2 months ago
    My argument for this initiative is that I pay for prescriptions for all public employees when I do not have any coverage in the private sector. I am not the only one. Goverments already pay for their employees, seniors, people under 25 in Ontario, welfare, refugees etc....I know some seniors that do not take their required medications because they can't afford it. What's free doctors good for if their recommendations can't be followed.Also, there is so much wasted spending, if they wanted to they can find the money.
    Hide replies (2)
    • Mia about 1 month ago
      You have a strange idea of how health coverage works in the public sector. The workers PAY FOR IT. It comes off their check. Just like their pension contributions do. They get a better rate because they ALL buy it as a group. Sometimes instead of money as a part of their salary they are offered it as a % of the private coverage cost covered by the employer. It's still their salary that pays for it.
      • NickelCity 18 days ago
        Bingo, Mia!! As a public sector employee, I pay into my plans. It is not a free ride
  • BC Resident1 about 2 months ago
    Taxes are too high already. Over 50% of my paycheck is clawed away by taxes, UI premiums, plus there is a 12% sales tax in this country. The combined weight of federal, provincial, and municipal taxes are choking the average taxpayer and removing all incentive to wrok hard and build this country. The government is borrowing WAY to much money, placing our future, our childrens future, and the future of our social programs at risk. We need a return to sensible government that doesnt spend out of control. Ontario has the largest sub sovereign per capita debt in the world. When provincial and federal debt is combined, our debt to GDP ratio is near the highest in the world. A national Pharmacare program will only add another expensive social program that will create more deficit spending and higher taxes for Canadians. Drop the idea please.
    Hide replies (9)
    • maddog1950 about 2 months ago
      a few errors in this statement, #1 UI is not a tax as the name suggests it is insurance just like health insurance only it is EI employment insurance. #2 the sales tax in this country is not 12% your assuming this country entails only BC or Ontario there 8 other provinces and 3 territories
      • Zalev1336 about 2 months ago
        It is called UI now and has been for a while, and Ontario sales tax is 13%!
        • maddog1950 about 1 month ago
          That's storage my t4s and pay stubs still list it as EI
    • tpayer about 2 months ago
      Why is the government trying to be all things to all people? Why not bring in a dental plan? Why not make sure ambulance and glasses are covered too. Open this pharmacan of worms and you will not satisfy anyone.
      • Arby 19 days ago
        Not quite. You will not satisfy the believers in inequality.
    • Think Big about 2 months ago
      EI is a tax, it is a tax on employment. If it was an insurance policy those that never collected would pay less and those that abused it would pay a lot more or become ineligible. There is a massive surplus in the account that the feds syphon off into general revenue. It should be paid back to those that paid into the plan.
      • maddog1950 about 2 months ago
        We can go back and forth all day long on that but EI is an insurance based on income just like life insurance, do you expect a lower rate because you didn't die, in fact life insurance increases the older you get then is cancelled when you hit a certain
        • gophers about 2 months ago
          It's not an insurance scheme. If it were, higher rates would be charged to employees in seasonal industries. No, it's a scheme to take money from people west of the Ottawa River and send it to people east of the Ottawa River.
    • Arby 19 days ago
      Taxes should be fair. We are not taxed fairly. Having said that, I don't care about taxes. I care about what's left afterward. The bosses are getting away with murder (figuratively and literally).
  • Mags about 2 months ago
    The whole thing is a bad idea. Stop spending money that we don’t have! Everyone will suffer more than we already are.
    Hide replies (2)
    • Mia about 1 month ago
      Removed by moderator.
    • Arby 19 days ago
      Money that we don't have seems to be no problem when it's all about what the Right, and the military, wants. What does that even mean anyway? If we don't 'have money', rightwingers in and out of government, then stop enabling tax havens (seriously) and stop acting as mercenaries for the evil, expansionist empire down south. Stop shovelling out tax cuts to unpatriotic, tax-evading corporations.
  • Imago 2 months ago
    I support universal national pharmacare regardless of ability to pay. Prescription medication is often required in conjunction with physician and hospital care; it should be covered on the same terms as the latter. Means-testing is antithetical to respect for the dignity of all Canadians.
    Hide replies (16)
    • goldenyear? 2 months ago
      The Canada Health Act Is a nine page document that only allows for universal access not universal service. Each Province receives tax dollars for Health Care.They decide how to use it and what to cover. Some provinces have had millions of dollars of surplus that they use to fund other projects. I for one am tired of the principle of Universality. If you have the funds to pay a fee for your services why not. The Tax pie is only so large and each time we slice it so everyone gets a piece we diminish the effect. For example If a neighbourhood had five house ,one below the poverty level, one working poor, one middle class , one rich and one super rich, why do each of them get the same size of slice of pie. the rich and super rich don't need it and can afford to purchase whatever they want .Wouldn't it make more sense to give the bulk of the pie to the poverty level, and working poor so they could improve their life and health.
      • Suzieque 2 months ago
        golden year? I understand what you are saying. Until recently my province even charged considerable pharmacare deductibles for the very poor. Fact is that the working poor and seniors in poverty are outnumbered and thus it seems have lesser priority than the middle-class voting majority; that being said, some Medicines have become too costly even for those with higher incomes. I would prefer that the 10% who can't afford their medications (and medical devices and basic dental) be helped first, but it is true that the cost of medicines in Canada is too high compared to other countries, thus my post below in the hopes that public insurance (which will be needed because Pharmacare will NOT cover everything) will help with additional costs of pharmacare and, hopefully, medical devices/dental, based on means/income, since there are no provincial Extended benefits in my province for the working poor and seniors. Also of note is that other countries with universal healthcare, even the U.K., also have private healthcare to counter the public healthcare cost!
        • tpayer about 2 months ago
          What will happen is that the private insurance companies will boot those who are taking a majority of the pie for expensive medicines because there is now an alternative. The provinces will be supporting the most expensive drug takers while the private insurance companies support the healthy so they won't have to pay out. Profits for them and a bigger debt for Canada.
          • Suzieque about 2 months ago
            tpayer: the same process as now: Private (e.g. employer) or Non-profit (e.g.PBC) only non-profit to have option of means-tested coverage (with gov't funding the subsidies). Private offer better coverage than non-profit so expensive drug takers aren't going to get a better deal on expensive drugs since they are less likely to be covered to the extent they are under Private. It's an "either or" scenario; i.e. non-profit cannot be a secondary or default insurer when one already has private coverage.
            • Mia about 1 month ago
              I have private extended coverage. They most certainly DO NOT offer better coverage: as with all insurance they cover as little as they possibly can. And only pay for generics or the cheapest drug available. Of course this is not a surprise; they are in it to make as much profit as they can. The private insurers already expect the government plans to pay first, then IF you have met the huge yearly deductible, THEN they'll cover a % .
          • maddog1950 about 2 months ago
            Prime reason for only one system where the private companies do not provide prescription insurance
            • Suzieque about 2 months ago
              maddog1950: The insurance I'm referring to is for prescriptions NOT covered by National Pharmacare unless you believe in fairy-tales since complete coverage of all prescriptions will never happen; universal pharmacare in other countries such as New Zealand covers minimal prescriptions.
          • ewb1945 about 1 month ago
            There should only be one program for everyone.
            • Arby 19 days ago
              Then there must be a truly socialist system so that that makes sense. Right now, you've got socialism for the rich only.
        • Mia about 1 month ago
          Removed by moderator.
      • Niagra Falls Fan 2 months ago
        People make choices about how they live and what work they do. Drugs should be available for all regardless of their questionable means to pay.
      • maddog1950 about 2 months ago
        at what level do you decide to cover and not cover. $60K for example. someone earning $59K is covered so they make $59K, whereas someone earning $61K has to pay for private insurance or no insurance so their income is reduced by the amounts of the premiums putting them below the person earning $59K
        • Suzieque about 2 months ago
          maddog1950: It could be a percentage of one's income that is above the poverty line. Example: If the poverty line is $20,000 for a single and earnings are $30,000, then a percentage of the difference between $20,000 and $30,000. Means-testing is meant as an "option" so if one has a higher income they can choose a "flat rate".
      • Mia about 1 month ago
        Not quite. Health doesn't work that way. It's a collective pie. We all paid what we can afford with taxes already. You are tired of 'universality'? Concerned that you are paying for others? Concerned about abuses of tax money. Concerned about how we "find the money" to fund universal pharmacare? Or even much better healthcare for EVERYONE? Here's your answer. Boy do I have a story you will love. Please read:A sadly suppressed issue that the corporate owned media do not want us to know about widely:Whereas: Since 1974 Canadians have been paying billions in needless interest to international financiers called the Bank of International Settlements;Before this, the publicly-owned Bank of Canada had a mandate and practice of lending interest-free money to federal, provincial, and municipal governments for infrastructure and healthcare spending;Since this switch ( initiated by politicians with friends in big finance of course) Canadian taxpayers have been needlessly paying anywhere from $20 billion to $60 billion a year in compounded interest to private banks; This is money that could have been used to better the lives of every single Canadian, and instead we have been needlessly paying large sums of money with no gain and massive losses for Canada. We need to call upon the Government of Canada to restore the use of the Bank of Canada to its original purpose, by exercising its public statutory duty and responsibility. That purpose includes making interest free loans to the municipal, provincial, and federal governments for ‘human capital’ expenditures (education, health, other social services) and/or infrastructure expenditures. We all need to get on board if we are worried about 'finding the money' to pay for universal pharmacare. We need the private banks OFF the gravy train. Wouldn't you agree that this is kinda important? Funding? Where's the money going to come from you ask? And we're all worried that some poor little Canadian might be 'getting away with something' if we have universal coverage. Pretty sad.
        • Suzieque about 1 month ago
          Mia: You either did not read my initial post or read it and chose to take offence to Universality. My initial post was In response to what drugs will be covered (as explained in the Discussion paper) since there is no consideration to date as to how the poor will pay for the drugs not covered or partially covered. All medications are not covered now; some have exceptionally high costs, others lower costs but still unaffordable for those living in poverty. These are essential medications prescribed by Doctors. The suggested insurance I'm referring to is optional, for drugs not covered or partially covered, but with a "means" (subsidy) option for those living in poverty. Maybe you can afford to pay the difference for drugs not covered, but not everyone can. It's an "opinion" which is what this forum is for.
        • Arby 19 days ago
          You've been reading Linda McQuaig. (She fails w membership in the neoliberal NDP.) And you're right. But only God can upend this brutal gangster Corporatocracy. Pleading with neoliberal neocons to be reasonable, compassionate, etc, is a waste of time. I don't mean don't do it. But I really don't believe that that's going to help.
  • Skittykitty about 2 months ago
    I feel it would be most unfair to cover prescription costs for those whose incomes are "high"; these people can well afford to pay, and covering their needs would be spending money unnecessarily and making less available for those who really need it. I believe that those with lower incomes should definitely be covered, as it is we who often cannot afford to pay for our prescriptions and consequently sometimes choose not to fill them.
    Hide replies (7)
    • Dinah about 2 months ago
      Those who have high incomes would pay, but through their income taxes. The number of things wrong with our income tax system that need to be fixed is a discussion for a different forum, but this should be the principle the new pharmacare provision is based on.
    • polited about 2 months ago
      Even though the whole system is being paid for by those with high incomes? That doesn't seem fair either does it? They pay for everyone else and then can't take part in the benefit they provided? If all we have are low income people, we can't afford any system for anyone. People have to appreciate that none of us are owed anything. We all get what we contribute, and if we get more than we contribute we should be grateful.
    • gophers about 2 months ago
      I agree too. Why should the rich get "free" healthcare? Let's get rid of that too and maybe we can afford to cut taxes a bit.
      • maddog1950 about 2 months ago
        And let's return to the 19th century of an eye for an eye, start slinging pistols, hang em high then ask if their guilty
        • gophers about 2 months ago
          Glad to see you want to give the rich people - the people who can afford it most - more free stuff. Your characterisation is also horribly inaccurate. Economic growth rates were higher and the legal system was more efficient.
      • Mia 30 days ago
        They are paying taxes. We all benefit, as we should. Our healthcare works because it's a collective. Maybe if they aren't covered, they should have their taxes reduced. I mean we a ARE talking about "what's fair". Then let's see how much is in the pot to pay for the rest.
    • Arby 19 days ago
      You have a point. I have no use for neoliberal/neoconservative Jagmeet Singh, but I think he's right about universality. Why he takes the position he takes, I don't know. And I don't care. But, on principle, I think universality - apply social benefits to all, including the rich so that the rich support publicly funded - fails. Universality looks pretty rightwing to me. The rightwing idea of fairness is: You have two daughters. One is sick, but you treat both 'exactly' the same, conflating that sort of irresponsible behavior with 'fairness'. If the rich might use the argument that a program of benefits that excludes them from government largess (while those same governments let them use offshore tax havens, and much more), then all I can say is that the rich would just dream up any excuse for opposing that which might strengthen the people. And yes, it's that way. It's called class warfare (and counterrevolution). Murray Dobbin made the point long ago, that when citizens are economically strong (and healthy), they are also politically strong. And we can't have that, Can we? Capitalists (who break rules regularly) fear unknowns. They fear real innovators (if young people can survive the captured educational system - think Google - so as to become innovators), who might also innovate politically (not like fakers, like Bernie Sanders, do, however.) Thomas Friedman said it best. Without the death-dealing McDonnell Douglass F-15, McDonald's can't flourish. Naomi Klein (who blames God and the Christian Bible for the world's woes) notes, correctly, that capitalism has only triumphed (which doesn't make it superior) because capitalists have always resorted to force. And force, we see, is profitable. The people are screwed. (See Jeff Halper's "War Against The People," or the Nick Buxton and Ben Hayes edited "The Secure And The Dispossessed.")
  • rpangman about 2 months ago
    Government should not get involved.
    Hide replies (3)
    • Mia 30 days ago
      ??? Why not. It's our money we're talking about spending. Many of us would prefer it spent on this.
      • Black Dog 29 days ago
        Why do you say it is "our" money? It is the government's money that some politician or bureaucrat will have the end say of how it will be spent. The only way government can take tax is by force or the threat of force. Not very moral. As for the "many" you refer to it seems that there "many" people who don't want a national drug program. Not very fair or moral for them.
        • Arby 19 days ago
          Yes. And I want the government to care about 'all' citizens and appropriate whatever funds are necessary for the funding of health care, including pharmacare. If we can appropriate funds for aiding Nazis (Ukraine), we can appropriate funds for Canadians. The rich can buy solutions to problems. Most of us, which is the way the perverted rich like it (foisting neoliberal capitalism, with inequality at its core, on us), cannot buy solutions to problems. Now, I know that at this point, demanding that our governments serve 'all' the people isn't going to change things - governments have been captured by powerful, uncaring special interests - but if you're asking me what I want, now you know and, obviously, I also want something different than Corporatocracy, which, while we have it, makes my expressed wishes in regard to pharmacare moot. So, I guess capitalists and their tools can rejoice.
  • Appraiser 19 days ago
    I think it should be means tested to provide coverage for individuals when their drug costs exceed a percentage of their income.
  • Sunflower52 19 days ago
    It’s difficult to answer this question when we don’t know which drugs will be covered. We say ‘medically necessary’ drugs, but there is no definition of what that will be. And it matters because the drugs that are covered will determine what the plan will cost as much as who will be covered.Of the 2 options provided, I prefer a system that covers everyone equally, regardless of their ability to pay for their drugs. AND I would like it if payment were arranged through taxation (its easier to do, no administrative costs to the plan, allows people to pay on a monthly basis through deductions at source of income, and is fairly based on ability to pay). BUT just saying that even if we go with this option, where everyone is covered, we could still have annual deductibles, or co-pays or even means testing, but my preference is not. The simplest way is to just pay via taxation. I don’t like the means-tested approach for the uninsured, underinsured, and those with coverage who still cannot afford their prescriptions due to high copays and deductibles. We don’t use a means test for medicare, and pharmacare was always intended to be part of medicare. Also, a means test is demeaning to those who are poor or low income, and at the same time very unfair for the wealthy who would end up paying for their own drugs (or paying for their own private insurance) AND would also pay via taxes for those who qualify for assistance via means testing. I also think this would be a nightmare to administer and many would still fall through the cracks. But, until I know what drugs are intended to be covered, I don’t really know what I am supporting. For some reason, I get the feeling that if we go with the first option, in order to keep costs down we will end up with a very sparse formulary, making this a race to the bottom. No one will benefit then. The cost of the plan will be driven by the drugs we cover and the number of people covered. So if e cannot afford good coverage for everyone and we feel we need to drive costs down, rather than limiting the drugs on the formulary, I would rather go for the second option. This would mean limiting costs by limiting the number of people covered. I would hope that at least for the most vulnerable in our society, we could afford to provide access to all medically necessary drugs.
  • Black Dog about 2 months ago
    As well intention the government is this is going to cause a lot of hardship for the poor. The money needs to come from somewhere and it will be the poor who will end up paying the highest percentage of their income. It is a bad idea.
    Hide replies (4)
    • Mia 30 days ago
      Actually, not the poor; but the middle class, and those who just have 'enough'. They pay for it, but have little access to most benefit programs. So everyone needs to be covered.
      • Black Dog 29 days ago
        Taxation causes poverty. We already have a government that can't manage to control its spending and pay for the programs they already have without deficit financing. So where would the money come from to pay for this potential boondoggle?
        • NickelCity 19 days ago
          Not so true, Blackdog. Unfair taxation creates imbalance among all socio-economic classes. If only Canada had a fair taxation system, then maybe the discussion on a national pharmacare system would be much easier. I'm o.k. With paying my fair share of taxes as long as I know that other Canadians are also being fairly taxed according to their incomes.
          • Black Dog 19 days ago
            Imagine a family that is just getting by on their income. Their expenses match income. When the government raises taxes those costs are either paid directly by the individual or they are passed on by business (the consumer always pays the tax). In a normal economy without taxation some prices would rise while others would fall. When government adds taxation prices rise to compensate. (I'll explain how that works in a bit). Getting back to the family that is just breaking even: When prices rise or they are forced to pay more in taxes they now either have to reduce spending (or sell assets) to survive. If there is no room to reduce expenses or assets to sell they will need some outside help to make ends meet. These people have been put into poverty by taxation. A business that is taxed will treat that tax as an expense. All expenses get passed on to the consumer in the form of higher prices. Keep in mind that for a business to survive they must maintain margin (that is the revenue less expenses divided by revenue as a percentage). So the taxes a business is assessed gets passed on to the consumer with margin (or markup). If a business can’t pass the costs onto the consumer (they are under contract for a fixed price) they will need to reduce spending. Reducing hours (a direct hit to the employee making him/her poorer) or reduce purchasing other goods or services.I am the owner of a small mom and pop janitorial business. Suppose every time I clean an office I take the dirt out of the vacuum bag and spread it back all over the carpet only to have to vacuum it up again. Not very efficient is it? In fact I probably will lose money and go broke. The only person who wins is the person I hire to vacuum the carpet and that will only last until I go broke. Suppose instead I hire a person to take files out of one file cabinet and move it to another file cabinet. Then when that file cabinet is full take the files out and move them back to the other cabinet. The only winner is the paper shuffler. How much of what the government does is like the paper shuffler? Think of what the government does that is just paper shuffling. You know all those government forms, etc. that one needs to fill out. Development costs, tax forms, etc. are all busy work that is just paper shuffling that doesn’t add wealth to the economy. Is there much room for more innovation in the janitorial business? Probably not. I probably have my routine and systems as efficient as possible. But with the extra money I would keep rather than giving it to the government I could invest in companies that are the leading edge of innovation. Or I could lower my rates to be more competitive thus giving my customers savings that they could use to innovate or reinvest. Or maybe I could retire sooner and sell the business to a young entrepreneur who might see an edge that I haven’t thought of and innovate the janitorial business making it greener, leaner or whatever. The bottom line: money is always best left in the hands of the people and kept away from government. There is nothing special about government that an individual or group of individuals can do on their own .
  • Therightstuff about 2 months ago
    Pharmacare should be managed by the provinces. Please note that the countries with "successful" pharmacare programs are small countries like New Zealand, Norway, Sweden, Denmark who aren't big enough to have regional (e.g. state or provincial) governments. The provinces should manage pharmacare so they can adjust their system more specifically to their regional needs. Provincial programs are much better run. A "means-tested" approach is inefficient because many people have hidden incomes that don't show up on income tax returns. The bad health choices (drinking, smoking, drugs, obesity, etc.) that many people have should not become an economic burden for the whole. I am not interested in this country becoming a massive welfare state like Sweden with "through the roof" taxes.
    Hide replies (2)
    • Mia 30 days ago
      Actually, the most "welfare" handed out is to subsidize big rich corporations. Or maybe buying out defunct pipelines. On and On. We pay a lot of taxes. We deserve a lot more than we get.
      • NickelCity 19 days ago
        Excellent comment, Mia! Could not agree with you any more.
  • Arby 21 days ago
    Haven't Canadian citizens lost enough? Aren't we losing enough regularly? While 'leaders' whine that they can't afford social spending, they simply appropriate what funds they need to build armies that destroy, against the wishes of citizens, not to mention the targets of capitalists who only know how to expand - at any cost. $8 billion exit Canada yearly, destined for tax havens. Tax 'expenditures' (handouts to tax-evading, unpatriotic corporations), tax deferrals (much which becomes vanished taxes) and other freebies for those who don't actually support the system continue unabated because of captured electoral systems and captured (traitorous) political leadership. And you know this.
    Hide reply (1)
    • NickelCity 19 days ago
      Well said, Arby, I could not agree with you any more!! Canadians really do want programs that are helpful for not only themselves, but their fellow citizens. Unfortunately, it is the agendas of snide politicians, their lobbyist friends and the wealthy that prevent programs that really benefits Canadians from getting. Consider our past and how much of a struggle it was to get programs such as Medicare and public auto insurance off the ground in the first place!
  • Worldtraveller about 2 months ago
    Private insurance is working quite well for a significant number of Canadians. It would be desirable however to fill the gap for unemployed, underinsured, ( due to catastrophic costs, pre existing conditions, etc).A national pharmacare ideally should not prohibit or replace employer or private drug insurance .
    Hide replies (15)
    • phamde about 2 months ago
      I fully agree. Plans promoters (employers, unions and associations should not deny their responsibility and manage their private plans more closely). A well designed and closely managed plan can be more effective and generous than a monstrous public regimen. This being said, some very expensive substances for a very limited population ( catastrophic coverage) , could be more effective for a limited Canadian program.Providing access to those not currently having a plan and based on a private-public scenario should fill the gap and is already working very well since 20 years with well tested rules in some regions.
      • TaxpayerJoe about 2 months ago
        Agree phamde. Can anyone name a government program that is effective and efficient? Most big government programs are inefficient, slow, cumbersome and overburdened with red tape, regulations and bureaucracy. Any private health plans I have dealt with are faster to respond and provide excellent customer service because they know they must.
        • Mia 29 days ago
          Really now. you've dealt with many of them have you? That's not my experience. We feel like it's being between a rock and a hard place. We pay lots because we are afraid to be without it; like most insurers if they can give you as little as possible, or nothing at all, that's what they do; because their agenda is profit; not healthcare. Huge deductibles, ensure frequently not being covered at all. Can you name any private insurance that DOESN"T do this. House insurance, car insurance; travel insurance; we've all been there. You must work for a private insurer. If we have programs that are not 'efficient' it would be because of improper funding and cuts, probably because of lobbyists who want more public money funnelled to private businesses (who are the biggest 'welfare' recipients, only we call it buy outs, subsidies etc.; note with big oil ) Actually, Our healthcare; as it is, still, is wonderful. My cousin in the States is afraid to get old or sick. Health costs are like extortion ( costs are so high, if you travel there, you have to get an insurance company that will agree, at much more cost to you ,to even cover the States if it's on your itinerary ( even if you are only switching planes). This was our recent experience when being advised on travel insurance). So privatization and it's inevitable direction seems pretty clear. It's such repetitive nonsense to keep claiming government programs are inefficient, etc. It's actually a form of propaganda. Sort of like FOX news. Say it often enough and the masses believe you; further that agenda; repeat said propaganda if anyone disagrees with you. I mean it's working in the States. Fully covered public pharmacare for EVERYONE. Stop the bloodsucking private insurers feeding off of the sick and the old. ( Gotta love those descriptors eh)
        • Arby 21 days ago
          Capitalists will sabotage the publicly funded services and programs that their partners in the private sector want to steal from citizens. There's a big difference between inefficient because of sabotage (underfunding mainly) and inherently inefficient. We have a capitalist system. (And its a free universe. If that's really what people want, then okay. By now, I expect that people are pretty brainwashed on this subject. Even so...) Neoliberalism can't even tolerate a mixed economy. Neoliberalism is barbaric. If we are going to have a capitalist, free market society (which is what capitalists like to call it), but one that hasn't killed all compassion, there's obviously things that should not be handed over to privatizers. Investment minus profit, as long as the investment isn't sabotage, will always be better than investment period. I hope that, as Canadians collectively we decide to keep publicly funded health care, and I realize that in an ultra capitalist system, anything socialistic within it, especially if geared to the people and not powerful special interests, is threatened with survival. But this is my view of matters even if the Benefactors in power have no intention of caring.
          • NickelCity 19 days ago
            Thorough and correct observation! Unfortunately, the free market capitalists that can be found in the form of lobbyist and bureaucrats in various levels of provincial and federal government will always try to find a way to create for profit "opportunities " for themselves!
      • Mia 29 days ago
        You must work for a Private Insurer. I don't know where you could possibly make such a sweeping statement that private plans can be better than public . Where is the study on this? ( Note your qualifiers: " a 'monstrous' public 'regimen' : your choice of descriptors are designed to try to influence perception I think rather than contribute thoughtfully. This sounds like the usual nonsense with the bias toward privatization. Privatization in electricity vs Public here in Ontario has proven that Private= very very high , and climbing costs, and worse and less service. No surprise; they are a business looking to maximize profit and cut their expenditures. I'll take the "well designed", and "closely managed" public plan vs the private 'cabal' that wants to bloodsucker off of the sick. ( Note how easy it is to toss those descriptors around).
    • Dinah about 2 months ago
      A large group of individual plans with people moving into and out of them with every job change and change in life circumstances is only going to leave us with as much administration cost as we have now, and no opportunity to buy medications at huge discounts due to massive ordering leaving costs untouched.
      • Worldtraveller about 2 months ago
        Be careful to make distinction between individual purchased plans (where I agree ) and employer plans. Do we want taxpayers to takeover employer costs (most significant portion for under 65 years)? This will significantly add to costs and may therefore jeopardize implementation.
        • Dinah about 2 months ago
          Yes, I do, and I believe it would work out in that the higher taxes paid by employed individuals would be offset by the much lower premiums they (and their employers, who could give a commensurate raise) have to pay for drug coverage. And there would be other savings from mass purchasing, and fewer administrators.
      • phamde about 2 months ago
        There is already some price discounts currently for the benefit of all Canadians obtained through the pan-Canadian Pharmaceutical Alliance (pCPA). There is several levels along the distribution chain (drug manufacturers, wholesalers, pharmacists, etc.). Lowering the price from the top may not prevent an increased margin lower on the chain of distribution. There is documented evidence in our group where a 75 % decrease of the price obtained through pCPA price economy was used by distributors to increase their margins, with only 25 % of the economy transferred to the client.A significant burden on the current costs is also the very high prices of low volume drugs. As the volume for those 100 000 $/year and more drugs will not increase, we should not expect any volume discount for those.
        • Dinah about 2 months ago
          I have to confess I don't know how they do it in New Zealand, and I would like to know. Perhaps part of the plan is to get rid of some of the levels, eg wholesalers. On the low volume drugs, it would depend on the very success of them and what they are for. Drugs that extend lives would surely be needed for longer, and brand new ones that come in expensively would come down in price over time if they are more effective. If not they would disappear.
    • maddog1950 about 2 months ago
      not a significant number of canadians, only the minority that have a plan through their employer, the rest are not covered or go with plans like blue cross when self employed. If you had to pay the full premium that are covered mostly by employer benefits you would not being making that claim as your premiums on a self directed plan goes over $4000.00 yearly
    • Mia 30 days ago
      It is not working. It is paid for by these people. I pay for mine; I can barely afford it. I pay because "one day I may have a disease that requires expensive drugs"; in the meantime; yeas go by; I pay a lot of my meagre retirement to this private company, with out any drugs covered solar because the deductible is so high. What a rip off. I want to be covered by universal pharmacare. Are you suggesting I shouldn't be? Workers with plans pay for them too. Why should they not get coverage. Suggesting that is really unfair.
  • NickelCity 19 days ago
    If we are going to become serious as a first world country about a Natonal Pharmacare program, we need to return to the roots of how Medicare was originally paid for. Most young Canadians are unaware that Medicare was originally funded 50% by the federal government, 50% by each of the provinces. If we model a new Pharmacare program off of the original way Medicare was originally funded, address the problem of HUGE and unfair tax breaks for Canadians earning more than $250,000.00 annually ( e.g. in Manitoba alone 130 families are earning + 2 million annually, yet are only taxed at at the $250,000.00 rate) and eliminate wasteful spending at the federal level Canada, as a nation, can someday create a national pharmacare program that is fairly funded, universal, accessible and transferable, following the original tenets of howMedicare was set up.
  • health53 19 days ago
    I believe Pharmacare should follow the same principles as laid out in the Canada Health Act: Universality, Accessibility, Comprehensiveness, Public Administration, and Portability.
  • donbuck 19 days ago
    The only ones that have to be cover, are seniors and very low incomers who do not have enough money to pay the cost, and have to pass up getting the drug in the first place. Have be cover no matter what the conditions are,by the Pharmacare system.
  • tyghbn 20 days ago
    Why does it have to be one or the other - there is a place for both in a system that is widely designed for all. It doesn't have to be a large up front offset cost either - it can be smaller amounts charged per usage as well. The statements are also based on the fact that there is only one plan for every Canadian from start to finish - that doesn't have to be true either - why not build around employer and other sponsored programs to allow for a wider coordination that would spread costs more effectively. The fact that we should throw out all parts of the existing coverages to have this one is just wrong - it needs to change what is not working well to coordinating them all to spread coverage and cost and pick up all those that do not have coverage or enough coverage to ensure we all get the necessary help and drug when it is needed - though the most effective way possible. The national approach needs to be coordinated with revamped existing approaches to fit all those needs.
  • Hd_pharma 20 days ago
    I think it would be better to have the basic pharmacare program be open to all (ie., not means tested). Means testing would add a complexity and administration costs to the program. Just look at the U.S. with all its loopholes and doughnut holes. The poorest are covered, the middle class with jobs and private insurance are covered, but people working but without insurance are left out. It should be a safety net for everyone.
  • Retiredpoor 21 days ago
    As a previous hospital worker, I have never had medical coverage as there was no full time employment opportunities in order to qualify. Now I am retired and 56 and do not qualify for any reductions or paid prescriptions until I am 65. Both my husband and I have expensive medications and feel that if anything else was added we would most likely not be able to continue any kind of reasonable lifestyle. Some kind of assistance between the age of 55 to 65 would be very helpful. I don’t think prescriptions should be free but I also don’t think it should be based on income. A half and half paid prescription could be a viable option and help many people that can’t afford to pay.
  • Goddess 21 days ago
    All Canadians should be covered; the CHA guarantees access to healthcare. Provinces are turning to private clinics which should be banned, and access to pharmacare should be universal too
  • Christiebelle 21 days ago
    The sliding scale coverage is unfair. I have 4 children & live in BC. My minimum is $8000! Even with a type 1 diabetic son we barely get any coverage. That’s a lot of $$. Medications should be paid for with maybe a $5 co-pay per prescription. Not a minimum per calendar year.
  • drugsforK 23 days ago
    I don't think covering a ton of drugs for terminally ill/palliative care patients is effective use the tax payers dollar, beyond pain meds to keep a person comfortable. Society needs to come to terms with the concept of dying. Otherwise, unless it is cosmetic, cover it.
  • bcjcw1 24 days ago
    The decision is do we want people as healthy and well as they can be, or not? Means tests always have cracks people fall through. Fund people's meds, have docs make the case for rarely used meds, and let's get on with it!
  • Dhhe 26 days ago
    People with MS and chronic illnesses should be covered.
  • Barbara Golder 26 days ago
    Maybe it would be useful to provide Pharmacare under a mixture of systems related to age. Children under 18 and adults over 65 should automatically received subsidized or even free pharmacare ( as per the UK) and those in between could be provided a means tested care. I think the government should be a second payer to those pharmacare insurance and pay/contribute the deductible. It seems only far that even those with insurance should benefit from the scheme. The BC so called " Fair Pharmacare' scheme took away subsidies for seniors and means tested them, but put the threshold for subsidy so high, and drugs became so expensive, that many were choosing between food and medication
  • Black Dog about 2 months ago
    So people who don't take care of their health are going to be subsidized by the government for the drugs they need? Seems unfair to those of us who actually take care of our bodies and don't need or use prescription drugs.
    Hide replies (2)
    • Mia 30 days ago
      With that thinking, then we need to eliminate most people: let's see: the overweight, those who drink alcohol, those who participate in extreme sports, those who smoke, those who eat at McDonalds; those who don't exercise regularly... and on and on. Few people left to cover it seems.
      • Black Dog 29 days ago
        That is exactly why the government shouldn't be involved. There is no way they can make it fair for everyone. It certainly wouldn't be fair to me so please leave me out of it. Besides I am way better at spending my own money than some overpaid bureaucrat or irresponsible politician.
  • JoyceR about 2 months ago
    If people have a drug plan, I do not feel tax payers should pay for them & save drug companies BILLIONS $ like Wynne did with Ontario, that made zero sense. I think it should be for Canadians who have paid income tax & have therefore contributed to the country. These Canadians of convenience that pay little to no income tax & work in China etc. should not receive anything more. They are buying up 1 Canadian city at a time, easy to do when you are a rich freeloader & Canadian tax payers pay for everything they use, their entire family. Income tax rates are too high as it is & do not want to pay anymore, average is 42%, that is insane.If people cannot truly afford medications, there is already programs for them. Nothing is free for the middle class tax payer. Let the next gov't in 2019 sort this out. This liberal gov't has a terrible track record on everything. Scheer's team will make it fair for everyone.
    Hide replies (5)
    • maddog1950 about 2 months ago
      average is far from 42% unless you make over 150,000 a year, that is the top 1 percentile of canadians. I made 128,000 my last year of employment and my income tax bracket was around 30%
      • gophers about 2 months ago
        There are also provincial income, sales, municipal and capital gains taxes, such that as a proportion of your income it may easily be over 42% of your income. I am still not sure what we get for all of that.
        • maddog1950 about 2 months ago
          Capital gains are taxed at 25%Don't buy anything and you won't pay sales tax
          • gophers about 2 months ago
            Capital gains are a tax on being responsible and saving and investing for your future. Believe me, I spend as little as possible.
    • Mia 30 days ago
      People pay for those drug plans. Why should they pay taxes to fund pharmacare but not be allowed coverage themselves. Many people pay for those extended private plans but can barely afford it; they are afraid to get sick and not be able to afford the drugs; they are hostage to the private blood sucking private insurers.
  • cochraness about 2 months ago
    I prefer a 'means-tested' system of coverage. It is my opinion that if you have and income of $40 K or holdings worth $1.5 M, you should be able to pay your own way. Too many people cannot afford expensive critical care drugs.
    Hide reply (1)
    • Mia 30 days ago
      Everyone pays taxes. Why should anyone pay but not have access to the coverage they are paying for.
  • Darcy09 about 2 months ago
    Make it easy. Link to the "uninsured" and go from there. No reason for folks who are insured require Pharmacare. Make the deductible means tested?
    Hide reply (1)
    • Mia about 1 month ago
      No. If you are insured; you're paying for it. It's not free; it's a huge expense. EVERYONE should have pharmacare; NO ONE should have to KEEP paying private companies for coverage. That would mean you repaying into the collective with taxes, but are not allowed to access coverage except to keep being hostage to a private company. Awful idea.
  • maddog1950 about 2 months ago
    a national plan should be all inclusive, I have been covered by various private health plans of my working career, but once you retire and are over 65 these plans boot you. Get rid of the private plans as these a blood suckers on society that will always find a way to refuse to pay when a person really needs it. the old pre-existing condition way out
    Hide replies (4)
    • Janjan about 2 months ago
      My plan is good for life over 65, and pay promptly for medical and dental.
      • maddog1950 about 2 months ago
        Your lucky, mine didn't and I know of one support staff at Calgary school board that had her benefits terminated whenever she turned 65 even though she was still working there and paying into the plan
        • gophers about 2 months ago
          Removed by moderator.
      • Mia about 1 month ago
        My extended private health coverage is 'for life' but I sure pay for it, and in 3 years they have not covered any drugs because at retirement the yearly deductible is so high. If we manage to spend that much on drugs to exceed the deductible, they want the government plans to pay first, then if there's anything left, they pay 70%. It's a business; they are in it to make as much profit as possible; so no surprise; like Las Vegas; the odds are mightily stacked against you and of course 'THEY' win; not you. Otherwise, if your plan is so great, they'd be out of business. Working; they're a BIT better; once you retire: look out.
  • rhkary57 about 1 month ago
    History has proven that whenever government gets involved in medical decisions that think never work out in the best interest of the patient. In general I believe a national pharmacare plan would be detrimental to healthcare in Canada. More money spent on administration and less on actual health care.
    Hide reply (1)
    • Mia about 1 month ago
      Good Lord! "detrimental" ? Look at the mess the USA has; THAT'S what happens without universal healthcare; healthcare privatized is a gravy train for businesses and costs soar. When we travel we have to get 'special insurance' for the US because many travel insurance plans that cover all of Europe and most of the world won't cover the US because of their outrageous costs for healthcare. You have to be afraid to get old or sick in the US, unless you are wealthy. People are afraid to leave bad jobs in the US because they'd lose healthcare coverage. Their doctor's don't make health decisions; their insurer does( because they'll decide what they are willing to pay for). People choose which limb to save and which to lose after an accident because they can't afford to save both ( true incident). I think 'history' has proven quite clearly by our neighbours to the South that without the government the 'best interest' of the patient is a non-issue ( unless you have the big bucks). No thank you. I think looking to US models of anything health related is not advisable, and frankly, irrational. A national universal pharmacare plan is exactly what we need.
  • L'acadien about 1 month ago
    The system has to cover everyone who wants into the program. Allow people to have private insurance or employee benefits in addition to Pharmacare that can cover any deductible or that provides wider prescription coverage. The means testing you describe is terrible. Any means test should be only be to qualify, a general income test. Its terrible to require people to pay 100% of their drug costs for any part of the year. and complicates things when people change jobs or get a pay cut. Keep the program simple.
    Hide reply (1)
    • Mia about 1 month ago
      Get rid of private insurers for drugs. Use them ONLY for things like private hospital rooms etc. ; NOT for essentials in healthcare like medicine.
  • Open Minded about 1 month ago
    I think it should be for those who don't have any other drug coverage. Then if you don't have any other coverage you can apply but you have to pay a fee based on a percentage of your income. Say 5% regardless of how much you make. If you make $20,000 than you pay $1,000 a year. If you make $100,000 than you pay $5,000 a year. The percentage keeps it porportionally fair and only those that want it can opt into it.
    Hide replies (2)
    • L'acadien about 1 month ago
      $1000 is way too high to pay for people who only earn $20,000 gross, a year. $1000 per $20000 of taxable income would be better, but still expensive and not really proportional . Its way easier just to add the cost to income tax like we do for medicare. Just allow people to have insurance to cover any deductible and offer better coverage than the government.
    • Mia about 1 month ago
      Concerned about how we "find the money" to fund universal pharmacare ? Here's your answer. A sadly suppressed issue that the corporate owned media do not want us to know about widely:Whereas: Since 1974 Canadians have been paying billions in needless interest to international financiers called the Bank of International Settlements;Before this, the publicly-owned Bank of Canada had a mandate and practice of lending interest-free money to federal, provincial, and municipal governments for infrastructure and healthcare spending;Since this switch ( initiated by politicians with friends in big finance of course) Canadian taxpayers have been needlessly paying anywhere from $20 billion to $60 billion a year in compounded interest to private banks; This is money that could have been used to better the lives of every single Canadian, and instead we have been needlessly paying large sums of money with no gain and massive losses for Canada. We need to call upon the Government of Canada to restore the use of the Bank of Canada to its original purpose, by exercising its public statutory duty and responsibility. That purpose includes making interest free loans to the municipal, provincial, and federal governments for ‘human capital’ expenditures (education, health, other social services) and/or infrastructure expenditures. We all need to get on board if we are worried about 'finding the money' to pay for universal pharmacare. We need the private banks OFF the gravy train. Wouldn't you agree that this is kinda important? Funding? Where's the money going to come from you ask? (And we're worried about people and their little incomes and when we should make them pay for pharmacare. )
  • Mia about 1 month ago
    Concerned about how we "find the money" to fund universal pharmacare FOR EVERYONE ? Here's your answer. A sadly suppressed issue that the corporate owned media do not want us to know about widely:Whereas: Since 1974 Canadians have been paying billions in needless interest to international financiers called the Bank of International Settlements;Before this, the publicly-owned Bank of Canada had a mandate and practice of lending interest-free money to federal, provincial, and municipal governments for infrastructure and healthcare spending;Since this switch ( initiated by politicians with friends in big finance of course) Canadian taxpayers have been needlessly paying anywhere from $20 billion to $60 billion a year in compounded interest to private banks; This is money that could have been used to better the lives of every single Canadian, and instead we have been needlessly paying large sums of money with no gain and massive losses for Canada. We need to call upon the Government of Canada to restore the use of the Bank of Canada to its original purpose, by exercising its public statutory duty and responsibility. That purpose includes making interest free loans to the municipal, provincial, and federal governments for ‘human capital’ expenditures (education, health, other social services) and/or infrastructure expenditures. We all need to get on board if we are worried about 'finding the money' to pay for universal pharmacare. We need the private banks OFF the gravy train. Wouldn't you agree that this is kinda important? Funding? Where's the money going to come from you ask?
  • bcpokharel about 1 month ago
    Thank you everyone to this opportunity to share among you all.I believe that the cost of prescribed drugs should not exceed 2% of gross income that we make, particularly for the Canadian who are in low income range, and senior citizens who are 60 years or older than that.As I know, in many countries especially that considered developed countries, there is a health insurance to all citizens that covers 100% of prescribed drugs that is prescribed by the doctors.I do not know much about the financial position of Ontario government, whether it can afford this all or not.I would suggest that if possible make full coverage of prescribed drug, for those who are financially living under vulnerable conditions.
    Hide reply (1)
    • Mia about 1 month ago
      Cover EVERYONE. Period.
  • Mia about 1 month ago
    Cover ALL Canadians. EVERYONE. Period.
  • Old Guy about 1 month ago
    Means -testing is inconsistent with the concept of a universal, single-payer system, which is what we should be trying to achieve. Canadians would never support a means-tested system for access to doctors or hospitals and we should not accept if for pharmacare.
  • Veteran educator about 1 month ago
    Means testing is confusing and humiliating. Only universal coverage will have broad and durable middle class public support
  • Rene3h about 1 month ago
    Income thresholds should be considered but balanced when it comes to catastrophic drug costs
  • VictoriaZ about 1 month ago
    Even with a negotiated benefit plan, I do not have coverage for my medication. I believe a National program should cover all Canadians.
  • El Presidente about 1 month ago
    This should cover all Canadians We will penalize people for working harder and create that never get ahead system we have now.I feel the ideas about what’s possible to live on and what is actual reality when it comes to benefits are never realistic anyhow , so let’s just create a damn system that works for everyone period
  • gophers about 2 months ago
    Wait, let's be real for a moment here. Canada has no national insurance coverage for doctor and hospital care. Aside from marine hospitals, healthcare is the constitutional role of the provinces, not the Federal government. So this is not even a discussion that should be happening and the fact that it is shows the disrespect that the Government has for our Constitution. The previous Government in Ontario understood this and introduced and later expanded their own program in this regard.The preferred approach should be to have no program, and not just due to the BNA Act.Most healthcare spending happens later in life. A pharmacare program would be a program to redistribute money from the young to the old. As a young person who pays approximately 50% in my income for government "programs" I don't use and/or find morally reprehensible, an additional tax to pay for a program who chose irresponsibility in their youth is just another reason for me to consider leaving this country. Best to look to places like Singapore, where they understand how demographics work and force people to save for their own - inevitable - future.
    Hide replies (5)
    • maddog1950 about 2 months ago
      Good bye, Don't let the door hit you on the way out
    • maddog1950 about 2 months ago
      And where were you educated. It was taxes by the general population that paid for your education. Even if you went to post secondary your tuition is less than half of what it cost for your degree. So the seniors assisted you with your education now you be grudge them assistance when they need it.
      • gophers about 2 months ago
        I came to Canada and paid my way as an international student, subsidising all your children. So you can't claim that one. And if you can't pay for your own children's education without government assistance, you probably shouldn't have them.
        • maddog1950 about 1 month ago
          And what was your yearly tuition in university or wherever you took post secondary. If you ever have children their education through to finishing school will be on tax payer dollars, not your dime.
    • Zalev1336 about 2 months ago
      Removed by moderator.
  • resaw about 1 month ago
    Every person in Canada, currently eligible for public health insurance should be covered.
  • Spinnaker175 about 2 months ago
    Covering drug costs for people who can afford it themselves without hardship is too expensive, and will result in loss of other services or higher taxes. Pharmacare coverage should be means-tested, maybe annually, to ensure that the money is spent on those who really need it.
    Hide reply (1)
    • ewb1945 about 1 month ago
      Why should they not be covered, they will be the one's who will be paying for the program via their taxes.
  • ewb1945 about 1 month ago
    Everyone who is a Canadian citizen should be covered for all drugs that are on the approved list.
  • HealthProgress about 1 month ago
    Pharmacare should cover everyone, and should not be means tested. I understand the potential need for cost recovery mechanisms (e.g. a modest fee for each prescription, that could be determined on a sliding scale based on income) but the coverage should be universal to all Canadians. When people are compliant with their medications, they remain healthier, and cost the system less money in doctors visits, hospitalization, etc. This is as true for people making $20,000 per year as it is for people making $200,000 per year.
  • Boatdood about 2 months ago
    Stay out of it. I have no confidence in this government to do anything
  • Lincoln about 2 months ago
    cover the drug costs of all Canadians, regardless of their ability to pay (like Canada’s insurance coverage for doctor and hospital care)
  • Zalev1336 about 2 months ago
    No one has mentioned the Trillium program in Ontario. It really is a good model for coverage, based on income! If your self employed or don’t have access to drug coverage for whatever reason, you can apply for Trillium coverage and you pay a quarterly deductible based on your net income! Then we have The Ontario Drug Benifit Program, which definitely needs help!
  • Robadam about 2 months ago
    Please cover Diabetes drugs and test equipment. It seems odd that testing needed for diabetes when most other health testing is covered by Universal health coverage. I spend about 500.00 a month on diabetes related products such as insulin, needles, and blood sugar testing material.
    Hide reply (1)
    • Robadam about 2 months ago
      Without these diabetes products, I would die!
  • healthy about 2 months ago
    It should be universal coverage. A progressive tax system is the best way to share the cost.
  • Black Dog about 2 months ago
    We don't need more government spending. How do we pay for it? Our present government can't even balance the budget in good economic times. They want to add more expense to the government budget?
  • ?Rosco? about 2 months ago
    It should be a system where all have access to prescription drugs.
  • Chanel about 2 months ago
    This is a provincial matter under the BNA, why is the federal government getting involved here? To get more votes next year, that's why.
  • steinley69 about 2 months ago
    How does one determine the ability to pay? Whom makes that decision and what about the costs and time to make these decisions when standing inline to pick up drugs-more public servants, bigger governments is not the solution? Means tested also requires administration, reports etc to determine if the drug costs exceed % of income. Income that can change thru out the year. Pharmacare would be a costly administrative nitemare under the means test proposals above. Thus, it would have to cover all Canadians-and can this country afford that???
  • Robert in Vancouver about 2 months ago
    We can't afford a pharmacare programme. It will bankrupt Canada. Demographics are working against this idea and it will only get worse in the coming years. Everyone should look after their own drug requirements. Government could encourage insurance companies provide us with more types of drug coverage plans, but we should pick and choose what suits us the best without any government involvement.
    Hide replies (3)
    • maddog1950 about 2 months ago
      Maybe you would prefer to move to the USA and pay taxes there and get nothing in return
      • gophers about 2 months ago
        Look up Medicare Part D. That's America's national pharmacare program and it will bankrupt the country.
      • Robert in Vancouver about 2 months ago
        No I don't want to move to the USA, why would you even suggest that? I also don't want a government run drug program. Anything the government does costs way more than it should and provides much less than promised. If we had a public-private medical system like France, Germany, and Finland, maybe I would agree with a limited pharmacare for only the poorest Canadians.
  • happy_canuck about 2 months ago
    Coverage without user fee. Do as Ontario does for its drug benefit program and have the patient pay the dispensing fee which seems to range between $2.11 and $6.11. I pay $4.11 per prescription. There is a deductible fee as well (relatively small) which I would prefer not to have in this progream.
    Hide replies (2)
    • gophers about 2 months ago
      I would prefer free Ferraris, but who will pay for them?
      • maddog1950 about 2 months ago
        Ferrari's aren't life and death, health care and medication can be.
  • let's talk health about 2 months ago
    means tested and only if no current coverage
  • Jlatrace about 2 months ago
    Everyone is covered equally
  • Jarviedean about 2 months ago
    Total coverage as for medical care.
  • Supermom about 2 months ago
    I believe this should only be for people who don’t have existing coverage. I don’t want my insurance based coverage touched. I saw and see what the Provincial plan has done to my son with crohn’s and ulcerative colitis. The government plan does not cover what he needs and therefore he remains in constant pain and consistently vomiting. The insurance paid before the government interfered with their plan. It doesn’t make sense. You are allowing illegals into this country unscreened and they are getting free dental over and above Canadians and getting free housing on the backs of taxpayers, not the politicians who give it to them but don’t pay taxes, who store their money overseas. They don’t consult us about who they give our money away to, like Quebec getting huge amounts over Ontario because almost all PMs are French. The taxes are paid by the people. We don’t want government intervention in anything else. Stay away from my insured drug plan.
  • Ponderosaman about 2 months ago
    No means test. Free to one, free to all!
  • Marnie about 2 months ago
    short answer: 'means-tested'long answer: There are two (2) major things that the government should be doing to help low-income people. The first (1st) thing is actually letting people know about options such as the Alberta Adult Health Benefit (AAHB). Unfortunately, the government typically tries to keeps it programs a secret, if not directly then at least indirectly. The government certainly does not go out of its way to let people know about them! And then, if one is lucky enough to finally find out about a program such as the AAHB after needing it, the government refuses to cover anything retroactively; even though, if one had known about the program and signed up for it, items would have been covered. The second (2nd) thing that the government should be doing is not having programs that say:if your income is below x, then you will be covered one hundred percent (100%) for whatever it is that the program covers andif your income is x or above x, then you will be covered zero percent (0%) for whatever it is that the program covers. Thus, because my income is, say, one dollar ($1.00) more than someone else's, I get zero percent (0%) of whatever it is that the program covers while that someone else gets one hundred percent (100%) of whatever it is that the program covers. That is not right or fair. Government programs should use tables similar to child support tables. This would not have to cost the government (much) more money; it would simply distribute the money more fairly. For example, let's say that x is one hundred dollars ($100.00). So, if your income is below one hundred dollars ($100.00), then you will get one hundred percent (100%) of whatever it is that the program offers andif your income is one hundred dollars ($100.00) or above one hundred dollars ($100.00), then you will get zero percent (0%) of whatever it is that the program offers. Let's say that the total money to be distributed is one hundred dollars ($100.00). Let's say that this money is currently being distributed as follows:$10.00 (100%) each to ten (10) people, with the incomes of those ten (10) people being:- zero dollars ($0.00),- ten dollars ($10.00),- twenty dollars ($20.00),- thirty dollars ($30.00),- forty dollars($40.00),- fifty dollars ($50.00),- sixty dollars ($60.00),- seventy dollars ($70.00),- eighty dollars ($80.00), and- ninety dollars ($90.00). By instead using tables similar to child support tables, the distribution of the one hundred dollars ($100.00) could be something like the following:- $10.00 (100%) to the person whose income is zero dollars ($0.00);- $9.50 (95%) to the person whose income is ten dollars ($10.00);- $9.00 (90%) to the person whose income is twenty dollars ($20.00);- $8.50 (85%) to the person whose income is thirty dollars ($3.00);- $8.00 (80%) to the person whose income is forty dollars ($40.00);- $7.50 (75%) to the person whose income is fifty dollars ($50.00);- $7.00 ($70%) to the person whose income is sixty dollars ($60.00);- $6.50 (65%) to the person whose income is seventy dollars ($70.00);- $6.00 (60%) to the person whose income is eighty dollars ($80.00);- $5.50 (55%) to the person whose income is ninety dollars ($90.00);- $5.00 (50%) to the person whose income is one hundred dollars ($100.00);- $4.50 (45%) to the person whose income is one hundred ten dollars ($110.00);- $4.00 (40%) to the person whose income is one hundred twenty dollars ($120.00);- $3.50 (35%) to the person whose income is one hundred thirty dollars ($130.00);- $3.00 (30%) to the person whose income is one hundred forty dollars ($140.00);- $2.50 ($2.50) to the person whose income is one hundred fifty dollars ($150.00);- $2.00 (20%) to the person whose income is one hundred sixty dollars ($160.00);- $1.50 (15%) to the person whose income is one hundred seventy dollars ($170.00);- $1.00 (10%) to the person whose income is one hundred eighty dollars ($180.00);- $0.50 (5%) to the person whose income is one hundred ninety dollars ($190.00); and- $0.00 (0%) to those whose incomes are greater than or equal to two hundred dollars ($200.00). This example would cost the government $105.00 instead of the current $100.00. And, if you really wanted to keep it to the current $100.00,then simply make it zero percent (0%) for those whose incomes are greater than or equal to one hundred sixty dollars ($160.00)instead of greater than or equal to two hundred dollars ($200.00). Using tables similar to child support tables not only helps more people but also helps people more fairly than what the government is typically doing right now.
  • Owl about 2 months ago
    In my opinion, the only fair way to provide coverage is to provide prescribed drugs in the same manner as doctor and hospital care is provided.
  • Linus about 2 months ago
    This whole deal is suspiciously like vote stumping. Is there an election coming up that will suck people into voting Liberal like the legalization of pot in the last election? That has worked out well hasn't it.
  • Linus about 2 months ago
    1.Who is going to pay for this? The tax payer is and I can't afford to pay any more taxes. In BC we are taxed past the limit and our NDP government is squeezing more out of us.2.The government can't even run our Canadian medical system. It is in shambles. One of the costliest systems in the world and the worst serviced. Now they want to run a pharmacy drug system? Sounds more like vote stumping to me.
  • Taffy about 2 months ago
    It should cover costs of all Canadians - since taxpayers are the ones funding the program, why should certain taxpayers not be covered while others are? I don't want my tax dollars going to pay for someone's drugs if I am not covered myself. If the current government stopped giving away billions to other countries and started looking after our own country, there would be plenty of money to fund such a program without raising income taxes.
  • Think Big about 2 months ago
    The first option is definitely not a choice. We are miles over budget with deficit budgets well into the future and no sign of a balanced budget. The second option is preferable, citizens should pay for their drugs and get a tax deduction and only covered when it exceeds a high level.
  • mustanger about 2 months ago
    I have paid taxes plus CPP during my 35 years of working for Parks Canada and I totally agree with Layla that I deserve Pharmacare. I do have the Gov't plan that I kept after retirement in which you had a choice of keeping or find an insurance plan of your own but I still pay for it.
    Hide reply (1)
    • gophers about 2 months ago
      You paid taxes for other programs. No savings or accounting was done for the cost of drugs in your retirement during all of those 35 years. How do you deserve that?
  • nmctague about 2 months ago
    Drug costs should be covered for all Canadian. Everyone pays taxes
    Hide reply (1)
    • gophers about 2 months ago
      Taxes for other programs. What do you want to cut to pay for these drugs? If not you'd need to increase the already unsustainable level of taxation in this country.
  • Mia about 2 months ago
    National pharmacare could be structured to cover the drug costs of all Canadians, regardless of their ability to pay (like Canada’s insurance coverage for doctor and hospital care). This is important because their is a segment of the population that is NOT wealthy, but never receives benefits because they are not 'the poorest' among us. We are a working demographic ( and some are retired) but just have 'enough'. Costs like pharmacare can break us, or at the very least greatly reduce our available net income. ALL CANADIANS should receive this benefit. We pay A LOT of taxes. This is the least we should get in return for funding the coffers that supply arms to Saudi Arabia, and support the exhorbinent costs of supporting US warmongering around the globe, and the big bail outs and buy outs of huge, rich corporations. Health care is the right of ALL Canadians. All of us should receive this benefit regardless of income.
  • Layla2018 about 2 months ago
    I have paid high taxes as well as CPP during my 55 years working and I feel that I deserve pharmacare. I currently have to pay provincial plan and it is not cheap!
    Hide replies (2)
    • maddog1950 about 2 months ago
      You didn't pay CPP during your whole 55 years of working, CPP has only been in for 50 years
    • gophers about 2 months ago
      Yes, those taxes went to other programs. No savings or other provisions were made for this sort of expenditure in all those years.
  • leewardside about 2 months ago
    Many Canadians have healthcare plans through their employment or purchase it or are able to pay for their drugs from their income. Pharmacare should be available for the poor, the working poor, and those requiring drugs that are essential for chronic illnesses but too expensive for the average person to pay for.
  • Janbob51 2 months ago
    Universal coverage
    Hide reply (1)
    • gophers about 2 months ago
      How will you pay for it? Increasing taxes on people who work in the productive sector of the economy? This country is increasingly uncompetitive economically.
  • Eddiedog$4025 about 2 months ago
    Removed by moderator.
  • Tomato about 2 months ago
    Means tested, but the bar should be set high.Millionaires don't need handouts from the government.Families, seniors, veterans, the sick disabled, and those on very expensive drugs should be fully covered.
    Hide reply (1)
    • maddog1950 about 2 months ago
      no means test, just like our present health system, if a drug isn't covered the millionaires will go else where and pay for the drug, just like they 'q' jump and leave the country for surgery.The rich higher tax bracket should be the only means test. Nothing else and zero deductible
  • keithmnop77 3 months ago
    We should vary the deductible by income and assets rather than using a means test.National Pharmacare should definitely apply to all Canadian citizens resident in Canada and landed immigrants of Canada who live and pay income taxes here.It should also apply to people here on work permits or student visas for over 6 months, with the cost built into the permit or visa fee.It is inevitable that the courts will require that what applies to Canadians must apply to people claiming to be refugees. And so, since it would be racist to penalize foreigners coming to Canada for following our regulations those here on work permits and student visas, morally we must also cover people here on work permits and student visas.We should stop considering just income, because that gives too much of an unfair and unjust benefit to wealthy trust fund beneficiaries at the expense of those who've worked for their money.To have social justice the means-test that determines the deductible should include both income and assets. Perhaps do the calculation using 100% of taxable income plus 1% of assets.
    Hide replies (5)
    • keithmnop77 3 months ago
      Reading the other comments, I'd just like to add that the deductible should be something reasonable. So for an income of $60,000 it should be less than $600 a year total for that person and their dependents. $300 a year total would be good too.Manitoba has a good pharmacare system that applies to all ages, except that its failing is that the deductible is far too high.I definitely do NOT want a system where the deductible is simply $20 per prescription because the people who need pharmacare the most are often stuck with filling many prescriptions each month. The deductible must be capped to a reasonable level annually.
      • Dinah about 2 months ago
        No deductible at all. Not worth administrating.
      • maddog1950 about 2 months ago
        once you install a deductible you are penalizing the population that your trying to help, if they can't afford the medication they probably can't afford the deductible. If you can't afford the medication to get better then you become a burden on the health care system by constantly returning to the doctors
    • Christine0912 3 months ago
      I don't agree that student visa holders should get health coverage. I believe that should buy insurance before they come. I bought insurance for my daughter and the cost was under $200 for the year. If parents can sent their kids to another country for education they should be able to afford insurance as they never paid into our system
    • TaxpayerJoe about 2 months ago
      I worked for a small business that had a benefit plan. Everyone paid $ xx per yr and got equal benefits up to an annual maximum plus a “limited insurance” for special treatments, drugs etc. Everyone paid the same, everyone got the same coverage. To me that’s fair, A plan where everyone benefits, yet only a % pay is not fair.
  • Tikkadog 2 months ago
    Pharmacare should be universal first dollar coverage of essential medications. I think we need to have discussions about what is essential. I don’t think it should be all drugs, I think we need to start with an essential medications list, like from WHO, and work from there. I think there is still a place for private insurance, but outside of the essential list.
    Hide replies (3)
    • concernednewfoundlander 2 months ago
      While I agree essential medications are important, how do you qualify what is essential versus non-essential? My partner needs her asthma medications or else she'll face a much lower quality of life, as she cannot do anything too strenuous without an attack. I think that would qualify as essential, however, it may not be. A diabetic needs their insulin, that's not something anyone would argue. It gets tricky when we talk about things like the antacid I take for my reflux disease. Not essential to my life, I can live without it, albeit pretty uncomfortable, but if I go without it too long, I risk developing things like throat cancer or stomach ulcers. I think if a doctor prescribes it and it has a recognition from Health Canada, it should be essential
      • Wildfirev about 2 months ago
        I have a friend in the UK and as he explained the system they use there, essential is a medication that a person could die without or something that a person has to take in order to replace something. I myself would qualify for it as I had my thyroid removed due to cancer. I'm on a replacement hormone for the rest of my life. My body needs that replacement. So someone who is diabetic would also qualify, as well as anyone with epilepsy. Is it so wrong to want those people who need medications to live to not have to pay exorbitant amounts of money for something their body needs?
    • maddog1950 about 2 months ago
      your talking a 2 tier system, it has to be equal for every one. Private insurance needs to go, as they will still make the national system pick up the tab before they cover any balance. when I turned 65 and working in Alberta, my plan through the union forced the senior blue cross plan to be the first payor then they paid out what the blue cross plan didn't, I didn't see my/union premiums decrease because of this. Private insurance are blood suckers on society
  • terryc about 2 months ago
    First off, seniors should be universally covered (period) Not the case in many provinces including the great bastion of the NDP British Columbia. With some planning and forward thinking Pharmacare could be a hybrid of a straight out universal drug coverage. What that could look like would be a partnership with the private insurance companies not unlike or similar to Alberta. The private sector has been doing this for a long time and that is worth looking at (my opinion) as opposed to handing it off to government bureaucrats to build yet another government bureaucracy.
  • JANET825 about 2 months ago
    Should be available for all Canadians for their health care needs
  • TaxpayerJoe about 2 months ago
    The debate should also be around who PAYS for “universal health or pharmacare” Example: A recent study showed Aboriginal tobacco tax exemptions cost $686 million in lost revenue in 2017 alone. Assuming every Canadian citizen has access to universal health care regardless of race, also assuming the recent science proving the use of tobacco is a health risk, regardless of race, also assuming a tax is to either reduce or deter tobacco use, or help pay for the negative health issues smoking causes regardless of race. Why do we allow this? We have non smokers paying for the health care of smokers, and a % of smokers paying $0 for their self inflicted health issues because of race? Or a treaty or agreement made a hundred years before the effects of tobacco use was known? Our political system wants to promote “universal care” but then caves to special interest, racial, religious, minority or marginalized groups with payment exemptions, so they can get votes. No one wants to debate these issues for fear of being branded a racist or bigot. If we are going to implement a new plan, we have to have these uncomfortable discussions.
  • Wildfirev about 2 months ago
    Let's focus on the main point here. This is about health. Health of the entire Nation not just those with the means to access what they need. Put yourself in a scenario where where you need a prescription to handle, say anxiety, and you suddenly loose your job. You're unable to pay for your medication, but to get a new job, that medication would be key as it would help control your anxiety. You're caught in a loop of not being able to afford that medication and needing a new job to get that medication which would worsen your condition. With universal coverage this would be less of a worry for you as you would still have access to the medication and you would be able to find a new job without making the anxiety worse.
  • deadeye about 2 months ago
    Of course this will be "free" and will be paid for with magic funds that will come out of nowhere. Of course this sounds like a great idea coming from a government that is still running big deficits with no plan to get back to balance.I'd be on board if they could find the fund from the massively excessive spending and waste in our Federal government.
  • jentatrans about 2 months ago
    I don't want a pharmacare system
  • Shirlkolo about 2 months ago
    Means-tested. At this time I feel that thousands of people are given free drugs leading to over-dozing. My husband is diabetic and retired, he must buy his medication, yet drug addicts receive free medication.
  • TaxpayerJoe about 2 months ago
    Universal coverage should have some level of universal contribution. My wife and I pay about $1000/yr. for a plan that covers specific health care items and a % of prescription drugs up to a maximum cap. Yes, the program is somewhat subsidized by all the people in the plan, but no one gets a free ride. Everyone should pay a minimum annual premium and a % (ex 20%) of their prescription drugs. Basing is solely on income is not necessarily “fair “. (A person earning $80,000/yr. in Vancouver compared Winnipeg, or a couple with 1child vs a family with 4kids) With the new child benefit plan 1child under 6 gets $6400/yr and $5400/yr. from 6-17yrs.)How much more of our paycheque does the government want to redistribute?
  • * about 2 months ago
    Means-tested. Fill in the gap for those who don’t have private insurance
  • C about 2 months ago
    I vote for the first option. Coverage should be universal, and if there is already private insurance in place, Pharmacare should kick in to cover any gaps in coverage by private or employer-sponsored insurance.
    Hide reply (1)
    • Dinah about 2 months ago
      Coverage should be universal and private plans should drop medications from their plans.
  • Dabble58 about 2 months ago
    One purpose of pharmacare is to force the drug companies to keep costs down. For this, you need the entire country to be covered. One could add a copay option/insurance coverage, etc, but then you add the costs of administration. Overall, covering medications should reduce other hospital /health care costs.
    Hide replies (4)
    • phamde about 2 months ago
      "Overall, covering medications should reduce other hospital /health care costs" may sound nice and logical, but is not necessarily supported by realty. Evidence shows that in countries like Norway, Denmark and Sweden (frequently used as references for public coverage for drugs), the total health costs (per capita) at the country level and the amount of money ("out of pocket") that a person must support are more than what the Canadian are currently paying ! Conclusion, more drug coverage (and a universal 100 % public drug program) may not result in reducing total health costs. https://data.oecd.org/healthres/health-spending.htm
      • Dinah about 2 months ago
        While reducing health costs is certainly a laudable goal, it is not the only goal of Pharmacare. Surely, the primary reason for going to Pharmacare is still to ensure coverage for every Canadian who needs it!
        • phamde about 2 months ago
          I agree, but in doing so we have to make sure that in selecting the model to provide access for those needing it, we will not scrap some private-public models which have been proven effective for more than 20 years (as with the Regime général d'assurance médicaments du Québec). We can fix a problem with a graft, not necessarily with a drastic amputation of the part that is currently working. We don't need to take the risk and put more money than required in reinventing the wheel.
          • Dinah about 2 months ago
            We have a big amalgam of plans and programs at the moment and I think bringing in one big SIMPLER plan would be worth the disruption. There may be a one time cost but it would be made up for in the first few years.
  • Pcare2018 2 months ago
    This component of the discussion is giant. We don't need to cover the drug costs for all, regardless of their ability to pay. Yes it would be easy to collect enough tax to do so, but is that really what we want. I have read the comments on "means-tested" and some condemn the idea, and a few would consider it. Don't we all have a responsibility and an accountability to some degree to participate in the cost? Some could contribute a dollar, some a thousand dollars- so everyone could benefit and we could become a healthier nation.
    Hide replies (2)
    • opiedopey 2 months ago
      Funding a pharmacare program through taxes is "means-tested" though because it uses existing tax brackets to calculate how much a household contributes to government programs. Adding an additional layer of means-testing is not only burdensome to households but adds an unnecessary level of bureaucracy and expense to administrate the program.
      • Dinah about 2 months ago
        Exactly!!
  • LoriMacDB about 2 months ago
    1. The public program should be second-payer to private insurance. Prescription drugs represent the vast majority of an employer's Extended Health plan cost. Few employers would take the significant savings they would achieve from public pharmcare and reinvest them in their own Extended Health plans. 2. Many provincial drug programs are already means tested. We would all have equal access to medication, just some of us would have higher deductibles. What isn't equally distributed across Canada is drug coverage, especially for cancer medications. Your ability to survive cancer shouldn't depend on the province in which you live.
    Hide reply (1)
    • Dinah about 2 months ago
      I appreciate that a lot of employers try to foster loyalty with their extended health plans, but imagine what would happen if the government took over most of those things. People would be free to give up full-time work and go to part-time (those that now work full-time just to get coverage, and I knew loads of these where I worked, usually because the partner was self-employed). More jobs would open up for others, people would be less stressed and have more time to develop healthy behaviours that would lessen their need for pharmaceuticals!!
  • peaceologist about 2 months ago
    CBC's Fifth Estate made a documentary on kickbacks from the pharmaceutical industry, to Costco in this case, which the consumer gets to pay for. https://www.cbc.ca/fifth/episodes/_search_results/5d8416791d58eb6e0ee22d250e0ae153/Costco, not the CEO, was fined a few thousand dollars by pharma overseer and is still in business, while the whistleblower is still unemployed. The gov't, which enjoys a hand-off position, has done nothing.
  • canadianbug23 3 months ago
    I actually don't agree with either one of those approaches. Currently, there is a large portion of the population that has private coverage. National Pharmacare should address the unmet need -- that is Canadians that do not have any form of coverage.
    Hide reply (1)
    • phamde about 2 months ago
      👍
  • peaceologist 3 months ago
    I have no problem with providing universal care to those who need it and private care for those who can afford it. I do have a problem with those who abuse our universal care, regardless.
    Hide reply (1)
    • phamde about 2 months ago
      👍
  • brindle about 2 months ago
    It should be means tested. Exceptions for catastrophic illness and orphan drugs.
  • bneilbel about 2 months ago
    Coverage for all
  • Babs about 2 months ago
    Means tested but lower percentage of income!
  • VeggieBibliophile about 2 months ago
    Pharmacare should in principle be a universal program but, if a sliding-scale makes it more likely to be implemented, I would be agreeable to that.
  • makhsudulalam about 2 months ago
    Should cover the drug cost regardless of their ability to pay.
  • kelowna about 2 months ago
    everyone should have coverage and equal access. those with higher incomes are already paying more provincial and federal tax to cover everyone else's costs already
  • msstew1 about 2 months ago
    All should be covered.
  • stoongal about 2 months ago
    All should be covered. Period
  • fieryfee about 2 months ago
    NOT means tested! All I have experienced with anything means tested is that it drags down the quality of life for anyone who is marginally above that line.
  • thornburyone about 2 months ago
    I feel that treatment for a medical condition should be provided. This would include prescribed medications. If the medication is effective it could reduce the number of doctor or hospital visits. The costs should be covered from tax revenues so that all citizens are covered.
  • Anthony041 about 2 months ago
    Should cover all Canadians. The devil is in the details, but I'd recommend some type of co-pay - and that could be means-tested.
  • mjsingh about 2 months ago
    Universal coverage, regardless of ability to pay-same as for doctor and hospital care.
  • Bestmedicine 2 months ago
    A limited formulary of essential medicine should be covered for all. I have patients who are working poor who would never agree to a means test, they don’t want ‘government money’
  • leftfielder718 2 months ago
    National pharmacare should cover all Canadians regardless of ability to pay, exactly like our national medicare programs covering the costs of doctor and hospital care
  • Dovid 2 months ago
    universality is my preference. All should be covered.
  • LankyPaul 2 months ago
    I believe that a drug plan should be the same as our health care plan which covers everyone without the need of tons of paper work to keep track of exceptions and requirements that in turn increase the costs of the plan.
  • victoriapharmacist 2 months ago
    Issues that we are currently seeing in BC with that model is that people who are unable to adequately file their taxes due to mental insufficiency, disability, immobility, etc etc are being cut off of benefits. It's a negative reaction to a negative action and ends up affecting these individuals the most because they lose access to their prescriptions while their already compromised.The requirement of a "special authority" is quite problematic as well. Physicians need to complete lengthy paperwork which they are not paid for. Once submitted, if correct the process can take weeks. This can lead to a decrease in patient care and prolonged wait times for vital medications. Pharmacists are usually coordinating communication between the physician and the patient which is also problematic and a process they are not paid for either. I wouldn't recommend a process where there are special authorities. Universal coverage may be the best. It would benefit employers and employees as the private benefit plans wouldn't have to pay for exorbitant priced medications when the group of people is small and could adversely effect their premiums. Also, there is very little transparency in pharmacy pricing and if there was universal coverage patients wouldn't have to worry about price shopping pharmacies.
  • BugDoctor 2 months ago
    Balancing population health needs with economics is a challenge. Costs can rapidly escalate and certain drugs have limited benefit to the individual or society. Some examples may include costly chemotherapeutic agents that extend life by a few months. Other drugs are costly but potential for benefit is great (sofosbutivir for Hepatitis C might be one such example). Others have high impact for low cost but remain out of reach for the vulnerable (antibiotics, antihypertensives, hypoglycemics). I believe the optimal use of public funds fore the provision of a pharmacare programme is that a comprehensive list of formulary drugs be available to all Canadians, free of charge, without a means test, just as all other healthcare is available. The formulary would be tables by experts, recognizing the cost-benefit of treatment. Drugs not covered under the Pharmacare formulary would have an appear or application process to determine if they should be covered, if the patient should cover some of the costs(e.g. a deductable). Such a deductable of coverage of non-formulary drugs could be means-based or not. This approach would offer the vast majority of Canadians' drug needs and provide all the overall cost-saving benefits of a national pharmacare programme.
  • Janbob51 2 months ago
    Removed by moderator.
  • Careforall2 2 months ago
    Prescriptions should be available for everyone without cost and without a means test. If we negotiate drug coverage nationally with the pharmaceutical companies, the cost of drugs will be less than we pay now. As an example, New Zealand, 5 million people, has universal drug coverage. In Canada, a year supply of Lipitor costs $811. In New Zealand, a year supply costs $16. We can learn from other countries that have already implemented universal pharmacare.
  • Niagra Falls Fan 2 months ago
    I do not agree with means testing. All people should have access to necessary prescription drugs, regardless of their supposed ability to pay.
  • Elfrida 2 months ago
    No means testing at all. Every permanent resident , Canadian citizens, legal immigrants and refugees should be covered. Visitors should rely on their own insurance.
  • goldenyear? 2 months ago
    I believe it should be means tested, but the testing has to take into count the age and earning power of the individuals. Many seniors worked hard to put a little money aside to live out their golden years, however, the rising cost of living in their own home or going to reasonable assisted living alternative effects seniors. These people are experiencing full inflation costs of 3 or more percent while receiving only a 1.3% pension increase. they have to keep dipping into their saving to meet expenses. They see these saving(principle) dwindling and worry they will not have enough money to last their life time and will be forced into poverty. Their earning power is minimum usually in minimum wage jobs that just help to make ends meet.
  • Suzieque 2 months ago
    Universal coverage of all Formulary Medicines (based on need not ability to pay) funded by taxation. Private and Public (non-profit) insurance for Medicines partially or not covered. Public insurance to include Health (Extended) Benefits for all essential prescribed assistive/medical devices and basic dental care and must have an income/means option. The over 3% income tax medical allowance would still be needed for any medicines not full covered under Universal or Insurance and Extended Benefits since such Benefits even with insurance can still result in out-of-pocket costs of thousands of dollars (often for seniors).
  • peaceologist 2 months ago
    I have no problem with Canadian millionaires and more --aires paying their own way but the rest-of-us grew up thinking we had complete coverage only to find, in most provinces, we didn't. That's not what the original Bill was meant to do and it was a nasty thing to suddenly pull the plug.
  • Wmstockd 2 months ago
    Pharmacare should be a universal benefit with deductables. We are fortunate to have privately funded pharmacare plans that cover our prescription drugs. Other Canadian are not as fortunate, so I support a universal plan that will offer coverage to everyone. It could be operated on a means test with benefits coordinated with plans that unionized or regular full time employees benefit programs. This would ensure that all Canadians have coverage for necessary drugs and are not left with the choice of buy food, paying rent or purchasing essential medications.
  • asdf 2 months ago
    Pharmacare, in order to be successful, must cover everyone in the country. Means-testing is a great way to make sure it fails.
  • docbell 2 months ago
    Universal coverage is the way forward. No form of ill health cares how much (or how little) you have in the bank. Taxation can take care of financial differences,
  • RTYK 2 months ago
    Universal coverage. Means-testing fails to account for individual realities and often serve as a continued barrier to access.
  • Human Rights Advocate 2 months ago
    I am personally in favour of using a progressive taxation system to fund a national pharmacare program that covers all Canadians, regardless of their ability to pay.
  • EclecticPony 2 months ago
    Universal coverage. And drugs that are a better option than current ones should be included as soon as approved for sale here. Eg. My husband's pain medication isn't covered. It is $160/month. We are on disability. It is a fairly new idea - a slow release weekly patch that allows chronic pain sufferers to have consistent pain relief without the possibility of accidentally (or purposefully) overdosing. It will get him off the liver damaging pain meds that include acetaminophen - which will ultimately save the health care system money, and make him able to at least participate in family life again. It should be covered, and we're going to appeal for it to be, but a universal coverage plan could have had it included as soon as it was approved.
  • richard.mathias 3 months ago
    Like medicare, all have coverage. The issue that must be addressed is similar to that of the pharmacare review team in BC disbanded because industry did not like their findings. Only effective drugs both pharmacologically and effectively would be funded. A committee with no industry input would need to be formed and supported against intensive lobbying
    Hide replies (3)
    • Dinah 2 months ago
      Don't forget that different medications work more or less well in different people. It is already possible in these days of personalized medicine to get genetic testing that will show how you are likely to metabolize a given drug.
    • Lainey 2 months ago
      Exactly. Get rid of the Pharmababes & Pharmabros.Either drugs work or they don't.Pharmacists shouldn't opt to use a certain drug because some pretty young thing suggested it. Pharmacists are concerned with wellness not a drug comany's profit margin!
      • Dinah 2 months ago
        Getting rid of the pharmaceutical reps visiting doctors would be a wonderful idea!
  • canadiannapoleon 2 months ago
    All Canadians should be covered for the sake of their health and personal finances.
  • will-o-the-west 2 months ago
    Canada's new pharmacare system should NOT be means-tested. The bureaucratic and administrative costs of means-testing simply couldn't be justified. Means-testing can be psychologically demeaning too. Instead, our federal government should cover Pharmacare costs by making our income tax system more progressive. Anyone with an annual income of half a million a year should be taxed at 60% -- and if they make more than $2.5 million a year their rate should be 70%.
    Hide replies (2)
    • Dinah 2 months ago
      I agree with your first half, but I don't think income tax should ever be over 50%, as that is disincentivizing. However, there are loads of other taxes that we have or could institute that would capture more money from those that have it.
    • Lainey 2 months ago
      I like how you think! Reminds me of Robin Hood. The drug companies are owned by the wicked Sheriff of Nottingham LOL.My hub pays 29%. 60% seems quite
  • MattP 2 months ago
    The difficulty with a universal program funded through taxation is that the benefits of a private system won't be available. The public system starts reimbursing drugs at least one year, and typically much, much longer, after receiving Health Canada approval, and the public system doesn't reimburse anywhere near the same range of drugs. If you want the newest drugs, you're pooched. The question that's being asked is disingenuous because the concept "universal pharmacare" hasn't been defined. The basic question regarding how many people and exactly who would benefit from a "universal" system has also not been clarified. Are we talking about all drugs? Just some? Would we be giving up the private system? How much would our taxes go up to pay for a universal system that pays for everything (which will be a much smaller variety of drugs, is more restrictive, and where access to new drugs will take much, much longer)? In Ontario, drug coverage is currently means-tested through Trillium, however this may not be the best system because some people appear to fall through the cracks, however this is not the case in most other provinces. So, to answer this very unspecific question without any contextual information, I would say that some form of means testing to clearly identify those who would benefit from a "universal" (whatever that means) program would be the best way to go. Raising taxes for all (by how much?) and transferring me over to a public system with all of its faults just to benefit a potentially small number of people (which has NOT been identified yet) seems like a very silly way to go. Asking silly questions like this one without providing contextual information seems like the Advisory Council already knows how they would like respondents to answer.
    Hide replies (2)
    • Dinah 2 months ago
      Just because the current public system doesn't cover all drugs, etc. doesn't mean that we can't design our new one to be much, much, better. The drug approval process is a separate problem, and private plans don't make a difference as not one of them will cover a drug not already approved for sale in Canada.To me, Universal Pharmacare means that every Canadian and landed immigrant is covered! Simple!
    • Lainey 2 months ago
      So many good points & questions in there!I didn't understand your comparison of The Public system & The Public system?My understanding is that this is all in the beginning stages . Everything is on the table. Everything is up for discussion. Every idea is welcome. That's why there is no contextual information provided.No question is a silly one.This is my opinion; doesn't mean I'm right."Universal Pharmacare" defined as "based on need not the ability to pay" sounds familiar.As far as I'm concerned the means test concept is flawed. My brother-in-law always made more money than my father. Regardless of that fact, my sister and brother-in-law were always strapped for cash. Whereas my parents managed the money they had very well. I think my husband is right when he says "it doesn't matter how much money you earn it matters how much money you save." My point is I'm working with children that parents are sending to school without the proper clothing or a lunch because the parents are more interested in getting high!These children need Universal Pharmacare to survive their childhood!I'm going out on a limb here & guessing that anyone who wants to sign up with a Private Provider, can? No one can force you to use Universal P.harmacare against your will.I haven't a clue about which drugs are new & which drugs are old?As an aside you come across like a politician to me, just sayin'.
  • Lainey 2 months ago
    Everybody should have access to Universal Pharmacare. What's the alternative? The American System? That's inhumane & people aren't commodities!
  • DRED 2 months ago
    I think it should be universal if implemented. In NS, we pay a monthly insurance premium for our health care coverage .. I don't believe that the rate is influenced by income.I have grave concerns about our ability to manage pharmacare nationally especially with the cost of new pharmaceuticals with limited use, so I believe there would need to be a limited list of available products. Associated with the implementation of a national pharmacare should be the implementation of a functional tracking system that blocks abuse of prescription drugs.
  • BPB 2 months ago
    I assume there will be a set of approved prescription drugs (often generic) for which the government will have negotiated prices. These should be provided to patients regardless of ability to pay. That would be the most efficient way to manage the system, thus costing less to operate. Since our taxes would pay for the cost of the drugs, our graduated income tax system insures that the wealthier pay more for the benefit. But what about patients who want a non-approved similar but more expensive drug? I think they should pay the difference as a deductable. For very expensive drugs to treat relatively rare conditions, I think the ability to pay should be considered, probably using a deductable that could be substantial for wealthy patients..
  • concernednewfoundlander 3 months ago
    Means-tested pharmacare does not take into account the level at which a person spends their income. While I may be budgeted through the means-testing to have 10% for pharmacare, I may have much less in savings available, due to a myriad of factors, including preexisting debt. This could be combatted with having special circumstances reviews that can lower the percentage of your income you have to spend to be covered, but this still creates a barrier, by requiring people who will likely have the least amount of time and education to deal with this type of bureaucracy to have to do just that to benefit. A universal system removes the barriers for those with disabilities, low incomes and low education, allowing them to take care of themselves and focus on getting the medication needed for their health, not the process of getting help itself. While cost is a major prohibitive barrier for pharmacare currently, administrative delays and "red-tape" could become just another barrier that keeps people from getting the healthcare that they need until it's too late, too far advanced, and will cost the program significantly more to treat. If a busy person has a small cough and minor irritation, they likely wouldn't go through several hours of paperwork and dealing with government services to get approved for a lower threshold, and if they are struggling financially, are less likely to spend the money on medication, even if they probably should. It won't become a priority until it's a significant issue in their life, having developed to be much worse than it originally was. At this point, the healthcare cost is higher, but likely the associated medications for this issue will also cost more. Universal, hassle-free access will result in better health outcomes for all Canadians
    Hide replies (2)
    • Dinah 2 months ago
      Look at how much you had to type there! A metaphor for how much work it would be to means test people and then make a whole bunch of allowances for those in financial difficulty for whatever reason. Cover everyone and keep it simple!
      • concernednewfoundlander 2 months ago
        Exactly! I looked at some of the other posts, so I tried to keep this one short, but just trying to cover a few scenarios where means tested would have to be adjusted makes it so complicated. And we all know that when you add so many different steps, it leaves people to fall in the cracks. Universal seals those cracks!
  • Buffy70 2 months ago
    I prefer a Pharmacare system that would cover every Canadian regardless of their ability to pay. By purchasing drugs in bulk the government should pay a lower the cost of prescription drugs.
  • Pharmacist 2 months ago
    Funding for pharmacists in primary care teams is essential to ensure medications are necessary, safe and effective. This should be publically funded so Canadians can access. A national evidence-based formulary needs to be created that has full coverage for all.
  • Iolaus 2 months ago
    Coverage for all, like health care plan now. Means tests require more administration and audit, which quickly makes it more expensive in the long run. Tax the top 1% to 5% income earners and businesses at a higher rate to pay for the additional health care costs nationally.
  • mikomoka 2 months ago
    The fundamental principle of our health system is universality and that is non-negotiable (NAFTA or not). This same principle must apply to our National Pharmacare program. No means test - health is a right that applies to all Canadians.
  • Owl 2 months ago
    There is no way to know what other demands are being placed on a person's income which could severely limit their purchase of adequate amounts of prescribed medication and thereby skew the relationship between drugs purchased and income. Universal coverage, as is done for doctor and hospital care, is the only fair system.
  • sillverwillow 2 months ago
    Pharmacare should be universal across Canada to all persons covered by their provincial health plans. There should NOT be a means test of any sort when it comes to receiving the appropriate medical care.
  • SeniorLG 3 months ago
    Pharmacare should be structured to cover drug costs regardless of ability to pay - if you are in hospital you don't pay for your drugs and nor should you have to pay when your care is provided in the community. I am thinking of cancer patients getting out-patient treatment as one example. I believe research has shown that even small deductibles or co-pays can reduce a person's compliance with taking necessary medication.
    Hide reply (1)
    • Dinah 2 months ago
      This is a very good point. I actually think that reducing their medication costs is one reason hospitals have been on this get people home as soon as possible bandwagon.
  • leslea_kate 2 months ago
    Universal pharmacare needs to be universal. Stop trying to make it about how much money people "need" for co-pay BS. If there's co-pay, even on a sliding scale, it's not really a universal pharmacare plan.If you want to figure out more money, just start making the rich & corporations pay their fair share in taxes for the first time since the 1980's. There's PLENTY of money to fund this if the feds were to cowboy up for a change.
  • HW 3 months ago
    I'm in favor of KISS - a means test would involve a costly bureaucratic overhead. People should certainly be informed of preventive actions they can take to avoid chronic conditions, and both patients and health care professionals should be made more aware of the costs and risks of taking unnecessary drugs. But everyone should be covered for medications that are effective and where there is a reasonable cost benefit. For example I don't think it reasonable to cover extremely costly medications that only extend life for a very short time, or where there can be no quality of life - of course, where to draw the line on this is challenging and all stakeholders should be involved in such decisions.
    Hide replies (5)
    • keithmnop77 3 months ago
      You make a very good point. Keep it simple.Pharmacare is going to be funded by tax revenues, preferably income tax revenues because income tax is a progressive tax.If it is funded by income tax, the "wealthy with taxable income" are going to be paying more than their share anyways. So no need for a means test.Any injustice would be people with assets and income that are not taxed, due to it being in a trust fund, or being inherited and living in one of the few developed countries with no inheritance tax. That injustice won't be fixed with a means test.So go with what HW says, no means test.--- --- ---I also agree with not funding extremely expensive medications that do not extend life that much. There are numerous academic papers on the subject of extending life, and pro-rating that extension based on the quality of that extended life.No way should we be paying for $30,000 to give a cancer patient another 30 days of panicked vomiting and agony.And no way should we be paying for experimental drugs unless we're becoming shareholders in the company that owns the drug.
      • keithmnop77 3 months ago
        Having thought about it further I'm now persuaded by HW.No means test. Pharmacare should be funded by one of the means of progressive taxation, such as income tax or inheritance tax. That way the wealthy are paying fully for their benefit and they're also funding the impoverished.It is a waste of money to filter recipients with a means test.It is a waste of money to filter recipients with large annual deductibles or per-prescription deductibles.The social justice can come in how pharmacare is funded, by funding it with progressive taxation.
      • Christine0912 3 months ago
        that 30 days may be what is needed for the person to get their life in order. Nausea and pain can be treated. a month duration of life is not considered short to one who is dying in the near future.
      • will-o-the-west 2 months ago
        Ah, but Canada's income tax system is NOT very progressive. Anyone making over $206k a year pays just 33%, and that includes a whack of eye surgeons and resource CEOs who make ten times that much. Rich investors pay no tax at all on half their capital gains. That said, it's still true that national Pharmacare should be funded by our tax system.
        • Dinah 2 months ago
          Fixing the income tax system is a whole other subject that should be discussed elsewhere. I don't care which part of government revenue funds Pharmacare. In any case, aren't all the taxes more or less put in one pool of money once received? And NO means tests--not just degrading, but cost a lot of money to carry out, and that could be spent on medications!
  • Jane Doe 2 months ago
    I believe all Canadians should have access to medications they need without having to pay a deductible, regardless of their income.
  • JJoachim74 2 months ago
    I definitely feel that Pharmacare should cover the drug costs of all my fellow Canadians, regardless of their ability to pay. We can thus maximize the scale of government purchasing power to save money, (via bulk buying). I am not supportive of a means-tested model. Coverage for Canadians only when their drug costs exceed a certain percentage of their income, may not capture those who have a higher cost of living (e.g. those who live in cities or towns, or those who may be spending money on medical equipment, etc).
  • Moparmaiden 2 months ago
    No Means Test We all pay taxes so we should all have drug coverage and I am on disability with a medical marijuana prescription and its not covered so I can barely afford it and its the most effective and least harmful drug for pain management and it is also the most affordable
  • jaguar 2 months ago
    National Pharmacare is a misnomer. Health is a provincial domain. The best we can hope for is an agreement on a cadre of covered medications. Given this fact, a combination of public/private prescription with a means test is likely to be optimal.
  • healthcare101 2 months ago
    National all the way. If you single ppl out because of income it is discrimination measures at the least, if national that is what Canada is all about, everyone regardless.
  • PET 2 months ago
    A Pharmacare system should be available to all, no matter their income. A means-tested system creates a feeling of inequality, in that some people will feel that they're not getting full value from the program. I know this because I have a sister and brother-in-law who complain about the benefits I receive from my public sector job that they don't have, but my benefits are funded by their taxes.
  • kuzniarz 3 months ago
    I think it should be universal because it would reduce costs to administer. The tax system should manage the costs.
  • freedomrider1983 3 months ago
    I think the first option is the best because the means tested option may still be too much to pay for some Canadians.
  • hutchb 3 months ago
    Cover all Canadians. Access to necessary prescription drugs without financial barriers is a right of all Canadian residents. Prescription drugs should be available to all on the same terms and conditions. We're all in this together
  • Nursegirl 3 months ago
    Universal coverage. As a middle class income family, I make a decent wage but I do not get subsidized for my son’s sports, school supplies etc or our housing. We get by but an illness would destroy us financially if I have to pay up to a deductible of thousands of dollars before being covered
    Hide reply (1)
    • Del 3 months ago
      Yes, Universal coverage. As a senior caretaker of a senior parent, savings goes to basics of life. I get by but if, something came up, ? I know young professional singles & couples, with & without children working part time, struggling to find a bank to renew a better mortgage / loan on their home, car etc. What are they going to do if an illness requires costly medication?
  • Mamarazzi 3 months ago
    People should be required to participate in reducing their health issues with exercise and diet before a government paid drug option is used. I don't want to pay for laziness or preventable issues. Reducing the incidence of many health problems can also be government supported through mandatory reductions in sodium levels in processed and restaurant foods, better labelling of food products and exercise and healthy living programs supported by the medical system.
    Hide replies (2)
    • SeniorLG 3 months ago
      Yes Mamarazzi, preventive health care should also be part of our overall health care system and I agree with the approaches you are recommending. To clarify your final statement - do you want the government to also support exercise and healthy living programs for all as a complement to a pharmacare program? What could be exciting is that, once a pharmacare program is in place, there would be incentives to replace drug use with other health care and fitness programs.
    • Christine0912 3 months ago
      I am sure that you have habits that are not healthy- as if any restaurant can adhere to mandatory reduced salt levels and survive-Sodium is NOT a major cause of illness. People can be taught to reduce the levels at home-as for unhealthy habits, being an angered judgmental human being set on controlling others carries health risks of it own.Being miserable is associated with negative health. Using your own words, I don't want to pay for preventative issues so you should alter your conduct to assure better health
  • sphoenix 3 months ago
    EVERY Canadian should be entitled to the best medical care (not in favour of means=tested).
    Hide replies (3)
    • richard.mathias 3 months ago
      Best is a value laden issue. That is what is needed, effective drugs only
      • keithmnop77 3 months ago
        When I came down with my particular disease I learned that with drugs "effective" is also a value laden issue.Consider a drug that only works on 10% of the patients with a disease, but for that 10% it extends life at a cost of $10,000 a year. The drug might be considered valueless, except that for that 10% it is life giving.
        • Christine0912 3 months ago
          I would consider that drug as having value
  • Christine0912 3 months ago
    Cover all Canadians who do not have coverage through other means except newly released medications (due to cost) unless they are found to be life saving or life changing due to less side effects, better efficacy etc -allowing one to reach a cost that is more than a specific % of income will still be a financial hardship for many and prescriptions might go unfilled which can drive up health care costs when a person gets complications associated with their condition and those complications could have been avoided had that taken medication as directed.
  • Canadian Gal 3 months ago
    Far better to just cover everyone the same. Less costly, less confusing, easier for everyone. It can be expensive and difficult for low-income people to prove that they're low-income, and it can be humiliating. Circumstances can change quickly, someone who has a good income can suddenly lose their job for health reasons - not everyone has disability insurance - and that would impact their dependants as well. Using an arbitrary percentage is unfair to disabled people - we are more likely to live in poverty, yet we tend to require more medication to manage our conditions. Every dollar counts for us, we live on such tight budgets, so even 10% of our income is a LOT to spend & would have to come out of food budget. The idea behind national pharmacare is so that seniors, disabled people & low income people won't be forced to choose between buying their medications and buying food.
  • tooth-ed 3 months ago
    Covering everyone is the better way. Even people who are well-off can be temporarily short of cash. Rules must be written around this, staff employed to enforce the rules, provision made to appeal against official findings, resulting in employment for lawyers who must be paid. With programs like pharmacare, we should expect to pay higher taxes. It's worth it.
  • DaveP 3 months ago
    Having a means test is not ideal, but can ensure that the costs are held to reasonable levels while still keeping benefits available to those that might not have access.