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Deciding Who Will Be Covered and Under What Conditions

18 days 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:


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  • Anthony041 2 days 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 2 days ago
    Universal coverage, regardless of ability to pay-same as for doctor and hospital care.
  • Bestmedicine 5 days 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 5 days 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 5 days ago
    universality is my preference. All should be covered.
  • Pcare2018 5 days 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.
    Reply Do you agree? Agree 0 Disagree 1 Alert moderator Hide reply (1)
    • opiedopey 5 days 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.
  • LankyPaul 5 days 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.
  • Jayne 17 days 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).
    Reply Do you agree? Agree 23 Disagree 3 Alert moderator Hide replies (8)
  • victoriapharmacist 5 days 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 5 days 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 5 days ago
    Removed by moderator - this was a duplicate comment. Please refer to moderation rules
  • Janbob51 5 days ago
    Universal coverage
  • Careforall2 9 days 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.
  • Imago 10 days 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.
    Reply Do you agree? Agree 4 Disagree 2 Alert moderator Hide replies (3)
    • goldenyear? 10 days 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 10 days 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!
      • Niagra Falls Fan 9 days 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.
  • Niagra Falls Fan 9 days 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 9 days 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? 10 days 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 10 days 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 10 days 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 11 days 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 11 days 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 13 days 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 14 days ago
    Universal coverage. Means-testing fails to account for individual realities and often serve as a continued barrier to access.
  • Human Rights Advocate 14 days 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 14 days 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 18 days 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
    Reply Do you agree? Agree 10 Disagree 0 Alert moderator Hide replies (3)
    • Dinah 17 days 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 15 days 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!
  • canadiannapoleon 15 days ago
    All Canadians should be covered for the sake of their health and personal finances.
  • will-o-the-west 17 days 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%.
    Reply Do you agree? Agree 3 Disagree 3 Alert moderator Hide replies (2)
    • Dinah 17 days 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 15 days 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 17 days 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.
    Reply Do you agree? Agree 1 Disagree 5 Alert moderator Hide replies (2)
    • Dinah 17 days 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 15 days 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 15 days ago
    Everybody should have access to Universal Pharmacare. What's the alternative? The American System? That's inhumane & people aren't commodities!
  • DRED 15 days 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 16 days 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..
  • Tikkadog 17 days 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.
    Reply Do you agree? Agree 3 Disagree 1 Alert moderator Hide reply (1)
    • concernednewfoundlander 16 days 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
  • concernednewfoundlander 18 days 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
    Reply Do you agree? Agree 14 Disagree 2 Alert moderator Hide replies (2)
    • Dinah 17 days 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 16 days 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 17 days 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 17 days 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 17 days 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 17 days 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 17 days 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 17 days 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 18 days 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.
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    • Dinah 17 days 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 17 days 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 18 days 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.
    Reply Do you agree? Agree 9 Disagree 2 Alert moderator Hide replies (5)
    • keithmnop77 18 days 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 18 days 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 18 days 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 17 days 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 17 days 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 17 days ago
    I believe all Canadians should have access to medications they need without having to pay a deductible, regardless of their income.
  • JJoachim74 17 days 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 17 days 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 17 days 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 17 days 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 17 days 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.
  • peaceologist 17 days 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.
  • kuzniarz 17 days ago
    I think it should be universal because it would reduce costs to administer. The tax system should manage the costs.
  • freedomrider1983 17 days 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 17 days 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
  • canadianbug23 17 days 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.
  • Nursegirl 18 days 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
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    • Del 17 days 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 18 days 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.
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    • SeniorLG 18 days 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 18 days 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
  • keithmnop77 18 days 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.
    Reply Do you agree? Agree 1 Disagree 2 Alert moderator Hide replies (2)
    • keithmnop77 18 days 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.
    • Christine0912 18 days 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
  • sphoenix 18 days ago
    EVERY Canadian should be entitled to the best medical care (not in favour of means=tested).
    Reply Do you agree? Agree 12 Disagree 0 Alert moderator Hide replies (3)
    • richard.mathias 18 days ago
      Best is a value laden issue. That is what is needed, effective drugs only
      • keithmnop77 18 days 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 18 days 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 18 days 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 18 days 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 18 days 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.